|Author(s):||B. Joshi*1, B. Shahi1|
|Affiliation(s):||1Sociology and Rural Development, Tribhuwan University, Nepal, 2Community Health, All India Institute of Medical Sciences, New Delhi, India|
|Keywords:||Gender, HIV/AIDS, women, vulnerability, rights|
Current statistics indicate that 6.1 million people in South Asia are infected with Human Immunodeficiency Virus (HIV). HIV is an extraordinary kind of crisis. It requires an exceptional response that remains flexible, creative and vigilant on the one hand and on the other hand those who are affected need a multi-dimensional approach to their lives. Now HIV infection in Nepal has a female face because of it growing fastest in this subpopulation. How do gender and HIV/AIDS make women jeopardized? Gender is a crucial element in health inequalities in developing countries. Gender can be conceptualized as a powerful social determinant of health, which interacts, with other determinants such as age, family structure, income, education and social support and a variety of behavioural determinants. In a patriarchal system, men dominate women and exercise control over their lives including their sexuality and reproductive choices. Nepalese women’s vulnerability for HIV is further fragmented by a combination of factors such as biological, social- class, caste, urban/rural location, sexual orientation, culture, economic and legal factors, etc. These factors have an impact on women’s access to services, resources and information.
A study was conducted with PLWHA women during 2005-2007. To examine the complexity of HIV/AIDS and to learn more about the specific problems faced by women living with HIV - how the concept of gender & HIV/AIDS make their life vulnerable. Case studies and Informal Interviews with HIV infected women. Data was analysed with EPI info programme.
Case studies and interviews with women from the study illustrate that low status in family, sexual violence, economic and social problems such as poverty, lack of education are some of the primary reasons to get infection. Cultural orientation inhibits them to talk about sex to their partners, which results in infectious status. In the middle-aged women, after sterilization they do not practice regular use of condoms, because they think it is primarily for family planning. Among the newly-married women they know their status only at time of pregnancy, which results in psychological trauma and other related aspects. Most of them are widows and they know their sero status at a later stage of their partner’s HIV infected life. After the death of their partner, some of them are being expelled from their home and undergo various violations of human rights.
This study revealed the need to develop appropriate programme would be emphasizing the target communities. Due to illiteracy, poverty, gender inequality women and girls are facing with spousal battering, sexual abuse of female children, dowry related violence, rape including marital rape, traditional practices harmful to female, no spousal violence, sexual harassment and intimidation at work and in school, trafficking of women, forced prostitution, rape in war, female infanticide, constant belittling includes controlling behaviours such as isolation from family & friends, monitoring her movements, restrict her access to resources. Social workers can minimize these issues by giving empathy and psychosocial support, change behaviours and attitude providing medical treatment, offer counselling ,documents injuries and refer their clients to legal assistance and support services, family planning and other mental and reproductive healthcare. Peer-educators (healthcare workers and medical students) approaches for prevention of violence are cost effective, sustainable, easy access to-hard-to reach groups. Governments, NGOs, INGOs also have crucial role to work hand in hand on these issues by empowering women, law and policy, equal education and equal economic opportunities.