HIV/AIDS is a global epidemic. As of December 2002, over 42 million people were living with HIV/AIDS, with 70% of those cases occurring in Sub-Saharan Africa (UNAIDS 2002). Women are fast becoming the predominant group infected and affected by HIV/AIDS; in Sub-Saharan Africa, women have a higher number of new HIV/AIDS cases than do men. Because HIV/AIDS is growing among women, gendered perspectives and research are needed to understand contexts of infection and its effects on agriculture and other aspects of the economy and society. The Gender and HIV/AIDS bibliography is divided into two major sections. The first, “Gender and Development,” gives an overview of literature concerning how HIV/AIDS has affected land and water rights, agrarian livelihoods, and food and nutrition, as well as how those issues may affect the course of the disease. The second section, “Empowerment, Vulnerability, Rights, and Sexuality,” focuses on constructions of gendered power and risk as well as human rights and social justice. The bibliography includes citations from many countries but the major focus is Sub-Saharan Africa, the current epicenter.
I. Gender and Development
HIV/AIDS is not solely a health crisis; it is a development one as well. Ninety-five
percent of HIV/AIDS cases are from developing countries. As women often bear
the double burden of being both sick and a caregiver to the sick, the context
of gendered development is critical to understanding the epidemic.
Akeroyd, Anne
1996. Some Gendered and Occupational Aspects of HIV and AIDS in Eastern
and Southern Africa: Changes, Continuities and Issues for Further Consideration
at the End of the First Decade. Occasional Paper #60. Centre for African
Studies: Edinburgh University.
Understanding and evaluating the broader and long-term consequences of the
AIDS pandemic in developing countries require the analysis of national and
international political and economic systems, of social institutions and organizations,
and the cultural contexts of behaviors and beliefs, as well as of individual
responses and motivations. This paper addresses some of these sociocultural
factors with a particular emphasis on the gendered and occupational aspects
that impact the spread of AIDS in Eastern and Southern Africa, using evidence
and inference and noting the silences.
Barnett, Tony and Alan Whiteside
2002. AIDS in the Twenty-First Century: Disease and Globalization.
New York: Palgrave Macmillan.
Barnett and Whiteside examine HIV/AIDS at the intersection of poverty and
inequality. The book is divided into three main sections. The first details
the global epidemic with statistics and outlines the epidemiology of HIV/AIDS.
The following section reviews the socioeconomic factors of the pandemic and
gives national case studies. The last part concentrates chapters on the impact
of HIV/AIDS on development, marginalized populations, agrarian livelihoods,
land tenure, governance, and globalization. Barnett and Whiteside work to
contextualize HIV/AIDS and development not only in specific places, but to
place the epidemic in a global viewpoint.
Benell, Paul, Karin Hyde, and Nicola Swainson
2002. The Impact of the HIV/AIDS Epidemic on the Education Sector in Sub-Saharan
Africa: A Synthesis of the Finding and Recommendations of Three Country Studies.
Centre for International Education. University of Sussex, Institute of Education.
Dryer, Abigail, Julia Kim, and Nikki Schaay
2002. Violence Against Women: What Do We Want to Teach Our Teachers? http://www.id21.org/zinter/id21zinter.exe?a=5&i=EgveDreyer&u=3f579ed8.
South Africa has a history of very high levels of violence which dates back
to the apartheid era, if not further. A women is raped every 35 seconds, estimates
the South African Police Service. Gender-based violence (GBV), and its link
to HIV infection, is very gradually being discussed in the public domain,
but educators have no choice but to provide learners with the basic skills
to cope with the dual threat of gender violence and HIV/AIDS now. But how,
and when, can this be done within an education system?
Eldis
http://www.eldis.org/hivaids.
This website contains a resource guide, complete with full-text articles,
to the impact of HIV/AIDS on issues regarding human rights, agrarian livelihoods,
gender, and more.
Epstein, H.
2002. The Hidden Cause of AIDS. The New York Review of Books 49(8).
This article links HIV/AIDS in rural Mozambican areas with poverty, unemployment,
and the mining industry in South Africa.
Ferguson, Anne
2003. Water Reform, Gender, and HIV/AIDS: Perspectives from Malawi.
Paper delivered at the Society for Applied Anthropology Meetings, Portland,
OR, March.
In Southern Africa, where the rates of HIV/AIDS infection are the highest
in the world, the disease is increasingly recognized as both a health and
a development crisis. New policies and laws on water, land, poverty alleviation,
and natural resource management recently enacted in the region have largely
overlooked the implications of HIV/AIDS. This article considers the gender
and health implications of the neoliberal inspired water reform being implemented
in Malawi, one of the poorest countries in Southern Africa. While privatization
of municipal water supplies has captured much international notice - and criticism
- little attention has been given to the effects of "community based"
policies for rural water supply in the context of the HIV/AIDS epidemic. Here
too enclosure is underway. Research findings from Southern Malawi suggest
that the new water reform policy may increase social and gender differentiation,
inequality, and ill-health.
Fleishman, Janet
2003. Fatal Vulnerabilities: Reducing the Acute Risk of HIV/AIDS Among
Women and Girls. Washington: CSIS. http://www.csis.org/africa/0302_fatalvulnerabilities.pdf.
The HIV/AIDS crisis makes lethal the subordinate status of women and girls.
In some of the worst-affected countries in Southern Africa, HIV prevalence
among girls aged 15 to 19 is four to seven times higher than among boys their
age, a disparity linked to widespread sexual abuse, coercion, discrimination,
and impoverishment. In Sub-Saharan Africa, the epicenter of the epidemic,
women and girls account for more than half - 58 percent - of those living
with HIV/AIDS, and infection rates are rising rapidly among young women in
many parts of the world.
Gupta, Geeta Rao
2001. Gender, Sexuality, and HIV/AIDS: The What, the Why, and the How.
In Global Perspectives on Gender, Sexual Health, and HIV/AIDS, SIECUS Report
29(5).
Halperin, Daniel
2001. Is Poverty the Root Cause of (Southern) African AIDS? AIDS Bulletin
10(2):12-14.
This article considers whether we should also be looking at some of the more
neglected factors behind the pandemic.
Kempe, Ronald Hope Sr.
1999. AIDS and Development in Africa: A Social Science Perspective.
New York: The Haworth Press.
This book demonstrates the human consequences of AIDS and the efforts being
made by governments, individuals, families, villages, communities, and non-governmental
organizations to respond to the pandemic. The reader will go beyond the usual
analysis of demographics and receive much more substantial assessments and
analyses of the burden on the people, economics, and healthcare systems of
the African countries. Specifically this book focuses on: socioeconomic context
of AIDS; social scientific explanations of the AIDS pandemic in Africa; HIV/AIDS
and the status of women in Botswana and Swaziland; sexual abuse and HIV/AIDS;
law and HIV/AIDS; orphans of the AIDS pandemic; media and the African context
of social construction; human resource development and training in relation
to HIV/AIDS in Zambia.
Manuh, Takyiwaa
1998. Women in Africa's Development: Overcoming Obstacles, Pushing for
Progress. http://www.un.org/ecosocdev/geninfo/afrec/bpaper/maineng.htm.
Using data collected from numerous sources, Manuh seeks to present an overview
of women and development in Africa. While realizing women's power, she recognizes
women have mutual aid organizations and spheres of influence. Yet women lack
control over many aspects of their lives. Manuh attributes the lack of power
to three factors. First, structural adjustment programs have increased women's
responsibilities in the household. Second, civil strife and violence have
also eroded women's empowerment. Finally, more women than men have been infected
by HIV/AIDS. Manuh explores these factors in relation to economics, education,
health, law, and politics. While these issues affect women's lives, women
are still responsible for over half of household food production and often
work 12 to 13 more hours a week than men. Manuh closes by exploring routes
of empowerment by detailing women's organizations in Africa.
Page, Sam
2001. Promoting the Survival of Rural Mothers with HIV/AIDS: A Development
Strategy for Southern Africa. Development 44(4):40-46.
African women are often responsible for care of children, care of the sick,
and ensuring food for the household. Many women are infected with HIV/AIDS;
the suppression of their immune systems speeds the progression of the disease
and their deaths. Page looks at factors that increase immune suppression.
First, a poor diet affects health - many farmers turn to low-impact crops
like cassava and taro when they are sick, even though those foods have few
nutrients. Contact with organophosphate and carbonate pesticides, without
proper protection, suppresses the immune system. Exposure to other infections
and reinfections of STDs also wears on one's immune system. Successive pregnancies
also repress the immune system. Finally, fatigue due to labor, as well as
anxiety over disease and poverty, negatively affects one's health. After reviewing
the factors that inhibit the immune system, Page puts forth recommendations
for development strategists that address each issue.
Siyanda
http://www.bridge.ids.ac.uk/.
Siyanda is a site dedicated to gender equality and development. Its database
contains full text articles on gender, development, and HIV/AIDS.
Tallis, V.
2002. Gender and HIV/AIDS: Overview Report. Institute of Development
Studies, UK.
Topouzis, D.
1998. The Implications of HIV/AIDS for Rural Development Policy and Programming:
Focus on Sub-Saharan Africa. UNDP, Geneva.
This paper examines the implications of the HIV epidemic for rural development
policies and programs in Sub-Saharan Africa and, in particular, the interrelationships
between rural development and HIV/AIDS; and broad policy and programming challenges
that the epidemic poses for rural institutions. The proposed conceptual framework
for the identification of key policy and programming issues for rural development
raised by HIV is intended to provide guidance for the design and conduct of
a set of four case studies to be carried out in Southern and Eastern Africa.
United Nations Development Fund for Women (UNIFEM)
2001. Turning the Tide: CEDAW and the Gender Dimensions of the HIV/AIDS
Pandemic . UNIFEM, New York.
This booklet is a guide to assist governments and NGOs in understanding and
incorporating a gendered human rights perspective in their responses to HIV/AIDS.
UNIFEM
http://www.genderandaids.org.
The United Nations Development Fund for Women produced this web portal that
has news, full-text articles, and links to other websites concerning gender
and HIV/AIDS.
United Nations Programme on HIV/AIDS (UNAIDS)
2002. Report on the Global HIV/AIDS Epidemic. UNAIDS, Geneva.
This report presents the considered views on the state of the HIV/AIDS epidemic
of the joint United Nations Programme on HIV/AIDS (UNAIDS), which is comprised
of eight United Nations system agencies. It also presents evidence of the
responses to the epidemic mounted by many partners, including governments,
the business sector, and civil society. The report provides positive proof
that HIV, if left to run its natural course, will cause devastation on an
unprecedented scale.
UNAIDS
http://www.unaids.org.
This is the United Nations website dedicated to HIV/AIDS. It includes links
to HIV/AIDS and gender, human rights, and more. It also has updated news,
links, and full text articles.
Wellesley Center for Research on Women
2003. Unsafe Schools: Gender-Based Violence and Its Impact on Girls' Education
and Health: A Literature Review and Analysis. (USAID Draft only.)
Explores the impact of an unsafe, hostile school environment on girls' education
and health. Reviews literature in the areas of 1) violence against girls and
young women and 2) HIV/AIDS and youth. Also engages in a systematic exploration
of literature in the area of harassment and violence again female students,
HIV risk in schools, and programmatic interventions that attempt to address
these issues. Concludes with a series of recommendations for further research
and interventions derived from the literature reviewed.
Whelan, Daniel
1999. Gender and HIV/AIDS: Taking Stock of Research and Programmes.
International Centre for Research on Women. United Nations, http://www.unaids.org.
Gender norms significantly affect an individual's risk and societal vulnerability
to HIV/AIDS because they ascribe distinct productive and reproductive roles
to women and men, and because they differently influence women and men's access
to key resources such as information, education, employment, income, land,
property, and credit. Insofar as gender permeates all aspects of society and
social relations, any accurate analysis of personal and societal vulnerability
to HIV/AIDS must examine these factors from a gender perspective. This article
has two sections. The first describes public health and social science research
on personal and societal vulnerability of HIV/AIDS in terms of prevention,
care, and support as they relate to gender. The second reviews programme efforts
within public health and development initiatives to address gender issues
and concerns as a key component of reducing personal and societal vulnerability
to HIV/AIDS and its impact.
I. a. Water and Land Rights
Drimie, Scott
2002. The Impact of HIV/AIDS on Land: Case Studies from Kenya, Lesotho,
and South Africa. Southern African Regional Office of the Food and Agricultural
Organization of the United Nations. http://www.sarpn.org.za/documents/d0000147/P143_Impact_of_HIVAIDS.pdf.
Using research collected from three African nations, Drimie examined the effect
of HIV/AIDS on land use, rights, and land tenure administrations. Paying close
attention to women and children, he investigated tenure policies, survival
strategies, security of rights, food security, and the training of new administrators.
Overall, Drimie saw that HIV/AIDS caused more land to remain fallow, a switch
to less labor-intensive crops, a preference for home gardens, and an increase
in the selling of livestock. He closes by putting forth recommendations to
diversify income bases, increase access to water, overcome stigma, and develop
community-based strategies and homecare projects. Drimie also argues for more
formalized, enforceable land tenure policies in order to protect women and
children's land rights.
Mphale, Matšeliso M. and Emmanuel G. Rwambali
2003. Feedback Report on Communities Reactions to the Findings on the Study
of HIV/AIDS and Its Impacts on Land Tenure and Livelihoods in Lethoso.
Southern African Regional Poverty Network. http://www.sarpn.org.za/documents/d0000258/P249_Lesotho_Report.pdf.
Supported by the Southern African Regional Poverty Network and by the Food
and Agricultural Organization, Mphale and Rwambali gathered data on the national,
local, and community levels regarding results from a study on HIV/AIDS. Arguing
that research results are often confined to journals or books, the researchers
sought to share the results of a study with the people that were studied.
Also knowing mass media does not reach rural areas, the researchers organized
workshops to get feedback. The topics of the original study and of the workshops
included food insecurity, delays in farming, school fees, reduced wages, cultural
restrictions on widows, garden farming, sale of assets, and stigmatization
due to HIV/AIDS.
Mullins, Dan
2001. Land Reform, Poverty Reduction and HIV/AIDS. Paper presented
at the Southern African Regional Poverty Network Conference on Land Reform
and Poverty Alleviation in Southern Africa. http://www.cbnrm.net/pdf/mullins_001.pdf.
Mullins argues that HIV/AIDS is not only a development issue, but a long-term
one as well. Attention must be paid to the present and future impacts of HIV/AIDS
on land reform policies. As there is usually a four- to ten-year period between
HIV infection and AIDS, current statistics are reflective of circumstances
five years ago. Current circumstances must be studied in order to anticipate
future issues. In assessing impacts on human, financial, physical, social,
and natural capital, each policy must be contextualized within its own setting.
National statistics cannot be relied on for individual communities. Mullins
argues that land reform institutions must educate themselves first about the
HIV/AIDS epidemic in local settings and then create workplace policies and
vulnerability audits to mitigate future effects.
Walsh, Janet
2003. Double Standards: Women's Property Rights Violations in Kenya.
Human Rights Watch 15(5A). http://www.hrw.org/reports/2003/kenya0303.
Gathering data from interviews across ten ethnic groups, Walsh investigates
women's lack of access and ownership of land in Kenya. Women, often because
of cultural norms, cannot own land. Women are to be supported by fathers and
husbands. As HIV/AIDS claims more and more lives, greater numbers of women
are left to head households, yet many are denied land from family and from
the state. The government, according to Walsh, often states that it should
not get involved with culture, meaning it does not challenge customary, patriarchal
land tenure. Walsh's report details her interviews with women who have lost
land and women who have retained it, as well as offering insight from men
regarding changing land tenure to include women.
I. b. Agriculture, Food Security, and Nutrition
de Waal, Alex and Joseph Tumushabe
2003. HIV/AIDS and Food Security in Africa. Southern African Regional
Poverty Network. http://www.sarpn.org.za/documents/d0000235/P227_AIDS_Food_Security.pdf.
The authors focus on the effects of HIV/AIDS on agrarian livelihoods, specifically
on food insecurity in Southern Africa. de Waal and Tumushabe argue for an
alternative paradigm regarding HIV/AIDS called the "New Variant Famine,"
which recognizes the effects of the epidemic and prolific food insecurity
as intertwined. In addition, they argue that even in the absence of HIV/AIDS,
current stress coping strategies may be inefficient for meeting a household's
food needs. People, usually women, who rely on agriculture and livestock for
subsistence and survival, suffer from loss of income, productivity, land,
labor, knowledge, and experience when a household is affected by HIV/AIDS.
After reviewing the consequences of HIV/AIDS on agrarian livelihoods, de Waal
and Tumushabe give recommendations to developers that include the incorporation
of low-input, high-yielding cash crops, lighter ploughs for women and children,
animals who need less care, the forum to share agrarian knowledge, and the
opportunity for community micro-credit projects. As the epidemic grows, action,
not just awareness, will need to be taken to combat both HIV/AIDS and food
insecurity. The article includes statistical listings regarding labor losses
and cassava production for Southern and Eastern African nations.
Egal, F. and A. Vlastar
1999. HIV/AIDS and Nutrition: Helping Families and Communities to Cope.
FAO, Food, Nutrition, and Agriculture 25.
This article focuses on the detrimental impact of HIV/AIDS on nutrition and
household food security. The article focuses on the interaction between HIV/AIDS
and nutrition from the biological and socioeconomic perspectives.
Food and Agriculture Organization of the United Nations
n.d. http://www.fao.org,
search on "AIDS."
A number of articles and other resources are available on this site that focus
on a combination of the interrelationships of gender, AIDS, agriculture, poverty,
and food security.
Mtika, Mike Mathambo
2001. The AIDS Epidemic in Malawi and Its Threat to Household Food Security.
Human Organization 60(2):178-188.
With AIDS taking the lives of the most economically productive members of
a household, there is a decrease in labor and increase in medical costs, funeral
costs, and food insecurity. Mtika argues that the escalation of household
food insecurity negatively impacts social immunity, which he defines as a
collective resistance against problems. The collective he discusses is not
only extended family, but community as well. In researching food security,
Mtika breaks down labor, caregiving, and funeral attendance responsibilities
between men and women. Women were often laborers, primary caregivers, and
attended more funerals than men. Interestingly, though, Mtika concludes AIDS
is not a direct factor in food insecurity. The level of social immunity directly
impacts food security. It is AIDS that affects social immunity, making it
difficult for families and friends to have the resources or labor to support
each other during a time of epidemic.
Mutangadura, Gladys, Helen Jackson, and Duduzile Mukurazita (eds.)
1999. AIDS and African Smallholder Agriculture. Harare, Zimbabwe: Southern
Africa AIDS Information Dissemination Service.
This edited volume is the product of a conference held in Harare, Zimbabwe,
addressing AIDS and agriculture in Southern and Eastern Africa. The papers
have been divided into four main themes. The first section, "AIDS and
Rural Livelihoods," focuses on how AIDS has affected the quantity and
quality of African agriculture and livestock production. It also pays attention
to how decreased production affects both child labor and nutrition. The papers
in "Gender Dimensions of the Impact" center on women's roles as
household supporters working to acquire and maintain land as they fight AIDS.
The third section, "Technology Development for Smallholder Farmers,"
deals with AIDS as the impetus for agricultural reform by looking at the resource
bases of both affected and non-affected households. The fourth theme concentrates
on how to call attention to the effect of AIDS on agriculture, both internationally
and locally, as well as how to make farming practices possible for older and
younger farmers, who have lost the most economically productive family members
to HIV/AIDS. The book includes two appendices that summarize the other papers
presented at the conference and gives contact information on the participants.
Each paper also includes bibliographic references.
Rugalema, Gabriel
1999. HIV/AIDS and the Commercial Agricultural Sector of Kenya: Impact,
Vulnerability, Susceptibility and Coping Strategies. FAO Report, SDdimensions.
http://www.fao.org/WAICENT/FAOINFO/SUSTDEV/EXdirect/EXre0026.htm.
This article illustrates the effects of HIV/AIDS on agriculture in Kenya and
on the economy as a whole and how the epidemic severely hits the Kenyan workforce
in its prime. Many of the victims are in their 20s and 30s, their most productive
years, when they begin to develop symptoms and fall ill. These severe losses
affect an entire generation. Beyond the human tragedy, this situation results
in steadily rising costs to companies, and these companies suffer sharp profit
losses as a result of the loss of workers and decreased working hours due
to illness, death, overwork and stress, attendance at funerals, and home care
of ill dependents.
SADC FANR Vulnerability Assessment Committee
2003. Towards Identifying Impacts of HIV/AIDS on Food Insecurity in Southern
Africa and Implications for Response: Findings from Malawi, Zambia, and Zimbabwe.
http://www.sarpn.org.za/documents/d0000321/P315_SADC_FANR_Report.pdf.
The article focuses on the link between HIV/AIDS and food insecurity. SADC
found that food security relied on three factors: adult morbidity, adult mortality,
and demographic load. In turn, these factors were most negatively affected
by HIV/AIDS. The authors then ask the question of what can slow, prevent,
or reverse the growing trends of HIV infection and food insecurity. Using
data collected from Malawi, Zambia, and Zimbabwe, each of which has over 25
percent of their respective populations on food aid, SADC puts forward three
recommendations. First, aid should focus on consumption side support, looking
at households headed by chronically ill adults, women, and children. Second,
productivity enhancing projects should be initiated for women and the elderly.
Finally, household and community safety nets such as micro-credit and savings
projects should be started. Used in combination, the authors believe that
the effects of HIV/AIDS and food insecurity could be positively affected.
The article includes tables and graphs illustrating quantitative data from
the national studies.
Stokes, C. Shannon
2003. Measuring Impacts of HIV/AIDS on Rural Livelihoods and Food Security.
http://www.fao.org/sd/2003/PE0102a_en.htm.
Stokes reviews the five capital assets of rural households - human, financial,
natural, social, and physical - in relation to the effects of HIV/AIDS on
each of them. Using research funded by the Food and Agricultural Organization,
Stokes investigates those assets at the household and community levels. Stokes
argues that, in addition to developing labor saving technologies and better
access to water and fuel, researchers must also investigate to see if and
how the technologies are being used. She also contends that knowledge must
be shared across generational and gender boundaries. The article has tables
on the effects of HIV/AIDS on household and community assets.
Takashi, Yamano and T.S. Jayne
2002. Measuring the Impacts of Prime-Age Adult Death on Rural Households
in Kenya. Tegemeo Working Paper 5. Nairobi, Kenya: Tegemeo Institute of
Agricultural Policy and Development.
http://aec.msu.edu/fs2/kenya/wp5.pdf .
Using a two-year panel of 1,422 Kenyan households surveyed in 1997 and 2000,
the authors measure how prime-age adult mortality affects rural households'
size and composition, agricultural production, asset levels, and off-farm
income. First, the paper uses adult mortality rates from available date on
an HIV-negative sampling from neighboring Tanzania to predict the number of
deaths that might have been expected in the absence of HIV, and compares this
to the number of deaths actually recorded over the survey interval in the
Kenyan sample. Next, using a household fixed-effects model that controls for
time-varying effects, the authors measure changes in outcomes between households
afflicted by adult mortality vs. those not afflicted over the three-year survey
period. The effects of adult death are highly sensitive to the gender and
position of the deceased family member in the household. The paper concludes
by discussing the implications of these findings for agricultural research
and extension programs as well as for safety net programs designed to cushion
the impacts of prime-age adult death.
Topouzis, Daphne and Jacques du Guerny
1999. Sustainable Agricultural/Rural Development and Vulnerability to the
AIDS Epidemic. FAO and UNAIDS Joint Publication.
The impacts of AIDS in developing countries are out of the ordinary in many
ways, but three stand out. First, AIDS affects primarily the most productive
age groups; second, although it strikes most harshly among the poor and marginalized
in global terms, AIDS does not spare the elites or middle class; and third,
AIDS is not gender-neutral. For an example of the latter, one has only to
look at the acute vulnerability of widows compared to widowers in high-prevalence
societies. However, no matter what level of prevalence is found in any given
country, the impact of AIDS on affected families and communities is of devastating
magnitude. Thus, while macro-economic effects are of importance in evaluating
the socioeconomic impact of HIV/AIDS, they must never be separated from the
human-scale consequences on individuals. FAO's constitutional mandate is to
improve food production and distribution as well as the conditions of rural
populations. To that end, it works in partnership with governments, regional
organizations, international organizations, non-governmental organizations
(NGOs) and, where appropriate, with the private sector. For its part, UNAIDS
has the task of mobilizing a broad-based response to the global health and
development challenges posed by HIV/AIDS. The programme works in partnership
with governments, NGOs, and the business sector as well as seven co-sponsors
(UNICEF, UNDP, UNDCP, UNFPA, UNESCO, WHO, and the World Bank) and other regional
and international bodies. Together with their range of partners and expertise,
FAO and UNAIDS are uniquely positioned to develop measures to alleviate the
impact of AIDS on food security, and to reduce vulnerability to AIDS through
sustainable rural development. This joint publication is but one example of
cooperation between the two partners.
Topouzis, Daphne and Jacques du Guerny
1995. Module III: Gender, Rural Fertility/Mortality & Farming Systems.
United Nations Population Information Network.
This article focuses on how approximately 80 percent of African women live
and work in rural areas under conditions that support and sustain high fertility
and where the expected economic contribution of children is substantial. Further,
Sub-Saharan Africa exhibits the highest rates of economic activity and fertility
and the highest levels of maternal and child mortality in the world.
UNAIDS
2002. Nutrition and HIV/AIDS. United Nations Administrative Committee
on Coordination, Sub-Committee on Nutrition. Nutrition Policy Paper #20. http://www.unaids.org/publications/documents/nutrition/index.html.
Each section of this paper is followed by audience questions with answers
from the authors:
Sassa, Oliver S.
HIV/AIDS and Development - Unsolved Challenges for Africa. Pp. 26-37.
Poverty is a driving force behind the AIDS epidemic. Poverty, in turn, is driven by a lack of control over resources, such as land, water, livestock, and social support. Sassa begins by examining HIV/AIDS with macro-economic indexes like the Human Development Index and Human Poverty Index, as well as GNP for African nations. He then investigates how those readings affect the nutrition levels of individual households, productivity of malnourished workers, and crop outputs of farmers. He argues that the education and health sectors of society are also affected by the malnourishment of not only those suffering from HIV/AIDS, but their families as well. This paper includes tables listing macro-economic indicators, boxes with statistics on AIDS, and a bar graph on AIDS and risk.Gillespie, Stuart, Lawrence Haddad, and Robin Jackson
HIV/AIDS, Food, and Nutrition Security: Impacts and Actions. Pp. 38-53.
The nutritional needs of an individual with HIV are higher than the needs of an uninfected individual. In addition, good nutrition may slow or lessen the effects of HIV. In turn, malnourishment speeds the effects of HIV and increases risk for vertical transmission. Women are the most affected by issues of food security, as they are often the primary caregivers of the sick and of the children in a household. AIDS diverts their labor from income or food generating activities or energy gathering work as they care for the sick. As medical costs increase, household assets are sold and malnourishment becomes an issue for the uninfected as well. Gillespie, et al., contends that food aid is a necessity, but wants to focus on three main points. One, food aid should be focused at the community, not household, level. Two, food aid needs to be combined with other initiatives like education and income training with the goal of sustainability. Finally, as AIDS kills individuals, farming knowledge is lost too. Food security policy should include farmer meetings so knowledge can be shared. The authors have included figures and boxes explaining how malnutrition and HIV vulnerability are connected to vertical transmission, and listings of rural household responses to HIV/AIDS.Dlamini, Phetsilek
Nutrition and the Care Package. Pp. 54-61.
As HIV/AIDS takes the lives of parents, a group of grandmothers and great-grandmothers are raising children. As these extended families grow, nutrition and food security are growing problems as well. Dlamini, the Minister for Health and Social Welfare in Swaziland, argues that while anti-retroviral drugs are needed, many are out of reach for most individuals. Good nutrition, though, is a reasonable goal, is necessary for a strong immune system, and may slow HIV progression. The paper includes a nutritional guide for people with HIV. Dlamini also argues for the implementation of school feeding projects to ensure children are being fed well.
II. Empowerment, Vulnerability, Rights, and Sexuality
Gendered inequality produces both social and individual risk of HIV/AIDS for women. This section explores how gender inequality manifests itself in education, employment, economics, survival sex, and violence. It is also concerned with contested means of empowerment including education, activism, contraceptives, and human rights discourse. Contextualizing individuals with HIV/AIDS in a specific time and place creates greater awareness of the risk factors and possible prevention initiatives it is necessary to identify to fight HIV/AIDS.
Baylies, Carolyn
2002. HIV/AIDS and Older Women in Zambia: Concern for Self, Worry over
Daughters, Towers of Strength. Third World Quarterly 23(2):351-375.
In Sub-Saharan Africa, there are more women living with HIV/AIDS than men.
Yet, as Baylies notes, women are not a homogenous group. Therefore, women's
vulnerability to HIV/AIDS is not uniform, but affected by social locale in
a particular time and place. Drawing from personal research in Zambia as well
as comparative studies from other African nations, Baylies looks at age, marital
status, family ties, and cultural gender norms as to how they affect women's
risk for HIV/AIDS. What Baylies reveals is that each factor may correlate
with decreased risk in one area and with increased risk in another. Finally,
Baylies looks at women as advocates for their daughters and within their communities.
As women work to educate their daughters and communities, they are also empowering
themselves by creating space to change their social status. Baylies also asks
for further exploration into what change women can produce and which women
are able to produce it.
Baylies, Carolyn, Janet Bujra, and the Gender and AIDS Group
2000. AIDS, Sexuality, and Gender in Africa: Collective Strategies and
Struggles in Tanzania and Zambia. London: Routledge.
The focus of this edited volume is on gender and HIV/AIDS. The authors are
researching women's physiological, economic, and social vulnerabilities to
the disease, as well as their ability and potential to actively prevent and
fight the disease. Using seven case studies from Tanzania and Zambia, the
authors work to not make women or men homogenous groups, but recognize age
and status as well. More importantly, the authors, while focusing mainly on
women, see HIV/AIDS as a gendered - concerning both men and women - problem
needing a gendered solution.
Bujra, Janet
2000. Risk and Trust: Unsafe Sex, Gender, and AIDS in Tanzania. In
Risk Revisited, edited by Pat Caplan. London: Pluto Press, pp. 59-84.
Using anthropological research from 1995-97 in Lushoto, Tanzania, Bujra looks
at ideas of risk regarding AIDS, including concepts from Ulrich Beck and Anthony
Giddens. Taking points from Beck and Giddens, Bujra constructs a risk framework
based on their work. In this framework, risk is a social equalizer, and it
is universalized, so there is no escape. While Bujra agrees that men and women
are suspicious of each other and that both rich and poor are vulnerable to
AIDS, she thinks that the framework does not fully address the concept of
risk for AIDS. In Tanzania, risk is intertwined with the concept of trust.
Trust is defined in relationships, as those "inside" one's community
can be trusted, while those "outside" are viewed with doubt. The
symbol of trust is defined by the condom in the AIDS epidemic. One does not
use a condom with those he or she "trusts." For women, though, trust
is outlined by others - they are to trust their husbands, regardless of personal
risk. While women and men both have multiple partners, women are often blamed
by society for HIV transmission, making women "untrustworthy." In
addition, the condom itself is from the outside, and is regarded with skepticism
as well. Effective HIV prevention initiatives, including condom campaigns,
must address societal norms about trust and risk in order to work.
Bujra, Janet and Carolyn Baylies
2001. Targeting Men for a Change. ID21 Research Highlights. http://www.id21.org/static/insights35art2.htm.
This submission to the ID21 Research Highlights points out that women cannot
protect themselves against HIV infection without the cooperation of men. Two
key challenges include (1) creating programs that treat men as individuals,
and (2) being aware that the relations between men and women -- not men and
women themselves -- are in need of change. Men continue to make important
family decisions, control the benefit of women's labor, consider it their
right to marry younger women and have extramarital relationships, and run
the risk of contracting HIV through unprotected sex with multiple partners.
At the same time, men are beginning to re-evaluate traditional gender roles
and discuss issues of sexual health and condom use. Prevention programs need
to focus on men in general rather than only such groups as long-distance truck
drivers and army personnel. HIV/AIDS programs should target men but also acknowledge
women's need for support and resources. Creative approaches should encourage
men to take responsibility for their wives, partners, and children. Effective
programs must also appeal to all sexually active men, not just those who appear
promiscuous. Finally, politicians and other high-profile men need to advocate
for men to assume their responsibility in HIV/AIDS prevention and care.
Cáceres, Carlos
2000. Afterword: The Production of Knowledge and Sexuality in the AIDS
Era: Some Issues, Opportunities, and Challenges. In Framing the Sexual
Subject, edited by Richard Parker, Regina Maria Barbosa, and Peter Aggleton.
Berkeley: University of California Press, pp. 216-259.
Cáceres investigates trends in the construction of sexuality in "Afterword."
The chapter is broken into four main sections, along with a bibliography.
The first part, "Science and the Construction of Knowledge of the Sexual,"
focuses on the use of scientific knowledge in sex culture research. Scientific
knowledge is universal, but interpretation is local. The "new paradigm
of the sexual" integrates power into the realm of the sexual, which has
driven a social constructionist movement both academically and in activism.
Cáceres uses the World Health Organization's policies on AIDS to show
that sexuality is a part of the social sciences, along with biomedicine. He
also argues for a more complete methodology and for a more local focus in
research on the sexual. The second section, "Looking for a New Paradigm?"
delves more into combining the methodologies of biomedicine and social science.
Cáceres views quantitative and qualitative research as complementary.
In "Some Relevant Issues," the author posits that sexual identity
and practices must be studied in cultural meanings, relational contexts, and
outside of biomedical classifications. Finally, in "Postmodern Concerns,"
Cáceres acknowledges that
researchers must also frame themselves within their research. There is no
objective researcher. The strength of the piece is in its exploration of the
theories on the sexual and in tracing how the sexual was appropriating to
certain disciplines.
Campbell, Catherine
2000. Selling Sex in the Time of AIDS: The Psycho-social Context of Condom
Use by Sex Workers on a Southern African Mine. Social Science and Medicine
50:479-494.
Campbell investigates the social support networks and coping strategies formed
by groups of marginalized women who work as sex workers. Using individual
interviews for data, Campbell notes that the majority of women have become
sex workers for economic reasons, and their poverty as well as their gender
makes them vulnerable to HIV/AIDS, as they are unable to negotiate condom
usage. While most sex workers feel separated from their biological families,
most have formed social bonds with their colleagues, who offer physical, psychological,
and economic support. By tracing "matrilineal lines" created by
retired sex workers for younger ones, Campbell reveals a stratified society.
By redefining social respectability, women have reappropriated for themselves
social norms of status, respect, and confidence.
Center for Reproductive Rights
2002. HIV/AIDS: Reproductive Rights on the Line. http://www.reproductiverights.org/pub_bp_hiv.html.
The Center for Reproductive Rights looks at seven areas of concern regarding
women, HIV/AIDS, and reproduction. First, the center argues for more research
regarding anti-retroviral drugs on the health of the pregnant woman. Also,
the center wants a more coherent message concerning whether breast milk or
formula is better for HIV positive mothers to give their infants. Looking
at some Chinese and African policies that try to reduce reproduction by HIV
positive women, the center would like to ensure the right of those infected
by HIV/AIDS to reproduce and marry. In addition, it calls for greater access
to abortion without coercion. It also seeks to decrease discrimination and
stigmatization associated with HIV/AIDS. Finally, it asks governments to direct
HIV/AIDS prevention policies to both men and women. The article also discusses
Nevirapine, a drug that may reduce mother-to-child HIV transmission.
Chiarelli, D., J. Delahanty, C. Marcelis, R. Murphy, B. Seaborn, and K.
Seabrooke
1999. Uncommon Questions: A Feminist Exploration of AIDS. Ottawa: Women's
Health Interaction.
The women's health movement has a powerful tool in feminist theory, which,
at base, includes a critique of male-dominated and hierarchical power structures
that underlie poverty and powerlessness. A feminist analysis of women's health
problems is based upon core principles with which to approach the phenomena
of disease and health, as well as the related processes involved in the research,
treatment, and prevention of disease.
Chiganze, F, J. Decosas, and J. Chikore
2000. Linking the Issues: HIV, Gender, Human Rights, and Child Protection.
Durban: International AIDS Conference.
There is general awareness of the links between vulnerability to HIV, gender
inequality, limitation of human rights, and the abuse of children. This awareness
is particularly high among AIDS service organizations, although it is often
only conceptual and not reflected in the organization's activities. On the
other hand, organizations working for gender equality, human rights, or the
protection of children may be aware of the impact of HIV on their work, but
have few means to translate this awareness into action.
Chigodora, J.
2001. Young Men and HIV/AIDS. SAfAIDS 9(4):17.
Though cultural practices in the region vary from one community to another,
young men are brought up to be heads of families and decision makers especially
on sexual matters, yet many care programs in the region do not specifically
target men. The burden is often carried by women and children with little
involvement of men, yet their inclusion in HIV/AIDS programs is of paramount
importance if they are to be effective.
Commonwealth Secretariat and Maritime Centre of Excellence in Women's
Health
2002. Gender Mainstreaming in HIV/AIDS: Taking a Multisectoral Approach.
London: Commonwealth Secretariat.
Gender mainstreaming is planning for the results of any development action
with respect to both men and women. The Commonwealth Secretariat has organized
a basic text that gives definitions for terms regarding "gender"
as well as statistics about HIV/AIDS for entire populations, as well as sections
of populations. It gives brief overviews of the effects of AIDS in agriculture,
education, health, labor, and law along with eight case studies from around
the globe. It also contains two appendices on the United Nations guidelines
for HIV-related human rights and on global commonwealth mandates on gender
and HIV/AIDS. In addition, the book has a list of online resources and a bibliography.
De Guzman, A.
2001. Reducing Social Vulnerability to HIV/AIDS: Models of Care and Their
Impact in Resource-Poor Settings. AIDS Care 13(5):663-675.
Knowledge about HIV/AIDS does not ensure that one will take preventative measures.
Structural factors also need to be taken into consideration by HIV prevention
initiatives, especially for women in resource-poor settings, who are most
vulnerable. De Guzman looks at several different models of prevention initiatives,
including couple counseling, community participation, youth programs, and
workshops to study their different goals and impacts on the groups for which
they were meant. The article includes a chart organizing the various prevention
models. While focusing on the positive outcomes, de Guzman does bring attention
to the different effects of prevention models. He also argues that HIV prevention
and care are intertwined. Care alone is draining resources from communities
and placing heavier labor burdens on women. Without adequate drugs or counseling,
many are unable to get the treatment they need. Prevention, also, must be
sustained in order to be effective.
Doyal, Lesley
2001. Sex, Gender, and Health: The Need for a New Approach. British
Medical Journal 323:1061-3.
http://findarticles.com/p/articles/mi_m0999/is_7320_323/ai_n27572187/.
The past two decades have seen considerable activism by women to improve the
quality of their health and health care. Recently men too have begun to draw
attention to the negative implications of 'maleness' for their health. There
is an increasing danger that these campaigns could be drawn into conflict
with each other as they compete for public sympathy and scarce resources.
If conflict is to be avoided there needs to be a much clearer understanding
of the impact of both sex and gender on health. This can then provide the
foundation for gender sensitive policies that take seriously the needs of
both women and men.
EngenderHealth
http://www.engenderhealth.org/
This website offers a wide range of information and resources on family planning,
maternal/child health, men's health, HIV and other sexually transmitted infections,
and sexuality and gender.
Farmer, Paul
1992. AIDS and Accusation: Haiti and the Geography of Blame. Berkeley:
University of California Press.
In this book Farmer situates the spread of HIV/AIDS in Haiti in a historical
perspective, taking into account the biological and social effects. In charting
both the social and biological movements of this virus, he attempts to set
the record straight by correcting widely held misperceptions about AIDS and
Haitians.
Farmer, Paul, Margaret Connors, and Janie Simmons
1996. Women, Poverty, and AIDS: Sex, Drugs, and Violence. Monroe: Common
Courage Press.
This book aims to fill the communication and knowledge gaps among women, poverty,
and AIDS. In cities throughout the world and in rural areas, HIV complications
have become the leading cause of death among young women. Poverty and gender
inequality are two reasons why the fastest growing epidemics are among women,
who in some regions of the world constitute the majority of those infected.
Large-scale social factors - economic, political, and cultural - are now placing
millions of women at increased risk for HIV infection. At the same time, these
forces render many of these aforementioned scientific advances altogether
irrelevant for most women at increased risk. As women living in poverty, they
were already denied access to such goods and services before HIV came along
to further complicate their lives.
Farmer, Paul, Margaret Connors, and Janie Simmons
1996. Women, Poverty, and AIDS: Sex, Drugs, and Violence. Monroe: Common
Courage Press.
This book aims to fill the communication and knowledge gaps among women, poverty,
and AIDS. In cities throughout the world and in rural areas, HIV complications
have become the leading cause of death among young women. Poverty and gender
inequality are two reasons why the fastest growing epidemics are among women,
who in some regions of the world constitute the majority of those infected.
Large-scale social factors - economic, political, and cultural - are now placing
millions of women at increased risk for HIV infection. At the same time, these
forces render many of these aforementioned scientific advances altogether
irrelevant for most women at increased risk. As women living in poverty, they
were already denied access to such goods and services before HIV came along
to further complicate their lives.
Feldman, R., J. Manchester, and C. Maposhere
2002. Positive Women: Voices and Choices, Zimbabwe Report. International
Community of Women Living with AIDS.
This project was initiated by HIV positive women in the International Community
of Women living with HIV/AIDS (ICW). The project aimed to document the reproductive
and sexual health experiences of HIV positive women. This was in order to
provide information that HIV positive women and AIDS service organizations
could use in advocacy for changes in policies and practices that would improve
the reproductive and sexual health choices available to women living with
HIV and AIDS. This report presents the findings from Zimbabwe, the first country
involved in this research.
Foreman, M.
2000. What Makes a Man. SAfAIDS 8(2):2.
This article is a broad exploration of male identity and sexuality, with a
global focus. Linking up with the UNAIDS theme for 2000 on male attitudes
and responsibilities, it provides food for thought on men's role in the HIV/AIDS
epidemic, and on factors that need serious consideration in policies and programs.
Gender and HIV/AIDS
http://www.genderandaids.org
The United Nations Development Fund for Women (UNIFEM) and UNAIDS recently
created "the first comprehensive gender and HIV/AIDS web portal."
This site is committed to providing users with cutting-edge research, studies
and surveys, training materials, multi-media advocacy tools, speeches and
presentations, press releases and current news, best practices, e-mail updates
and newsletters, online discussion forums, and links to websites and databases.
Gielen, A.C., K.A. McDonnell, A.W. Wu, P. O'Campo, and R. Faden
2001. Quality of Life Among Women Living with HIV: The Importance of Violence,
Social Support and Self Care Behaviours. Social Science and Medicine 52:315-322.
This paper describes the relationship between psychosocial factors and health
related quality of life among 287 HIV-positive women using items from the
Medical Outcomes Study HIV Health Survey to measure physical functioning,
mental health, and overall quality of life. Multivariate models tested the
relative importance of sociodemographic characteristics, HIV-related factors,
and psychosocial variables in explaining these quality of life outcomes. A
history of child sexual abuse and adult abuse, social support, and health
promoting self-care behaviors were the psychosocial factors studied.
Gollub, Erica L.
2000. The Female Condom: Tool for Women's Empowerment. American Journal
of Public Health 90(9):1377-1381.
In her article, Gollub focuses on four points regarding the female condom.
First, it provides the opportunity for women to negotiate protection with
male partners. Second, regulatory agencies are sometimes greater obstacles
to female condom usage than are cultural norms. Women may benefit from the
confidence, knowledge about their bodies, and control the female condom offers.
Third, the Federal Food and Drug Administration needs to find ways to increase
the speed in which female contraceptives are approved. Finally, Gollub works
on questions regarding how the condom should be introduced into society at
the community level.
Green, Gill and Elisa J. Sobo
2000. The Endangered Self: Managing the Social Risk of HIV. London:
Routledge.
Green and Sobo look at the cultural construction of the HIV positive individual
using ethnographic data from Northeast England, Central Scotland, and New
Mexico. Using the themes of stigma, identity, and risk, the authors look at
how infected individuals come to terms with their new social status, as well
as whether they decide to make their health status public. The second half
of the book focuses on the results of creating a new social identity, the
mental and physical consequences, and the interactions of sharing one's HIV
status in health and social situations. The book includes a bibliography as
well as an index.
Human Rights Watch
2001. Scared At School: Sexual Violence Against Girls in South African
Schools. New York: Human Rights Watch.
A central contention of this report is that sex discrimination in South African
schools, as manifested by inadequate state response to sexual violence and
harassment, impedes a girl's access to her internationally recognized human
right to education on equal terms with her male classmates. Many of the problems
faced by the current government, in responding to violence in schools, are
not of its own making, yet they are nonetheless urgent. Human Rights Watch
believes that educational institutions cannot fulfill their mission of strengthening
respect for human rights when the basic bodily integrity of female students
is not respected. Leadership at every level is vital to create an education
system free of gender bias and sexual violence. This exploration of the situation
in South African schools has relevance for schools in other countries around
the world.
Kaler, Amy
2001. "It's Some Kind of Women's Empowerment": The Ambiguity
of the Female Condom as a Marker of Female Empowerment. Social Science
and Medicine 52:783-796.
While the female condom holds different meanings for men and women, as well
as for stakeholders and for female condom users, Kaler, drawing from research
in both Africa and the United States, observes that all groups use "empowerment"
in reference to the female condom. Yet she also points out, "empowerment"
is not a rigidly defined term and has different meanings for both individuals
and groups. Using the structure of Maxine Molyneux's division of strategic
and practical gender interests, Kaler looks at the types of empowerment each
group envisions as potential outcomes in regards to gender relations, meeting
practical responsibilities, and as a threat to current gender norms.
Lawday, A.
2002. HIV and Conflict: A Double Emergency. Save the Children, London.
A growing body of evidence links wars and mass displacement to the spread
of HIV/AIDS. In war and related emergencies, the epidemic is fueled by sexual
bartering - mainly rooted in poverty and powerlessness, sexual violence and
exploitation, low awareness about HIV, and the breakdown in health and education
services. These are not the only determinants of HIV transmission in conflict,
but they are important dynamics that must be addressed in any response.
Long, Lynellyn D. and Lisa J. Messersmith
1998. Reconceptualizing Risk: A Feminist Analysis of HIV/AIDS. In Women
in the Third World: An Encyclopedia of Contemporary Issues, edited by
Nelly P. Stromquist. New York and London: Garland Publishing, Inc., pp. 157-164.
Long and Messersmith contextualize HIV/AIDS research within feminism. The
article is divided into three parts and includes a bibliography. The first
section, "Demographic, Epidemiological, and Sociocultural Factors,"
looks at the biological vulnerability of women to sexually transmitted diseases
(STDs) as well as how STDs facilitate HIV transmission. The authors then shift
to focus on how sociocultural factors, i.e. poverty and social status, make
women at risk for STDs and HIV/AIDS. Next, Long and Messersmith turn to "Programs
and Policy Efforts to Prevent HIV/AIDS in Women" to explore benefits
and consequences of certain efforts in education and counseling, condom negotiation,
social and economic empowerment, control and prevention technologies, behavior
change in men, and integrating HIV/STD prevention into other health sources.
Finally, in "Integrating HIV/AIDS in Feminist Analysis," Long and
Messersmith consider the theoretical standpoints of feminism with HIV/AIDS,
the construction of the "Other" with the "Plague," and
how research has shifted from solely the medical domain to also including
social sciences. HIV/AIDS, they posit, may have been ignored by feminists
attempting to separate women from the stigma of the disease, but the authors
argue feminist theory, with social constructionism and materialist perspectives,
in HIV/AIDS research is a way to unite women globally.
Marcus, T.
2001. Kissing the Cobra: Sexuality and High Risk in a Generalised Epidemic
- A Case Study. African Journal of AIDS Research 1(1):25.
This paper explores the social factors that may account for the way the HIV/AIDS
epidemic is unfolding in a racially segmented and socially differentiated
society. As a sexually transmitted infectious disease that particularly infects
adolescents and decimates young adults, there is an urgent need to critically
assess assumptions about the influence of culture and social relations on
differences in patterns and the scale of infection across racial groups in
South Africa. The point of departure is the recognition that while nationally
there is a generalised epidemic of gigantic proportions, the epidemic among
young white adults is still nascent. Through a qualitative exploration of
white student perceptions of risk, sexual networking and practices in an HIV/AIDS
environment, this small study hopes to shed light on some of the social and
cultural issues surrounding the epidemic.
Matlin, Stephen and Nancy Spence
2000. The Gender Aspects of the HIV/AIDS Pandemic. World Health Organization,
Division for the Advancement of Women, Presentation at an Expert Group Meeting
on "The HIV/AIDS Pandemic and Its Gender Implications", Windhoek,
Namibia. http://www.un.org/womenwatch/daw/csw/hivaids/matlinspence.html.
Across the world, there has been a changing pattern of male/female infections.
Early cases in many countries were concentrated in male homosexuals and intravenous
drug users, but as the epidemic has spread there has been a progressive shift
towards heterosexual transmission and increasing infection rates in females.
The reality today is that, globally, more women than men are now dying of
HIV/AIDS and the age patterns of infection are significantly different for
the two sexes. Beyond the statistics of sex-based differences in infection
rates, there are profound differences in the underlying causes and consequences
of HIV/AIDS infections in male and female, reflecting differences in biology,
sexual behavior, social attitudes and pressures, economic power, and vulnerability.
In many ways, the inequity that women and girls suffer as a result of HIV/AIDS
serves as a barometer of their general status in society and the discrimination
they encounter in all fields, including health, education, and employment.
It is for these reasons that HIV/AIDS is inherently a gender-based issue and
needs to be seen in this light if it is to be addressed effectively. HIV/AIDS
will only be conquered when the effort to achieve gender equity is successful.
Mill, Judy E. and John K. Anarfi
2002. HIV Risk Environment for Ghanaian Women: Challenges to Prevention.
Social Science and Medicine 54:325-337.
Interviewing HIV positive Ghanaian women, Mill and Anarfi had two goals. First,
they wanted to trace the life histories of the women to look for patterns
of risk. Second, they wanted to consult the women as to what they think would
work for HIV prevention. Women were vulnerable to HIV, broadly speaking, both
economically and socially. Economically, women receive less education, which
leads to higher levels of unemployment and poverty. Poverty results in a greater
dependence on men for survival, which perpetuates the social subordination
of women. In addition, cultural status for women stems from fertility and
fidelity. Condoms prevent pregnancy and, socially, imply an unfaithful woman,
not making them a useful HIV prevention tool. The women interviewed contend
that increased public education, directed at both men and women, will help,
as well as access to better health care and direction from traditional cultural
leaders.
Miller, Norman and Richard C. Rockwell
1988. AIDS in Africa: The Social and Policy Impact. Lewiston: The Edwin
Mellen Press.
Tolerance of gender-based violence in schools is a serious form of discriminatory
treatment that compromises the learning environment and educational opportunities
for girls. Girls are disproportionately the victims of physical and sexual
abuse at school. Girls are raped, sexually assaulted, abused, and sexually
harassed by their male classmates and even by their teachers. In South Africa,
some girls have left school entirely as a result of their experiences with
sexual violence. This volume brings together working papers and resource materials
from authors in Africa, North America, and the United Kingdom. The writers
are from both academic disciplines and operational organizations concerned
with health and development. This diversity is both a strength and a limitation.
No single thread weaves this collection of papers together, and no over-arching
theme moves them towards a common conclusion. Rather these are position reports
that begin to map the social science, policy, and health terrains of the disease.
They are aimed not so much at the academic research world of African and international
affairs, but at those who would teach about AIDS in Africa, and those African
and non-African policy makers who might bring their existing expertise to
bear on the problem. In this sense it is a recruiting volume, one that is
produced in hopes of helping solve the dilemmas of HIV/AIDS. This book is
divided into five parts: Epidemiology and Current Assessment; Historic and
Ecological Implications; Issues of Management, Policy and Politics; Issues
of Society and Education; Resource Material for the Study of AIDS in Africa.
Mwale, Genevieve and Philip Burnard
1992. Women and AIDS in Rural Africa: Rural Women's Views of AIDS in Africa.
Avebury: Ashgate Publishing Limited.
Much has been written about AIDS in Africa and elsewhere, however not much
has been written about how women perceive HIV. This book offers direct views
of HIV by women in Zambia through interview responses, illustrating how some
women think and feel about AIDS.
Panos Books
http://www.panos.org.uk/?lid=20136&Type=0&Region=0&Year=0&Topic=29.
The Panos Institute website lists several relevant publications for sale.
Parker, Richard, Regina Maria Barbosa, and Peter Aggleton (eds.)
2002. Introduction: Framing the Sexual Subject. In Framing the Sexual
Subject: The Politics of Gender, Sexuality and Power. Berkeley:
University of California Press, pp. 1-25.
Parker, Barbosa, and Aggleton outline historical trends, current situations,
and future issues in research on the sexual in "Introduction." Situating
the start of sex culture research in 1960s, the authors look at the "demedicalization"
of sex in the late 1970s. With the discovery of HIV/AIDS in the early 1980s,
sex was remedicalized and brought into the realm of biomedicine, which focuses
on individual behavioral intervention. Focusing only on individual behavior,
however, is inadequate when addressing sexuality, which can have cultural,
social, political, and economic aspects. The authors argue for using social
constructionism, local classifications instead of Western terms, and the recognition
of gendered power differentials in exploring sex culture research. After reviewing
past research and current issues, Aggleton, et al., propose three research
directions. First, in "Bodies, Cultures, and Identities," researchers
focus on social constructionism in classifying and contextualizing sexual
identities. In "Sex, Gender, and Power," sexual rights are argued
for in both the context of feminism and human rights. Working global social
movements, however, will require investigators to look at interactions at
the international and local levels. Finally, in "Hegemony, Oppression,
and Empowerment," researchers explore the many forms of sexual oppression,
from the physical to the societal to the cultural to the economic. The "Introduction"
theoretically embraces community-based research over focusing on the individual
in research on the sexual.
Patterson, David
2000. HIV/AIDS, Human Rights, and Development. Development Bulletin
52:14-17.
This article looks at the 1998 United Nations statement that development includes
a "broad rights based approach." Since HIV infection levels tend
to be lower in areas where rights are respected and protected, addressing
human rights is one way to speak to the structural violence that coexists
with HIV/AIDS. First, looking at the AIDS Law Project in South Africa, an
organization that counsels, researches, and fights for property rights, treatment,
and equality for those living with AIDS, Patterson then lists similar organizations
worldwide. These organizations address legal issues, monitoring HIV, women's
rights, children's rights, as well as partnerships to help fight HIV with
national governments.
Petchesky, Rosalind P.
2000. Sexual Rights: Inventing a Concept, Mapping an International Practice.
In Framing the Sexual Subject: The Politics of Gender, Sexuality and Power,
edited by Richard Parker, Regina Maria Barbosa, and Peter Aggleton. Berkeley:
University of California Press, pp. 81-103.
Petchesky delves into the international debates surrounding the inclusion
of sexual rights into the women's rights and human rights discourses. Tracing
the history of sexuality, including gay and lesbian, feminist, and heterosexuality,
from Human Rights Conference discussions starting in 1993, she discusses the
agendas of particular lobbyists, including religious groups and women's NGOs.
The pattern that emerges from their debates is that it is more comfortable
to assert that women are weak and need to be protected from abuse, rather
than asserting women as autonomous individuals, capable of making decisions
regarding sexuality. In addition, Petchesky argues that freedom from abuse
does not guarantee freedom from the socio-economic conditions that create
a market for sex work. Therefore, freedom must be linked to conditions that
make freedom of the sexual possible.
Pulerwitz, J., H. Amare, W. De Jong, S.L. Gortmaker, and R. Rudd
2002. Relationship Power, Condom Use and HIV Risk Among Women in the USA.
AIDS Care 14(6):789-800.
Using data collected from a Massachusetts women's health clinic, Pulerwitz,
et al., conducted an empirical study concerning power within a sexual relationship.
They wanted to correlate each woman's level of power within a sexual relationship
to condom usage by the couple. In order to measure power, the researchers
created the SRPS, sexual relationship power scale, which draws from Robert
Connell's theory of Gender and Power as well as Social Exchange Theory. Using
factors such as education level, income, age, social status, and primary language,
researchers found that those women assessed as possessing a high level of
power were up to five times more likely to be using condoms regularly. Therefore,
HIV prevention programs that focus on condoms should be aimed at individuals
who possess a higher level of sexual relationship power than their partners
in order to be effective.
Radlett, Marty and Olivia Bennett
1990. Triple Jeopardy: Women and AIDS. Paul & Co Pub Consortium.
This book focuses on how AIDS is much more than a medical issue. It raises
many of the fundamental questions of equity between the sexes and between
regions of the world at the heart of the development debate. This book illustrates
the "triple jeopardy" that women face as individuals, mothers, and
caregivers in the face of the pandemic. This report tells how and why, through
social empowerment, women can take measures to prevent AIDS.
Roth, Nancy L. and Katie Hogan
1998. Gendered Epidemic: Representations of Women in the Age of AIDS.
New York and London: Routledge.
This book portrays how and why women, due to class, ethnicity, and gendered
power structures, have had a silenced position throughout the discussion of
AIDS and, consequently, how they are at greater risk than men of contracting
HIV. It is a compilation of essays that fall into a range of registers, from
explicitly practical to explicitly theoretical. They engage the problems of
identity politics, strategies of self-representation, and the concrete processes
of moving knowledge across the invisible walls that divide the knowing from
the known. This piece is divided into three sections: Gendered Habit; Gendered
Abjection; and Gendered Silence.
Setel, Philip W.
1993. "Getting AIDS is Like Breaking Your Shaft in the Shamba."
Energy, Disease, and Changing Concepts of Manhood in Kilimanjaro. Working
Paper 168. Boston, MA: Boston University, African Studies Center.
In Tanzania, AIDS is seen to travel through the social world along networks
of productive and reproductive relations. As a disorder of these normative
relations the disease serves as a lens through which connections between productive
and reproductive life can be examined. This provides a general analytical
framework for what is primarily a descriptive account. This paper examines
changes in ideas of male labor and sexuality among Chagga in northeast Tanzania.
The paper presents a number of perspectives on productive adulthood and adult
sexuality in connection with AIDS. The relevant themes are the inter-connections
of work, money, and sexuality; the mechanism by which they are related; and
different modes of expressing these issues among people of different generations,
and among men and women.
Setel, Philip W.
1999. A Plague of Paradoxes: AIDS, Culture, and Demography in Northern
Tanzania. Chicago: The University of Chicago Press.
Setel approaches HIV/AIDS not as a health incident separate from culture,
but one shaped by histories of politics, economies, cultural traditions, demography,
and social practices. The book is divided into seven chapters, each emphasizing
a particular aspect concerning AIDS in the Kilimanjaro region of Tanzania.
It is based on anthropological research conducted in the early 1990s. The
first chapter introduces the themes of risk, sexuality, and modernization
contextualized within a specific time and place. Setel, within the first chapter,
also contextualizes himself within his own work. Next, Setel explores cultural
histories pre- and post-colonialism. While colonialism had a significant impact
on social patterns, Setel notes that social patterns were not immutable before
it. In the third chapter, he studies what he terms "moral demographies,"
which are the ways in which people come to understand HIV/AIDS. He delves
into concepts of desire and moral character, as well as the "inside the
home" and "outside the home" view of risk. The concepts are
explicated in the following chapter where Setel defines and explains different
types of sexual relationships - the motivations and expectations of each partner.
The fifth chapter takes a more in-depth look at the post-colonial situations
of politics and economics. Setel also looks at social conceptualizations of
prevention initiatives and contraceptives. In the next chapter, Setel reviews
the history of AIDS in Tanzania as well as the biomedical discourse used from
colonial times onward concerning AIDS, tuberculosis, and malaria. Finally,
Setel argues for more research about how disease is shaped by politics, economics,
and social norms, including gender inequality.
Siegel, Karolynn and Eric W. Schrimshaw
2000. Perceiving Benefits in Adversity: Stress-Related Growth in Women
Living with HIV/AIDS. Social Science and Medicine 51:1543-1554.
A diagnosis of HIV/AIDS is rarely described as a positive turning point in
a woman's life. Yet Siegel and Schrimshaw note an overwhelming majority of
New York women, across ethnicities, education levels, and economic backgrounds,
point to some positive impact of living with AIDS. Using the themes of resiliency
and adaptation seen in other stress-related growth situations such as Holocaust
survivors as rape victims, Siegel and Schrimshaw investigate three categories
of positive change: change in oneself, change in relationships with others,
and changes in one's life philosophy. Now, recognizing that some changes may
be coping strategies or just part of individual personality, the authors note
that most stress-related growth takes place after a traumatic event has occurred
and danger has passed. What is unique about the women interviewed is that
their resiliency and adaptation is occurring while they still live under the
physical threat of HIV/AIDS.
Susser, Ida and Zena Stein
2000. Culture, Sexuality, and Women's Agency in the Prevention of HIV/AIDS
in Southern Africa. American Journal of Public Health 90(7):1042-48.
Focusing on women, gender, and HIV prevention, Susser and Stein conducted
a five-site field study between 1992 and 1999 in Southern Africa. Interviewing
not only women, but also men, public health officials, local leaders, students,
and doctors, they explore the same topics in different communities in different
countries. They argue that the majority of women are aware of how HIV is prevented,
but lack access to the resources they wanted, such as the female condom, and
that women are aware political action needs to be taken in order to obtain
prevention resources. In addition, Susser and Stein posit that each community
must be researched so as to contextualize prevention methodology within its
place in space and time. Within the same country, communities differed in
gender norms, education levels, and access to resources. No one solution can
be applied to all communities affected by HIV/AIDS.
Tallis, Vicci
2002. Gender and HIV/AIDS: Overview Report. Bridge Publications. http://www.ids.ac.uk/bridge/reports/CEP-HIV-report.pdf.
Tallis gives an overview of HIV/AIDS in three areas. She first looks at gender
and HIV/AIDS through a rights-based approach, focusing on both human and women's
rights. Looking at issues of poverty, racism, sexism, and inequality as violations
of rights places the perpetuation of the epidemic within a rights discourse.
In the following section, Tallis looks at the effects of gender inequality,
social, political, and economic forces on HIV/AIDS, as well as the epidemic's
effect on them. In the final section, Tallis evaluates policy projects. There
is review of gender-based approaches that focus solely on men, solely on women,
and those that try and work with both.
Treichler, Paula A.
1999. How to Have Theory in An Epidemic: Cultural Chronicles of AIDS.
Durham and London: Duke University Press.
"AIDS is more than an epidemic disease," Treichler writes. "It
is an epidemic of meanings." Exploring how such meanings originate, proliferate,
and take hold, her essays investigate how certain interpretations of the epidemic
dominate while others are obscured. They also suggest ways to understand and
choose between overlapping or competing discourses. In her coverage of roughly
15 years of the AIDS epidemic, Treichler addresses a range of key issues,
from biomedical discourse and theories of pathogenesis to the mainstream media's
depictions of the crisis in both developed and developing countries. She also
examines representations of women and AIDS, treatment issues, and the role
of activism in shaping the politics of the epidemic. Linking the AIDS tragedy
to a uniquely broad spectrum of contemporary theory and culture, this collection
concludes with an essay on the continued importance of theoretical thought
for untangling the sociocultural phenomena of AIDS - and for tackling the
disease itself.
United Nations Programme on HIV/AIDS (UNAIDS)
2000. Men and AIDS: A Gendered Approach. Geneva: UNAIDS. http://www.thebody.com/unaids/men/contents.html.
Produced for the 200 World AIDS Campaign, this thorough document maintains
that women are at particular risk of HIV infection due to their "lack of power
to determine where, when, and whether sex takes place." At the same time,
the report underscores the need to establish a balance between acknowledging
how the behavior of some men fuels the HIV/AIDS pandemic and inculcating --
thereby perhaps alienating -- all men. Men and AIDS also discusses
in detail such topics as the impact on women, the roots of masculinity, reaching
adolescent boys, men's relations with women, sex between men, preventing sexual
transmission of HIV, violence and HIV, substance use, special settings (such
as prisons, mines, the military, areas of migrant workers and long-distance
truck drivers, and zones frequented by sex workers and people who live on
the street), men's health needs and health-seeking behavior, and how men interact
with their families. The document concludes with a series of points for action
aimed at increasing gender awareness, improving sexual communication and negotiations,
reducing violence and sexual violence, and promoting support and care.
Voluntary Services Overseas (VSO)
2003. Men, HIV and AIDS Conference Report. VSO Regional AIDS Initiative
of Southern Africa (RAISA)/VSO.
http://www.vsointernational.org/Images/Men_HIV_and_AIDS_tcm76-21036.pdf.
This document reports on a conference held in Africa to address issues around
men and HIV/AIDS. Its rationale was that twenty years into the pandemic, the
bulk of studies and interventions have centered on women and girls. There
is greater understanding of the gender dimensions of HIV/AIDS but little funding
and effort has gone into working with men, especially young men. According
to the report, many interventions fail because they do not take into account
the identity constructions of the men who interact with women and girls as
partners, husbands, fathers, teachers and so forth.
Walker, L. and L. Gilbert
2002. HIV/AIDS: South African Women at Risk. African Journal of AIDS
Research 1(1):75-85.
This paper engages some aspects of the HIV/AIDS epidemic and the complexities
associated with it. It outlines the socio-epidemiological patterns of the
epidemic and in doing so identifies the groups with the greatest and fastest
growing rates of infection. The pattern of the epidemic in South Africa is
as follows: it is primary a heterosexual one, the rates of infection in the
general population are very high, and the percentage of HIV positive women
is greater than men. An additional feature is the young age of onset of infection
for women. These data demonstrate the need to focus our attention on young
African women and the factors underpinning their predicament. In order to
shed light on the position of women in the epidemic and the particular risks
they face, we examine the long-standing relationship between gender and racial
inequalities and health. Within the constraints of limited and flawed statistical
data, the paper argues that a complex interaction of material, social, cultural,
and behavioral factors shape the nature, process, and outcome of the epidemic
in South Africa. It concludes with recommendations for the way forward.
Wallman, Sandra
2000. Risk, STD, and HIV Infection in Kampala. Health, Society, and
Risk 2(2):189-203.
Using research from a parish in Kampala, Uganda, Wallman looks at two points
regarding STDs and HIV infection. First, she explores risk assessment among
six categories of citizens: pregnant women, women who brewed alcohol, male
youths, female youths, adult men, and adult women. Second, Wallman looks at
the factors influencing choice of health care among self-treatment, biomedical
hospitals, and traditional treatments among the six categories of citizens.
Realizing that people were well informed about the transmission of STDs as
well as the effects of particular treatments, Wallman investigates the social
reasons people choose certain behaviors and treatments, such as time costs,
economic costs, and social counter-risks, like stigmatization.
Whelan, Daniel
1998. Human Rights Approaches to an Expanded Response to Address Women's
Vulnerability to HIV/AIDS. Health and Human Rights 3(1):20-37.
Whelan argues that both individual vulnerability and societal vulnerability
to HIV should be combined to create an expanded response to the HIV/AIDS epidemic.
The expanded response Whelan puts forth has two objectives. One, the response
should reform existing prevention initiatives to address gender sensitivity
and accessibility issues. Two, the expanded response should look to contextualize
societal issues within a human rights discourse. Whelan then studies the texts
of four human rights documents - the International Covenant on Civil and Political
Rights, the International Covenant on Economic, Social, and Cultural Rights,
the Convention on the Elimination of All Forms of Discrimination against Women,
and the Convention on the Rights of the Child - and posits that neglecting
prevention and treatment violates human rights doctrines.
Wingwood, Gina M. and Ralph DiClemente
2000. Application of the Theory of Gender and Power to Examine HIV-Related
Exposures, Risk Factors, and Effective Interventions for Women. Health
Education and Behavior 27(5):539-565.
Wingwood and DiClemente detail why gender inequalities produce higher risk
for women regarding HIV/AIDS. Starting with the three structures of Robert
Connell's theory of gender and power - sexual division of labor, sexual division
of power, and structure of cathexis - Wingwood and DiClemente expand the theory
in the context of HIV/AIDS to show how each creates economic, physical, social,
and personal exposures to HIV/AIDS. First, the sexual division of labor creates
inequalities in education, employment, job control, homelessness, and health
insurance access, as well as gender and age status. The sexual division of
power generates inequalities because of the effects of abuse, a partner's
power in a relationship, a partner's ability to have affairs, pornography,
access to education and treatment, and lacking the ability to negotiate the
use of contraception. Lastly, cathexis, or affective attachments, effects
power in that inequalities may arise from having an older partner, desiring
to conceive, familial influence, mistrust of the medical system, or adhering
to culturally conservative gender roles. The authors briefly explore women's
physiological vulnerability to HIV/AIDS. The article also considers intervention
practices that address each gendered power structure. It includes charts that
organize points that may get lost in only reading, as well as a bibliography.
Overall, the use of Connell's theory helps orient and outline a gendered approach
to the study of HIV/AIDS risk.
Wojcicki, Janet Maia
2002. "She Drank His Money": Survival Sex and the Problems of
Violence in Taverns in Gauteng Province, South Africa. Medical Anthropology
Quarterly 16(3):267-293.
As well as having HIV prevalence at 22.4 percent among women, with women under
30 at the greatest risk, South Africa also has the highest number of reported
rapes for a country not at war. Using research from Gauteng Province, Wojcicki
examines links between gendered violence and HIV vulnerability. Beginning
with apartheid history and patriarchal structures, she looks at how those
ideologies affect the lives of women, specifically those who trade sex for
resources. She also compares local opinions on the differences between survival
sex workers and commercial sex workers. While arguing that gendered violence
is propelling the AIDS epidemic and that women need protection from such violence,
Wojcicki is careful to note that these protections should not reinforce negative
stereotypes about women.
Women, Gender and HIV/AIDS in East and Southeast Asia
http://www.unifem-eseasia.org/HIV_AIDS/index.html.
The United Nation's Women's Fund (UNIFEM) East and South East Asia division
has developed an information kit available in several formats to view or download
(Microsoft Word and PDF versions). The kit includes sections on why HIV is
a gender issue; basic facts; facts specific to several countries in the region
(including Cambodia, China, Myanmar, Papua New Guinea, Thailand, and Vietnam);
how HIV is a human rights issue for women; vulnerability to HIV; mobility,
gender and HIV; mother-to-child transmission; the role of men; HIV, women,
and peace; what is being done in the area of gender and HIV/AIDS; and a list
of resources for information on women, gender, and HIV/AIDS.
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