Why HIV infection is more prevalent in women than men in SADC

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 Sharon Kavhu 

 

Women in the Southern African region are more vulnerable to HIV transmission compared to men as revealed by the UNIAIDS regional statistics.

According to UNIAIDS 2016 statistics, which are the latest, HIV prevalence in women is higher compared to men in the Southern African Development Community (SADC), particularly in eSwatini, Lesotho, South Africa, Namibia, Zimbabwe, Zambia, Mozambique, Malawi and Tanzania.   

In Eswatini, which is the leading country in HIV infection in SADC there is an HIV prevalence rate of 34.7% among women between the ages of 15 and 49 while the rate is 20.4% for men within the same age group.

This is followed by Lesotho, which has an HIV prevalence of 29.8% among the women aged between 15 and 49, while for men the rate is 20.4%.

South Africa is the third leading in HIV prevalence, the HIV prevalence rate among women between the ages 15 and 49 is 23.8%, while for men within the same age it is 14.2%.

After South Africa is Namibia, whose HIV prevalence rate for women in the 15 and 49 age group is 16.6% while for men it is 10.9%.

Zimbabwe stands as the fifth leading in the HIV infection, with an HIV prevalence rate for women above 15 at 16.1% while for men it is 10.7%. Then comes Zambia with an HIV prevalence rate of 14.5% among women aged 15 and 49 while for men the rate is 10.3%.

After Zambia is Mozambique with an HIV prevalence of 14.2% among women aged 15 to 49 and 10.2% among men. In the same age group, Malawi’s rate for women is 11.2% and men 7.1%.

Tanzania and Madagascar have the least HIV infection rate with the HIV prevalence rate in Tanzania for women aged between 15 and 49 at 5.8% while for men it is 3.6%.  However, in Madagascar, the HIV prevalence rate in men is higher than that of women. In men, the prevalence rate is at 0.3%, while for women it is at 0.2%.

Health experts have attributed the phenomenon to several aspects such as the biological make-up of the females, lack of preventative measures, culture and tradition, social, and economic factors among others.

In an interview, the Director of HIV, AIDS and TB unit in the Ministry of Health and Child Care in Zimbabwe, Dr Owen Mugurungi, told The Southern Times that the biological makeup of the female genital tract makes women more vulnerable to HIV infection compared to men.

“After sexual intercourse, a man disposes of his semen in the female genital tract. Scientifically, the semen of an infected partner has a higher viral load compared to the vaginal fluids.  Therefore, during unprotected intercourse with an infected partner, the deposited semen stays longer in the female genital tract and this increases the chances of HIV transmission,” said Mugurungi.

Unlike men who are only exposed to HIV transmission during the act, women’s risks are prolonged, as transmission can occur during and after sex.

According to Mugurungi, HIV transmission is high when the immunity is low and women during their menstrual circle or pregnancy, they will be exposed to a higher risk of transmitting the virus because, during such periods, their immunity will be low.

In some cases, Sexual Transmitted Infections (STIs) can cause wounds in the female genital track while the woman is unaware, as signs and symptoms may manifest later.

“Open cuts in the female genital track increase the risks of transmission in women after unprotected sex with an infected partner.  Unlike men, it is difficult for a woman to detect that there is a cut in her reproductive tract, which makes women vulnerable,” explained Mugurungi.

Supporting the above facts, Zimbabwean’s National AIDS Council Monitoring and Evaluation Director, Amon Mpofu, said HIV prevalence is higher in women because of some cultural values associated with marriage.

“Some women use herbs to tighten their vagina in order to satisfy their husbands because they believe that marriage is bonded by sexual intercourse for it to last longer,” said Mpofu.

Although the tightening may excite their husbands, the danger is that during the intercourse, the tissues of the vaginal walls may tear and such cuts may pave the way for the virus to penetrate the female body.

Most societies in the SADC region are patriarchal and men usually decide on the sex.  It is the men that determine whether the sex should be protected or not, especially when the couple is married.

In marriage, forced sex is quite common and such cases are rarely reported, as the women are afraid of losing their husbands. During such process, the vaginal wall tissues also crack making it easy for the virus to penetrate.

Mpofu said sexually active girls below 18 or 20 have immature genital tracts that are more prone to invasion by HIV.

“Many young girls in the region are indulging in sexual activities through abuse by family members and at times they are being forced to give elderly men sexual favours in return for material things,” he said.

“The issue of rituals that involve men sleeping with virgins or younger girls in some societies within the region also contribute to the girls indulging in sexual activities early.”

He said the ‘Sugar daddy’ syndrome is also contributing to young girls getting HIV infections, especially in poverty-stricken areas. In most cases, the ‘Sugar daddies’ will be HIV infected, but they indulge in sexual intercourse with innocent young girls in exchange for material things.

 

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