The study shows how gender inequality and harmful gender norms hinder the end of the AIDS pandemic with rising new infections and continued deaths in many parts of the world.
Last year, 650,000 people died of AIDS and 1.5 million were infected with HIV, the virus that causes the disease.
“The world cannot end AIDS by strengthening patriarchy,” said Winnie Byanyima, Executive Director UNAIDSwhich called for addressing the intersecting inequalities faced by women.
“The only effective road map to end AIDS, achieve the sustainable development goals and achieve health, rights and shared prosperity is a feminist road map,” she said.
“Women’s rights organizations and movements are already at the forefront of doing this bold work. Leaders should support them and learn from them.”
‘Dangerous inequality’ affects women
According to Dangerous inequality report.
Between 2015 and 2021, only 41 percent of married women aged 15-24 in 33 countries were able to make their own sexual health decisions.
The impact of gender inequality on women’s HIV risk is particularly pronounced in sub-Saharan Africa, where women accounted for 63 percent of new HIV infections in 2021.
In addition, adolescent girls and young women aged 15 to 24 in the region three times more likely contract HIV than their male counterparts.
The question of power
Power is the driving factor, UNAIDS said, citing a study that found girls’ vulnerability to HIV infection was reduced by 50 percent if they were allowed to continue school and complete secondary education.
“When this is backed up by an empowerment support package, the risks for girls are further reduced,” the agency said in a statement.
“Leaders must ensure that all girls attend school, are protected from violence that is often normal, including through underage marriage, and have economic opportunities that guarantee them a hopeful future.”
Meanwhile, “harmful masculinities” dissuade men from seeking help. In 2021, only 70 percent of men living with HIV were accessing treatment, compared to 80 percent of women.
“Increased gender-transformative programming in many parts of the world is key to stopping the pandemic,” the report says.
Young lives in danger
Treatment disparities between adults and children also constrain the AIDS response, but closing the gap will save lives.
While more than three-quarters of adults living with HIV receive antiretroviral therapy, just over half of children receive this lifesaving drug.
Last year, children accounted for only four percent of people living with HIV, but 15 percent of all AIDS-related deaths.
Discrimination, stigmatization and criminalization of key populations are also taking lives, UNAIDS added.
The new analysis does not show a significant decline in new infections among gay men and other men who have sex with men, either in the West and Central Africa region or in the East and South region of the continent.
“Facing with an infectious virus, failure to make progress in key populations undermines the entire AIDS response and helps explain the slowdown in progress,” the agency warned.
The report also shows that progress in the fight against inequality is possible.
For example, while surveys often indicate lower service coverage among key populations, in three districts in Kenya, HIV treatment coverage among female sex workers is higher than among women in general.
According to Ms Byanyima, countries know what to do to end inequality.
She listed activities that include make sure all girls attend school, combating gender violenceas well as support for women’s organizations.
“Encourage healthy masculinity— replace harmful behaviors that exacerbate risks for everyone. Make sure services for children living with HIV reach them and meet their needs, closing treatment gaps so we can end AIDS in children forever,” she continued.
“Decriminalizing people in same-sex relationships, sex workers and people who use drugs, and investing in community-led services that enable them to turn on, will help break down barriers to services and care for millions of people.”
Equalization benefits everyone
The report also shows that donor funding is helping to stimulate more funding from governments. However, new investment is urgently needed to address inequalities, especially at a time when many richer countries are cutting aid to global health.
Increasing support is critical to restarting the AIDS response.
“What world leaders need to do is very clear,” said Ms Byanyima. “In a word: Call. Equalize access to rights, equalize access to services, equalize access to the best science and medicine. Equalization will not only help the marginalized. This will help everyone“.