Factors determining the vulnerability of women to sexually transmitted HIV: a literature review

Abstract

Gender-related vulnerability is described as a crucial factor contributing to increased susceptibility of women to HIV, accounting for more women than men being infected. At the same time, empowerment interventions are being promoted as effective strategies for increasing the ability of women to adopt protective behaviours. The aim of the review was to identify, collate and categorise the factors determining the gender-related vulnerability of women to sexually transmitted HIV. A review of literature from theoretical and empirical studies using diverse methodologies was undertaken. Reports included those identified through electronic and manual searching. Twenty factors, forming five clusters, were identified as influencing the ability of women to adopt protective behaviours. Each factor was analysed to describe its component parts and the relationship between a factor, gender-related vulnerability, HIV risk level and empowerment status. Further analysis provided a description of markers named predictors and indicators. The literature portrays markers that can be identified and used to describe gender equality status, HIV risk level and related empowerment. This provides the potential to identify factors in gender equality status and HIV risk level to address in programmes designed to empower women in order to lower their risk to sexually transmitted HIV.
 
 <b>Opsomming</b>
 Geslagsverwante kwesbaarheid word beskryf as ‘n kritieke faktor wat tot verhoogde vatbaarheid van vroue vir MIV bydra, wat die verhoogde besmetting van vroue teenoor mans verklaar. Terselfdertyd word bemagtigings-intervensies aangemoedig as geskikte strategieë om vroue se vermoë om beskermende gedragspatrone aan te neem, te verhoog. Die doel van hierdie oorsig was om die faktore wat geslagsverwante vatbaarheid van vroue vir seksueel oordraagbare MIV bepaal, te identifiseer, vergelyk en kategoriseer. ‘n Literatuurstudie van teoretiese en empiriese studies wat ‘n verskeidenheid metodologieë gebruik het, is onderneem. Verslae bekom deur elektroniese en handsoektogte is ingesluit. Twintig faktore, wat in vyf groepe verdeel is, is geïdentifiseer as dié wat die vermoë van vroue om beskermende gedragspatrone aan te neem, beïnvloed. Elke faktor is ontleed om die samestellende dele en die verband tussen ‘n faktor, geslagsverwante kwesbaarheid, MIV-risikovlak en bemagtigingstatus te beskryf. Verdere analise het ‘n beskrywing van merkers, genoem voorspellers en aanwysers, opgelewer. Die literatuur beskryf merkers wat geïdentifiseer en gebruik kan word om geslagsgelykheidstatus, MIV-risikostatus en verwante bemagtiging te beskryf. Dit bied die moontlik- heid om faktore in geslagsgelykheidstatus en MIV-risikostatus te identifiseer wat aandag moet geniet in programme wat ontwerp is om vroue te bemagtig om hul risiko van seksueel oordraagbare MIV te verlaag

Experiences of sexual relationships of young black women in an atmosphere of coercion

“…Macleod-Downes et al (2008) add that women living in lower socio-economic conditions are afforded less authority and social status, which further increases their risk of HIV infection. Thomas (2007) concurs that the two major factors that inhibit women's ability to protect themselves in relationships are their lower status in society and their financial dependence on men.…”

“…Female risk of contracting HIV is accentuated in South Africa by harsh social inequalities that exist between men and women ( Fuller 2008 ; Varga 2001 ), while cultural norms have also been recognised as playing a central role in the spread of HIV ( Castle & Kiggundu 2007 ; Frank, Esterhuizen, Jinabhai, Sullivan & Taylor 2008 ; Naylor 2005 ; Varga 2001 ). Numerous African cultures uphold traditional and religious practices that can, in contiguity with one another, aid in the spreading of this epidemic ( Abdool Karim 2005 ; Fuller 2008 ; Macleod-Downes et al 2008 ; Strebel, Crawford, Shefer, Cloete, Henda, Kaufman, et al 2006 ; Thomas 2007 ). Patriarchal societal practices that subordinate the rights of women include cultural traditions such as lobola, polygamy and the economic dependence of women on men ( Abdool Karim 2005 ; Fuller 2008 ; Macleod-Downes et al 2008 ).…”

“…Numerous African cultures uphold traditional and religious practices that can, in contiguity with one another, aid in the spreading of this epidemic ( Abdool Karim 2005 ; Fuller 2008 ; Macleod-Downes et al 2008 ; Strebel, Crawford, Shefer, Cloete, Henda, Kaufman, et al 2006 ; Thomas 2007 ). Patriarchal societal practices that subordinate the rights of women include cultural traditions such as lobola, polygamy and the economic dependence of women on men ( Abdool Karim 2005 ; Fuller 2008 ; Macleod-Downes et al 2008 ).…”

“…Women living in poor societies are at additional risk of HIV infection owing to the immediate needs for survival being placed above sexual health concerns ( Abdool Karim 2005 ; Fuller 2008 ; Mathews 2005 ). Macleod-Downes et al (2008) add that women living in lower socio-economic conditions are afforded less authority and social status, which further increases their risk of HIV infection. Thomas (2007) concurs that the two major factors that inhibit women's ability to protect themselves in relationships are their lower status in society and their financial dependence on men.…”

“…Gender-related vulnerability has been recognised as a key aspect contributing to the increased propensity for women to contract HIV/AIDS, accounting for more women being infected than men ( Macleod-Downes, Albertyn & Mayer 2008 ). Women are also physiologically more at risk with regard to contracting HIV than men ( Harrison 2005 ).…”