Men and women have different behavioral, biological, and
psychological risk factors for HIV/AIDS.
Risks of Being A Man (1)
Generally, more men than women are HIV+. This is true
for all regions of the world except Sub-Saharan Africa.
All over the world, men have more sex partners than
Men who have sex with men have the biological risks
associated with anal sex.
Men are much more likely than women to abuse alcohol
and drugs--two behaviors that increase the likelihood of engaging
in risky sexual practices that put them at risk for contracting and
Men are more likely to inject drugs, exposing them
to the risk of HIV from infected needles and syringes.
The Risks of Being A Woman
The percentage of adults living with HIV/AIDS worldwide
who are women has been steadily increasing (2, 3). In Sub-Saharan
Africa, women's rates of HIV infection have already surpassed men's.
Although more men than women have been diagnosed with
HIV since the beginning of the epidemic, more women than men have
died of HIV, reflecting gender differences in access to medical care.
Because of socioeconomic inequities (less education, fewer jobs) and
gender norms, (partner age differences, partner communication practices)
many women do not have control over when (the timing) and how (whether
condoms are used) sex occurs.
Women are far more likely to experience gender-based violence, including
physical and sexual abuse, in which they do not have control over the
safety of sexual intercourse.
Women are far more likely to become infected through
heterosexual intercourse than they are through any other means of
transmission (4, 5).
Women are more likely than men to need blood transfusions,
because of blood lost during childbirth. Receiving HIV-infected blood
in a transfusion is still a risk factor for HIV/AIDS in many countries.
Socioeconomic inequities and social unrest also force
some women into exchanging sex for comfort, goods, or money (6).
The Risks of Being Transgender
Although there is limited information about rates of HIV
among transgender people, rates are expected to be higher because transgender
people have more behavioral risks factors, such as substance abuse and
use of shared needles (for injection of hormones as well as for illicit
drugs), irregular condom use, and multiple sex partners (8, 9).
In the United States, the group with the highest rates
of HIV infection is men who have sex with men. This group has the
highest rates of unprotected anal sex, which is a behavioral risk
factor for HIV transmission and contraction.
In most other regions of the world, however, the group
with the highest rates of HIV is people who have heterosexual intercourse.
In the U.S., racial and ethnic minorities represent
the majority of new AIDS cases, the majority of Americans living with
AIDS, and the majority of deaths among persons with AIDS.
Most of the excess risk of HIV/AIDS among African-Americans
and Latinos reflect discrimination in employment, housing, earning
power, and educational opportunity (10). This discrimination relegates
minorities to lower levels of socioeconomic status (SES) and to the
risks associated with lower SES.
status indicates people's standing in society,
and is usually measured by their income, occupation, or educational
attainment. Socioeconomic status is one of the most powerful predictors
of sickness and health.
People with lower SES are more likely to contract
and transmit HIV/AIDS, perhaps because they have less knowledge about
HIV/AIDS, because they are surrounded by people who are more likely
to have HIV/AIDS, and because they are more likely to use drugs and
practice unsafe sex to escape from stress (11, 12).
HIV+ people with lower SES also die sooner than HIV+
people with higher SES, because of their lack of access to medical
care, the high cost of antiretroviral drugs, and their lowered immunity
from other illnesses.
About half of all new HIV infections worldwide, or
approximately 6,000 per day, occur among young people aged 15-24,
the majority of them young women (12).
In US, for men who have sex with men, younger age
is strongly correlated with increased high-risk sexual behaviors (unprotected
Despite high levels of sexual activity, young people
often do not know the basic facts about HIV/AIDS, which puts them
at risk. In 17 countries of Africa, more than half of young people
demonstrated that they did not know how to protect themselves from
HIV disease morbidity and mortality vary greatly within
and between nations.
In the United States, for example, annual number of
deaths by HIV is highest in the South. U.S. regional disparities continue
to increase over time (15). Limited access to healthcare, poverty,
and discrimination all contribute to these regional disparities.
4. Türmen, T. Gender and HIV/AIDS. International
Journal of Gynecology and Obstetrics, 82: 411-418, 2003.
5. Joint United Nations Programme on AIDS (UNAIDS). Gender
and HIV/AIDS: Taking stock of research and programmes. UNAIDS Best Practice
Collection. Geneva, Switzerland: Joint United Nations Programme on HIV/AIDS,
6. Clements-Nolle, K., Marx, R., Guzman, R., & Katz,
M. HIV prevalence, risk behaviors, health care use, and mental health
status of transgender persons: Implications for public health interventions.
7. Denny, D. Transgendered youth at risk for exploitation,
HIV, and hate crimes. American Educational Gender Information Services,
Inc., 1995. Retrieved on January 20, 2004 from http://www.aidsinfonyc.org/Q-zone/youth.html.
8. Department of Health and Human Services. Fact Sheet
on AIDS and Transgender Persons. Retrieved on October 5, 2004 from http://www.surgeongeneral.gov/aids/factsheets/transgender.html.
9. Quinn, S.C. AIDS and the African American woman: The
triple burden of race, class, and gender. Health Education Quarterly,
11. Feldman, D.A. (Ed). Culture and AIDS. New York, NY:
12. United Nations Population Fund (UNFPA). State of World
Population 2003 Making 1 Billion Count: Investing in Adolescents’
Health and Rights. New York, NY: United Nations Population Fund, 2003.
13. Kalichman, S.C. Preventing AIDS. A Sourcebook for
Behavioral Intervention. Mahwah, NJ: Lawrence Erlbaum Associates, 1998.
14. Feinstein, N. and Prentice, B. The UNAIDS Gender and
AIDS Almanac. Los Altos, CA: Sociometrics Corporation, 2001.
15. Centers for Disease Control and Prevention (CDC).
Trends in the Percentage Distribution of Deaths due to HIV infection
by Geographic Region, USA, 1987-1999. Slide 21 of 36, Mortality slide
series L285. Retrieved on February 18, 2004 from http://www.cdc.gov/hiv/graphics/images/l285/l285-21.htm.