SUB-SAHARAN GENDER INEQUALITY AND HIV/AIDS

I recently read an article (ONE) themed very like an essay I wrote in the second year of study. I thought I'd publish my take on my blog to share with those interested..............



In 2004, the joint United Nations programme on HIV/AIDS, (UNAIDS) declared HIV as; “the most globalized epidemic in history.” (cited online) Latest figures from UNAIDS report that although the global percentage of people living with HIV has stabilised since 2000; “Sub-Saharan Africa remains most heavily affected by HIV, accounting for 67% of all people living with HIV and for 72% of AIDS deaths in 2007.” (UNAIDS, 2008, cited online) This statistical evidence suggests that, despite the optimism inspired by news of global HIV/AIDS stabilisation since the millennium year, the obvious concentration of a high percentage of cases across Sub-Saharan Africa continues to cause serious human devastation.
The purpose of this paper is to discuss a number of issues surrounding the Sub-Saharan HIV/AIDS pandemic, particularly its effect on African women. First and foremost there is clarification of a definition of HIV/AIDS and a reflection on the noticeable variations of its global prevalence, treatment and ultimate outcomes. This is followed by an evaluation of possible impacts of the pandemic from the cultural perspective of gender inequality across Sub-Saharan Africa. Remaining within the context of gender inequality, the focus shifts towards exploring the notion of African females, by and large, living in a climate of culturally accepted social oppression, which is contributory to increasing their vulnerability to the HIV virus.

HIV/AIDS, is classified by the World Health Organisation [WHO] as “a global pandemic.” (WHO, 2008 cited online) hence it is a condition that has spread across the world. However, closer analysis of the statistical evidence demonstrates a disproportionate extent to the epidemic across Sub-Saharan Africa. Accordingly, in order to appreciate the magnitude of the consequences caused by HIV/AIDS across highly affected African nations, it is valuable at the onset to establish, what HIV/AIDS is; how it is transmitted and consider its global prevalence per se.
Statistics produced by WHO and UNAIDS estimated that globally: “33.2 million people were living with HIV at the end of 2007.” (WHO, 2008 cited online) Sub-Saharan Africa accounts for two thirds of the global numbers, consequently, this may indicate an evident linkage between HIV prevalence and the underlining social and economic problems ubiquitous across the developing world.
Furthermore, this situation is perhaps further exacerbated by the notion that the African HIV/AIDS concern varies from country to country; “The continent’s experience with the disease is diverse.” (Patterson,2006 p6) This diversity adds further dimension to the discourse as it demonstrates how individual life prospects of those affected by HIV/AIDS, will fluctuate across African nations. Therefore, chances of survival are more likely to be influenced by factors that are beyond personal control, for instance: gender inequality; poverty; access to education, availability/affordability of healthcare services and national political stability. Consequently in such a precarious climate, this perhaps clarifies possible reasons why, for many, both personal and family health remains at great risk.
Based on this evidence, it can be suggested that the continued prevalence of the pandemic and the apparent lack of success in the provision of a sustainable solution is, perhaps a consequence of the impact of these variable social factors. Moreover, this highlights the underlying fact that there exists a contrast between the medical knowledge concerning implications of how HIV/AIDS attacks the human species, [which will be similar across the globe,] with the bearing of socio-cultural diversity, in terms of varying healthcare systems, cultural norms, preventative measures and political stability, all of which will create an imbalance life chances and ultimately impact on socially vulnerable groups.
HIV, stands for Human Immunodeficiency Virus, the British National Health Service describes it as: “a sexually transmitted virus that attacks the body's immune system.” (NHS, cited online), subsequently, the NHS goes on to describe Acquired Immune Deficiency Syndrome [AIDS] “a term that is used to describe the latter stages of HIV, when the immune system has stopped working.” Hence, the susceptibility in the immune system towards the latter stages of HIV, which can take as long as eight years after becoming HIV positive to manifest itself, creates a serious vulnerability in the body too many diseases and infections.
Medical research documents that the HIV virus proliferates through the exchange of bodily fluids, for instance, blood and semen. Most commonly this occurs through sexual intercourse, this includes oral and anal sex. Additionally, other instances where the HIV virus can be transmitted include: sharing infected intravenous needles and, in pregnant women, where the virus may pass across the placenta to the unborn foetus. HIV is terminal. There is no vaccine available to prevent becoming infected, however, given access to available medication, most HIV positive people will manage to live relatively normal lives. (NHS, 2008, cited online).
It is worthwhile to consider this medical information in the context of the previously mentioned diversities of Sub-Saharan Africa. This analysis will display a paradox between HIV/AIDS prevention programmes and universally available treatments, which are known and practiced in the industrialised, western world, against a HIV/AIDS ridden Africa, where there exists a widespread inconsistency in the implementation of prevention programs and availability of treatment. Evidence suggests that these inconsistencies appear to vary depending on diverse cultural, social, political and economic barriers. Arguably, it is these ‘barriers’ that continue to hinder the control of the epidemic.
The discourse thus far suggesting that the issue of HIV/AIDS across Sub-Saharan Africa is diverse between countries, causes the theme at the heart of this paper to re-emerge, since it is the close link to HIV/AIDS and cultural issues, such as women’s status and the dominant role of African men in relationships, (Hunter, 2003) that may contribute to the continuing seriousness of the pandemic.
The notion that the effect of AIDS on the African population depends on: “who the individuals are, their place in society, and the resources that they, their households, communities and societies have available.” (Barnett & Whiteside 2002 p182) is particularly applicable for African women. Arguably, due to widespread cultural gender inequality, women in Africa are often forced to “bear the brunt of HIV/AIDS” (Patterson, 2006 p8). This burden is illustrated in the rising cases of women carrying [and dying from] the HIV/AIDS themselves and/or from being the main care givers to others who have the virus. Indeed, one might argue that, the lack of social status for women as such, is the fundamental concern in the HIV/AIDS pandemic, because, ‘equality’ is a basic human right and is the foundation underpinning all of the articles documented in the Universal Declaration of Human Rights, 1948, (cited online) so, by denying this right to women will inevitably place them in a highly vulnerable position, particularly in terms of sexual health.
Hence this examination of gender discrimination accentuates two crucial concerns: primarily, how gender inequality is an identified contributor to the issue of HIV/AIDS in Africa, (Patterson, 2006) and secondly, how dangerous this remains for both women and the effected countries in general.
Conversely, it is inappropriate to assume that it is possible to easily adjust the cultural norms within the societies that accept gender inequality as reasonable. In sociological terms, the culture of a society will be the guiding force behind how members of that society think and feel. These shared cultural guidelines shape the individual attitudes and beliefs of its people and are known as ‘cultural norms.’ (Haralambos & Holborn, 2000) Since the cultural norms equate to unwritten ‘rules,’ they are transmitted and reinforced through primary and secondary socialisation and are largely accepted across the society. Hence, this exemplifies the challenge of adjusting the cultural norm which exists across many Sub-Saharan societies, where a lower status for women is accepted, regardless of the fact this inequality significantly contributes to the HIV Aids pandemic. This challenge is discussed in a short documentary film which was produced to address the inequality of girl’s access to education in Ghana. (Integrated Social Development Centre, 2007) The narrator explores the concept of changing cultural norms and suggests that there must remain “a delicate balance of keeping cultural identity when fostering gender equality.” (ISDOEC, 2007) In other words, a society may regard gender status as a normal element of their cultural identity, which complicates any adjustment to the deep-seated norm. Furthermore, this implies even if success in changing such norms is possible, such a mass scale paradigm shift will take time and so delay any impact such changes may have on the HIV pandemic.
Across Sub-Saharan Africa, gender inequality continues to be experienced by girls and women. (UNAIDS, 2008) This inequality, as an accepted cultural norm, effectively strips females of any rights to have any say in their own destiny. From birth, girls are perceived as potential wives and mothers, a role they practice during childhood as many are comparable to domestic slaves. (Patterson, 2006) When they marry, women become the property of their husbands, which is an identified reason of the logic behind birth families being more likely to invest in a boy’s education over that of a girl’s, since the girl will be ‘given away’ to a husband, and so will not provide economically for her birth family. (ISDOEC, 2007) In terms of HIV/AIDS awareness, this can cause catastrophic consequences for girls, since education may be the only source of information on protection from the virus. (Squire, 2007) Consequently, it could be concluded that, if access to schooling is denied or intermittent so will the knowledge on HIV prevention/protection.
The discrimination for females in many HIV/AIDS affected countries is a lifelong reality. Traditionally, African women marry at an early age, and male dominance within the relationship is accepted as normal; as one African woman in “Faces of Aids” explains: [when referring to rampant promiscuity of African married men] “most women in Africa are totally dependent on their husbands.....if your husband has decided to say this or do this, you will not say anything to stop him” (Saha, 2007)
A useful example of such dependence is evident through a woman’s right to ownership of possessions within the marital home. These are always regarded as the property of the husband. (Saha, 2007) This highlights an inequitable and frightening prospect for the many women who are widowed because of HIV/AIDS, since upon the death of a husband many African cultures accept that the marital property and possessions belong to the deceased husband’s family. Consequently, it is not unusual for widows and their children to become evicted at the hand of their husband’s family. (Saha, 2007) Based on this reality, it is clear that a culture, riddled with HIV/AIDS that empowers men in such a way, creates a scenario that exposes women to serious exploitation with devastating consequences. Faced with such desperation to secure the most basic of needs, women of Africa find themselves victim to the ultimate control of male dominance. Arguably, this continuing, accepted oppression can be regarded as a form of secondary socialisation, a consequence of which continuously lowers a woman’s self esteem, reinforcing the norm that she is worthless. Therefore even if she is physically, mentally or sexually abused by her husband, it is tolerated since, as one African women straightforwardly concludes: “there is no choice..”(Saha, 2007).
Conclusion
This paper demonstrates that despite the fact that the HIV/AIDS pandemic is a global reality, statistically Sub-Saharan Africa remains the most heavily affected area in the world. Closer analysis of the social, economic and political diversity across the African continent denotes that the HIV/AIDS problem cannot be either viewed or treated universally. In particular, discourse concerning cultural norms identified gender inequality as a major contributor in the continued prevalence of the virus, especially amongst women.
Evidence in this paper suggests that the disjointed access to regular and consistent schooling for girls may further a spiral of devastating consequences for females as they grow up in a HIV ridden environment. This is apparent not only in terms of how an imbalance of access to school between boys and girls may reinforce gender difference from an early age, but also, depravation of continued access to an educational environment may inadvertently deprive females of a vital and necessary source of knowledge surrounding protection of and prevention from HIV/AIDS. This fact further supported by recent analysis by the Global Campaign for Education, who suggest that a complete primary education for all children could greatly reduce the cases of HIV in young adults. (UNIADS/UNFPA/UNIFEM, 2008 cited online)
Furthermore, the culturally accepted oppression of African women in general, exemplifies the powerless situation endured by women. Arguably this severely affects their capacity to embrace such civil liberties as: freedom of sexual choice, personal healthcare and acquisition of protection [and knowledge] from the deadly virus.
Finally based on the information outlined in this paper, it can be concluded that the diversity of cultures which is rife across Africa, particularly the acceptance of gender inequality, significantly contributes to the issue of HIV/AIDS, making it a complex problem cannot be confined to programmes of treatment that may be effective in the industrialised world. Essentially, there needs to be realisation within African culture that the key to harnessing control over HIV/AIDS remains in the realm of an inclusive society.

BY Jeanette Snape


REFERENCES
Barnett T. & Whiteside A. (2006) AIDS in the Twenty First Century: Disease and Globalisation. New York, Palgave Macmillon
Cotton Anne (2007) An Uncommon Hero Educating Girls in Africa; video accessed online on 21st January 2009 from: http://uk.youtube.com/watch?v=_CCqI8KuZGc
Hunter S. (2003) Black Death: AIDS in Africa. New York, Palgave Macmillon
Integrated Social Development Centre (ISDOEC)(2007), Cultural Barriers to girls education part 1 & 2; video accessed online on 21st January 2009 from: http://uk.youtube.com/watch?v=Z-qHpx2qRso
National Health Service Online (2008) HIV/AIDS information, accessed online on 18th January 2009 from:
Patterson, A.S. (2006) The Politics of Aids in Africa, London, Lynne Rienner Publishers
Saha T. (2007) Faces of Aids; a Vanderbilt University Video, accessed online on 19th January 2009 from: http://uk.youtube.com/watch?v=mZaOpEztJzE
UNAIDS (2004) Report on the Global AIDS epidemic accessed online on 19th January 2009 from: http://www.unaids.org/bangkok2004/gar2004_html/GAR2004_07_en.htm
UNAIDS (2008) Report on the Global Aids epidemic accessed online in 19th January 2009 from:http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/2008_Global_report.asp
UNFPA (2008) Women and HIV/AIDS: confronting the crisis. Accessed online on 28th December 2008 from: http://www.unfpa.org/hiv/women/report/html
World Bank (2009) Country Information: Africa accessed online on 20th January 2009 from: http://web.worldbank.org/WBSITE/EXTERNAL/COUNTRIES/AFRICA.html
World Health Organisation (2008) Towards Universal Access Report, accessed online in 15th January 2009 from: http://www.who.int/hiv/pub/towards_universal_access_report_2008.pdf

BIBLIOGRAPHY
Barnett T. & Whiteside A. ( 2006) AIDS in the Twenty First Century: Disease and Globalisation. New York, Palgave Macmillon
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Hunter S. (2003) Black Death: AIDS in Africa. New York, Palgave Macmillon
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