Rodrigo Chaturaka, Rajapakse Senaka
University Medical Unit, National Hospital of Sri Lanka, Sri Lanka.
J Glob Infect Dis. 2010 Jan;2(1):15-27. doi: 10.4103/0974-777X.59246.
The increasing number of women acquiring Human Immunodeficiency Virus (HIV) has resulted in a 'feminization' of the epidemic. In this article we are reviewing whether females are disadvantaged in the epidemic, due to factors independent of the biological differences in sexes.
We searched MEDLINE and EMBASE for articles with key words 'Women', 'Gender,' and 'HIV' in any field. The search was restricted to articles published in English within the last 10 years (1999-2009). Data were coded independently by two reviewers from 94 selected sources. The coded data were categorized under five commonly encountered concepts; violence, poverty, gender norms, prevention-/treatment-related issues, and Highly Active Anti-Retroviral Treatment (HAART).
The link between inter-partner violence (IPV) and HIV risk for women is observed by many authors. In assessing the link between poverty and HIV, indicators such as food insufficiency and income inequality may be better indicators compared to wealth itself. Although women are disadvantaged with male-dominated gender norms, evidence suggests that the traditional norms are changing in many societies. A positive association between living in urban communities, education, and better HIV knowledge has been observed in females, although it is not always synonymous with reduced risk behavior.
Women are still disadvantaged in many HIV-related issues such as poverty, violence, and gender norms. At least in Africa, there is evidence of a positive change in spheres of education and gender norms. However, the situation in Asia is largely unexplored.
感染人类免疫缺陷病毒(HIV)的女性人数不断增加,导致了该流行病的“女性化”。在本文中,我们将探讨女性在这一流行病中是否因性别生物差异之外的因素而处于不利地位。
我们在MEDLINE和EMBASE中搜索了所有字段中包含关键词“女性”“性别”和“HIV”的文章。搜索仅限于过去10年(1999 - 2009年)以英文发表的文章。两名评审员对从94个选定来源获取的数据进行独立编码。编码后的数据按照五个常见概念进行分类:暴力、贫困、性别规范、预防/治疗相关问题以及高效抗逆转录病毒治疗(HAART)。
许多作者都观察到伴侣间暴力(IPV)与女性感染HIV风险之间的联系。在评估贫困与HIV之间的联系时,与财富本身相比,诸如食物不足和收入不平等之类的指标可能是更好的指标。尽管在男性主导的性别规范下女性处于不利地位,但有证据表明在许多社会中传统规范正在发生变化。在女性中观察到居住在城市社区、接受教育与更好地了解HIV知识之间存在正相关关系,尽管这并不总是等同于降低风险行为。
女性在许多与HIV相关的问题上,如贫困、暴力和性别规范方面,仍然处于不利地位。至少在非洲,有证据表明在教育和性别规范领域出现了积极变化。然而,亚洲的情况在很大程度上尚未得到探索。