ASIA: Marriage no safe haven for women

Ninety percent of women living with HIV in Asia are thought to have acquired it from their long-term partners
BALI, 12 August 2009 (PlusNews) - An estimated 50 million women in Asia are at risk of contracting HIV from male partners who engage in risky sexual behaviours, says a new UNAIDS report released at the 9th International Congress on AIDS in Asia and the Pacific (ICAAP) in Bali, Indonesia, this week.

The report, HIV Transmission in Intimate Partner Relationships in Asia, cites evidence from several Asian countries indicating that most women are acquiring HIV as a result of their partner's sexual behaviour, not their own: of the 1.7 million women living with HIV in Asia, more than 90 percent are thought to have acquired the virus from their husbands or long-term boyfriends.

"HIV and intimate partner transmission is nothing new - it was previously recognized under the term 'spousal infection'," said Dr Prasado Rao, director of the UNAIDS Regional Support Team for Asia and the Pacific.

"However, we need to expand this term to include MSM [men who have sex with men] - who are not gay but have sex with both female and male partners - injecting drug users, and clients of sex workers."

The drivers of the HIV epidemic in Asia vary, but there are common factors in all countries, such as high rates of unprotected paid sex, injecting drug users sharing contaminated needles, and unprotected sex by MSM.

The Commission on AIDS in Asia – an independent body of economists, scientists, civil society representatives and policy-makers from across the region - has estimated that up to 10 million Asian women sell sex, and at least 75 million men regularly pay for it.

Men who buy sex constitute the largest HIV-infected population group; most are either married or will get married, increasing the HIV risk for a significant number of women previously perceived as "low risk".

Secrecy often surrounds MSM behaviour so it is difficult to determine the precise number, but the Commission put the figure at around 16 million. Many are either married or have regular female partners, but do not always identify themselves as bisexual.

An estimated four million injecting drug users add to the number of men at higher risk of HIV infection who may pass the virus to their female partners.

Patriarchal culture

The strong patriarchal culture in Asian countries severely limits women's ability to negotiate safe sex in relationships; while multiple partners and extramarital affairs are tolerated for men, women are expected to abstain from sex until marriage and then remain faithful to their husbands.

In Indonesia, where HIV was initially concentrated among drug users, the virus is now spreading quickly through commercial sex networks; in Cambodia, India and Thailand the largest number of new HIV infections are occurring among married women.

Studies show that by 2008, women constituted 35 percent of all adult HIV infections in Asia, up from 17 percent in 1990.

"These women are a tragic reminder of the deeply engrained social construction of gender, which enables terrible acts to be perpetrated on women across the region, which tolerates extra marital sex and multiple sex partners for men, and which fails to enable women to negotiate safe sex and protect themselves from HIV," said Rao of UNAIDS.

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Domestic violence

The UNAIDS report also indicated that up to 65 percent of women in Asia experienced physical and or sexual violence at the hands of their intimate partners. Studies in Bangladesh, India and Nepal found HIV was linked to intimate partner violence and the extramarital behaviour of men.

A demographic and health survey in India showed that HIV prevalence was more than four times higher among women who experienced both physical and sexual violence from an intimate partner than among women who were not abused.

"Risks for women living with HIV are different and very high - they become exposed to domestic violence, experience disinheritance, and are sometimes disowned by their families," said Jean D'Cunha, regional director of the UN Development Fund for Women (UNIFEM).

D'Cunha noted that women who were married or in long-term relationships were being largely bypassed by current HIV/AIDS interventions, and called for a gender-based response to the problem of HIV transmission among intimate partners.

"Discrimination and violence against women and girls, endemic to our social fabric, are both the cause and consequences of AIDS," he said. "Striking at the root of gender inequalities and striving to transform male behaviours are key to effectively addressing the pandemic."


Theme (s): Gender Issues, HIV/AIDS (PlusNews), Prevention - PlusNews,

[This report does not necessarily reflect the views of the United Nations]

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Margaret Chan, Director-General of the UN World Health Organization, with Pamela Adhiambo, who is HIV positive,on a visit to Mbagathi District Hospital, Nairobi, Kenya
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