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What’s so different for women?

Stigma and discrimination are challenges for everyone with HIV, but women in particular can also face these issues:

  • Women are more vulnerable to infection during unprotected heterosexual sex
  • Women with HIV remain largely invisible
  • Women face sexual stigma
  • Power imbalances in relationships that usually favour men
  • Medical care doesn’t acknowledge women’s risk for HIV
  • Women are often caregivers with little resources for themselves
  • Disclosure can be dangerous

Biological vulnerability to infection

Women are far more likely to be infected with HIV by a man during unprotected intercourse than to infect a man themselves. During unprotected vaginal or anal sex, semen stays in contact with women’s tissues longer than a man is exposed to her secretions, and even microscopic tears in tissue can lead to HIV transmission. Young women and post menopausal women, who have less resilient vaginal tissues, are particularly vulnerable. Undiagnosed and untreated sexually transmitted infections can also increase the risk.

Invisibility of women with HIV

To the general public, women with HIV are still pretty invisible- it’s still largely seen as a disease of gay men or drug users. Women living with HIV are rarely mentioned, and if they are, it is usually women who live outside North America. As a result, women may not even know the facts about HIV transmission, safer sex, or where to turn if they do test positive.

Sexual stigma

Lots of sexual health information doesn’t reflect the variety of possibilities and potential risks for HIV transmission. When women talk frankly about their sex lives, they can be stigmatized as immoral or “deserving” of HIV. We’ve got to change this. Information needs to acknowledge that healthy sex lives can include a number of (male or female) partners in a lifetime and a wide variety of sexual acts. It also needs to acknowledge that women can’t always insist on safer sex and it’s not their fault if this is the case, because power imbalances exist (see below).

Power imbalances in relationships

Relationships are complex, and women don’t always have the say they would like. Maybe the partner limits access to friends, or withholds money as ‘a joke.’ It could be more extreme, like regular rounds of humiliation; telling her she’s useless and lucky to have her partner. If she’s positive, forbidding disclosure of HIV status is not unusual. If a woman is in a relationship with a controlling partner, she may not have access to essential medicines, support or information to help her stay healthy. This can also mean she’s not in a position to negotiate safer sex.

Medical care that doesn’t acknowledge women’s risk for HIV

It can be difficult for women to find the information they need if they do not have support from doctors. One member of PWN said she had to convince a doctor to test her, because she didn’t seem “the type.” Media stereotypes of women who ‘deserve’ HIV don’t reflect the reality that anyone having unprotected sex could get a sexually transmitted infection, including HIV.

Women of colour, immigrant women, aboriginal women and lesbians may face added discrimination via language barriers, racism, colonialism, and homophobia. This can lead to a misdiagnosis of the illness, and makes it difficult for women to make informed health care decisions.

Women acting as caregivers, with little time for themselves

Many women are caregivers to partners, children, and parents. Taking care of others means women have little time for their own health care. This makes it tough for women with HIV to access medical appointments, support groups, nutritional supplements, and other tools necessary to manage their HIV.

Dangers of disclosure

For many women living with HIV/AIDS, disclosing their status causes reactions of anger, judgment and hostility. Women fear the loss of their children, jobs and community. Others worry about physical violence from partners. These fears leave women feeling very isolated and alone. Fear can also prevent women from accessing the support and information they may require in order to live with HIV.

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