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This paper examines research on gender as it relates to women’s and men’s different vulnerabilities to HIV infection, and their different abilities to access resources for care and support in order to cope with the impact of the epidemic.

In most societies gender influences individual and societal risk of HIV/AIDS. Gender determines how and what men and women are expected to know about sexual matters and sexual behaviour. As a result, girls and women are often poorly informed about reproduction and sex, while men are often expected to know much more. The following is known about the relationship between gender and individual risk of HIV/AIDS:

• gender attitudes and behaviours can increase individual risk. For example, women may be socialized to please men and defer to male authority
• most efforts to understand individual risk of HIV from a gender perspective have focused on women. Fewer data are available on how gender roles and societal pressure put men at risk. For example, men generally have higher reported rates of partner change than women do, and the condoning of this often begins during adolescence

Social and economic factors also foster conditions for risky behaviour. These include:

• the migration of men to find employment which may disrupt marital and family ties and lead to risky sexual behaviour
• the increase in women entering manufacturing sectors of the economy without the protective features of their families and home communities. Young women are therefore often becoming sexually active at an earlier age and are often unaware of the risk of HIV and sexually transmitted diseases
• economic necessity is often linked to migration for the sex trade in south-east Asia
• due to a lack of economic equality, many women choose to stay in a high-risk relationship rather than face the greater economic risk of leaving the partner upon whom they are dependent
• women are likely to be disproportionately affected by HIV/AIDS when a male head of household falls ill. The burden of caring for children orphaned as a result of the pandemic is borne chiefly by women. Loss of income from a male income-earner may compel women and children to seek other sources of income, putting them at risk of sexual exploitation
• gender-related discrimination is often supported by laws and policies that prevent women from owning land, property and other productive resources. This promotes women’s economic vulnerability to HIV infection, limiting their ability to seek and receive care and support

Programmatic responses must take into account the following:

• access to information, education and skills regarding HIV/AIDS, sexuality and reproduction must be improved
• provision of appropriate services and technologies to reduce women’s individual risk and to improve women’s access to them is essential
• as small scale individual risk reducing strategies are expanded, it is essential to complement them with efforts to reduce societal vulnerability

The next generation of HIV/AIDS researchers and programmers face a number of challenges. One such challenge is to improve our understanding of how gender influences men’s knowledge, attitudes and sexual behaviour. Another challenge is to advocate for and provide more resources for gender-sensitive care and support. A third challenge is to develop indicators that will enable interventions to measure reduction in gender inequalities relating to vulnerability to HIV/AIDS.

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