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Ugandan Doctor Explains Why Women are More At Risk For HIV/AIDS

A new UN report says the number of women living with HIV/AIDS has increased around the world. UNAIDS and the World Health Organization say nearly half of all those infected with HIV are women. That’s an increase from 41 percent in 1998. However, in sub-Saharan Africa, about 60 percent of those infected are women.

Dr. Alex Coutinho is executive director of the Uganda AIDS support organization, TASO. From Kampala, he spoke with English to Africa reporter Joe De Capua about the spread of HIV among women.

He says, “TASO has been looking after people with AIDS since 1987. Over the 17 years, women have always been the predominant population that we care for. On average, 65 percent of our clients are women and 35 percent are men. So, in a small way, it also reflects the global trend.”

But why are women more at risk? Dr. Coutinho says, “Well, the epidemic in Africa is heterosexual. So, in theory, there should be equal numbers of men and women getting HIV or getting infected. But there are a number of reasons why women are more susceptible and also more vulnerable. First is really the whole issue of gender. The fact that women are in many African countries subservient to men in matters of sexuality. They cannot control those issues. They cannot decide issues of abstinence or faithfulness or condoms. All three are really determined by men.”

Dr. Coutinho adds, “From a biological point of view, women are also more physically susceptible, particularly if they’ve got sexually transmitted infections, if they have sex when in their periods, if that sex is violent and results in cuts and abrasions.” As for men, he says they are “more efficient transmitters in a polygamous society.” Men often have two are three partners, often younger.

Poverty and gender inequality are among the main issues that need to be addressed, according to TASO’s executive director. He says if girls can be educated for 7 to 12 years, it not only raises their awareness, but often delays first time sex.

He says marriage offers women very little protection from HIV, because of the unfaithfulness of many husbands. Dr. Coutinho is calling for increased research into developing microbicides. A woman could apply these anti-viral gels to the vaginal tract for protection against HIV. It would be one way of empowering women in sex. However, no such microbicides now exist.