Social and Cultural Vulnerability

Growing aspirations in societies where the gap between rich and poor is widening and women perceive few options for obtaining financial independence, coupled with cultural allowances for age-disparate relationships and exchange expectations in sex, make young women of southern Africa exceptionally vulnerable to HIV infection.

Suzanne Leclerc-Madlala, 2008

A critical factor aggravating the problem that AIDS poses for African women is the definition of the place of women in very many African societies. Of particular significance in terms of why sub-Saharan Africa has been hardest hit by HIV and AIDS is the subordinate social status of women and the many negative cultural practices and traditions that sustain that subordination. The majority of the vulnerabilities women face are not only maintained but are reinforced by cultural practices such as those at initiation (where women often are required to publicly display subordination), those relating to women’s health (traditional ‘infertility treatments’), those during sexual intercourse (e.g. ‘dry sex’ which increases women’s vulnerability to infection during such sex) and the generally accepted practice of men having multiple concurrent sexual partners. Currently the social group with the highest risk of HIV infection are married women where infection routinely occurs through external affairs by husbands and partners. Women do not have sufficient power to negotiate condom use within a relationship. Furthermore, women have insufficient power outside of a relationship to leave it if they are at risk of infection.

Other cultural practices and traditions contribute such as polygamy, levirate (marriage by a man’s brother to his widow) or sororate (concurrent marriage with a wife’s sister) and sexual cleansing. The gender role prescribed for women and ‘femininity’, demands a submissive role, passivity in sexual relations, while the role prescribed for men requires them to be more dominating, knowledgeable and experienced about sex. This also puts many young men at risk as such perceptions prevent them from seeking information and also promotes promiscuity.

Poor educational attainment generally entrenches gender inequalities leaving many women uneducated or ill-informed as regards issues such as the transmission of HIV and protection. Violence towards women compounds the link between gender inequalities and vulnerabilities where some women are continually subjected to abuse and rape. This is particularly of concern in countries with high prevalence rates (such as Zambia) as there is a high possibility of HIV transmission if a woman is raped.

Many cultures and religions give more freedom to men than to women. For example, in many cultures it is considered normal -- and sometimes encouraged -- for young men to experiment sexually before marriage. Also, in many cultures, it is considered acceptable for men -- even married men -- to have sex with sex workers. These cultural attitudes towards sex are leading to HIV infections in both men and women -- often the men’s wives.

UNAIDS, 2001