Gender and care

Abstract

HIV/AIDS transmission in the Middle East and North Africa region (MENA) has been on the rise for the most of the last decade. By the end of 2007, there was an estimated 380,000 people living with HIV/AIDS in the region (WHO/UNAIDS/UNICEF, 2008). The expansion of HIV testing in recent years, albeit still to a limited extent, has contributed to the increasing number of reported HIV cases, although limited reliable data and weak surveillance systems in the region make it difficult to accurately estimate the number of cases of HIV/AIDS or to determine trends over time. The spread of HIV in the MENA region remains relatively small except in Sudan which has the highest prevalence in the region. Although in recent years there has been a global momentum to expand ART access in low to middle-income countries, the MENA region lags behind and has the lowest regional coverage. In 2007, only 7% (5–10%) of those in need actually received therapy (compared to 5% (4–8%) in 2006) (WHO/UNAIDS/UNICEF, 2008).

The reported risk factors present in most of the countries of the region include injecting drug use, commercial sex work, men who have sex with men, youth, conflict, refugees, labor migration, and gender inequality (Jenkins and Robalino 2003). In addition, the limited available data indicate a growing feminization of the HIV epidemic in the region (UNDP/HARPAS 2005/6). Women and girls now constitute almost half of all people living with HIV/AIDS in the region compared to 40% in 2001. Young women aged 15 to 24 years are more than twice as likely to be living with HIV/AIDS as young men in the region. Similar to the HIV/AIDS situation in other regions of the world, particularly in sub Saharan Africa, women in the MENA region are more vulnerable to HIV infection than men. This is due to many factors including lack of negotiating power in their relationships including marriage, limited access to education among women and girls, and relative lack of knowledge about HIV/AIDS (UNDP/HARPAS 2005/6).

This paper focuses on the important gender dimensions of access to HIV testing, care and treatment in the MENA region. In the context of the global HIV/AIDS epidemic, gender is an important underlying factor in HIV risk perception, risk of infection, access to HIV testing, care, and support, and the ability to cope when infected or affected by HIV. Although integrating gender issues into HIV/AIDS programs can be challenging, the effectiveness of such programs are greatly enhanced when gender specific needs of men and women are considered (Gijsbers van Wijk et al., 1996; Standing, 1997).