Though the infectious agent may be the same, the risks and consequences of contracting HIV can differ dramatically for girls and boys, and young women and men. As the epidemic grips developing countries, the gender differences play out in startling numbers and stories, and demand a gender-sensitive response. At a minimum, the privilege of good quality basic education as well as skills-based HIV/AIDS education must be extended equally to boys and girls.
World-wide, 50 percent of all adults living with HIV/AIDS are female. However, the rate of HIV/AIDS among women is rapidly increasing: in just three years, it jumped from 41 percent of all infected adults in 1997, to 47 percent in 2000. In Sub-Saharan Africa, which has 70 percent of the world's HIV/AIDS infections, 58 percent of HIV positive adults are women.
The escalating risk is especially evident among young women and girls. Half of all new infections occur among young people (15-24 years old). Among young people in developing countries who are living with HIV/AIDS, 64 percent are female. However, this pattern differs across countries: where prevalence rates are low, young men usually have higher rates of infection than young women; while in countries with higher HIV infection rates, young women typically surpass young men of the same age. For example, in Lesotho, where the estimated HIV prevalence is 31 percent 15-49 year olds, 11 percent of young men and 25 percent of young women are infected.
Throughout sub-Saharan Africa, young women (15-24) are 2 times more likely to be living with HIV/AIDS than young men. This trend is also emerging in some Caribbean countries.
Why are HIV infection rates in young women escalating world-wide, particularly in high prevalence countries? The reasons are numerous and based in biological, social and economic realities.
From a biological perspective, an immature female genital tract is more likely to tear during sexual activity, creating a higher risk of HIV transmission. The presence of untreated sexually transmitted infections (STIs) enhance the risk of transmission. In women, many STIs are left untreated because they are often asymptomatic or because young women lack knowledge and access to sexual health services.
Social and economic factors compound the biological factors and increase young women's vulnerability to infection. For example:
- Power differentials and differences in social norms regarding girls and women affect young women's ability to control sexual situations (when and with whom they engage in sexual activities), thus making them vulnerable to gender-based violence and coerced sex;
- Young women may be forced into commercial sex or informal transactional sex in exchange for money, food or shelter;
- Young women tend to have sexual relations with older males, sometimes because males believe that young girls are free of HIVAIDS and thus safer partners. The older and more sexually experienced males are more likely to have contracted STIs or HIV/AIDS, and are more likely to control sexual situation;
- Girls and young women are expected to know little about sex and sexuality, but this lack of knowledge puts them at risk for HIV infection. Indeed, surveys have shown that fewer girls than boys, aged 15-19, have basic knowledge about how to protect themselves from HIV/AIDS;
- Women constitute the majority of the world's poorest. Their lack of access to life skills-based education, economic resources and opportunities deem them vulnerable to infection.
The net effect of the HIV/AIDS pandemic is to undermine or reverse hard-won gains in education and other development areas, as well as to complicate any attempts at further progress.
HIV/AIDS impacts the lives of girls differently than boys. For example:
- HIV positive females are less likely than males to receive family support and resources;
- The burden of care often falls on females, while orphaned girls are more likely to be withdrawn from school than their brothers;
- HIV/AIDS is threatening recent positive gains in basic education, and disproportionately affecting girls' primary school enrolments. An investigation by the Girls' Education Monitoring System found that children's participation in formal schooling is decreasing in African countries with the highest prevalence of HIV (11 percent or greater). Within these high prevalence countries, girls are most affected and their enrolment has decreased in the past decade. This is in contrast to countries with lower HIV incidence, where enrolments have increased. The researchers warn that, "if projections of HIV/AIDS infection rates over the next decade are borne out, current positive gains [in education] in most countries of Sub-Saharan Africa, and perhaps other geographic regions, are likely to be wiped out."
Major Impact On Education
Despite the increasing commitment to promoting the health and learning of school children, progress on these fronts is seriously threatened by HIV/AIDS. As the pandemic grips the developing world, HIV/AIDS is debilitating not only health, but social, economic and cultural systems. Symptoms of this are clearly manifested through the education sector, particularly in sub-Saharan Africa:
- The capacity to supply schooling services has decreased where large numbers of teachers and other staff have become infected and affected by HIV/AIDS;
- Quality of education has been jeopardised where teachers are affected by family trauma or AIDS-related illness themselves, where families lose purchasing power, and where fewer resources are available to support services and infrastructure;
- Demand on the current formal system has diminished where fewer children seek to enter or stay in school – for example, where fewer children are born, where children are sick, and where children leave school due to changed familial, social and economic circumstances, particularly those children who are orphaned by HIV/AIDS;
- Equality of opportunity has moved further beyond reach as girls' opportunities are disproportionately affected by HIV/AIDS. Equal opportunity is limited by girls' vulnerability to infection, particularly in high prevalence settings, and where the effects of poverty and other stressors on society are exacerbated by the low status of girls and women.
Education is one of our key defences against the spread and impact of AIDS. The evidence for this is growing: in countries with severe epidemics, young people with higher levels of education are more likely to use condoms and less likely to engage in casual sex than their peers with less education.
However, just as HIV targets the body's defence system, the HIV/AIDS pandemic is disabling the education sector's core functions and protective value. Achieving Education for All will require making HIV/AIDS the highest priority in the most affected countries. As committed to in Dakar, education systems have a responsibility for ensuring the right of every child to a good quality education and HIV/AIDS prevention must be considered an integral part of quality education.
Only by managing the impact of HIV/AIDS on children, young people and the education system itself can education realise its potential to decrease vulnerability to HIV/AIDS and reduce the risk of further infections.
There are three key lines of action in the education response to the challenge of HIV/AIDS and its effects on girls:
- Get girls into school - and ensure a safe and effective environment which can keep them at school and learning.
- Ensure HIV/AIDS prevention education is provided - as part of the overall quality education that all children and young people deserve.
- Ensure special measures for those not in schools - to extend the definition of education well beyond schools alone, and to consider the needs of working children, street children, those who are exploited or made vulnerable by poverty and poor living conditions.
These key lines of action are supported by strategic actions on the ground.
What can be done to protect girls and young women from HIV/AIDS and its effects?
- HIV/AIDS is stubbornly resisting quick and narrow responses. Stemming its spread and mitigating its pervasive impact require that we correct the fundamental inadequacies that propagate its transmission. This includes unacceptable gender inequities in basic education. Keeping girls in school so that they can complete their education is important and requires measures such as providing safe water and sanitation in all schools. Local programming experience suggests that a lack of privacy and adequate water and sanitation facilities may be a factor in girls' drop out, particularly as they enter puberty and begin menstruation.
- Schools provide an ideal opportunity to ensure girls' and boys access to good quality skills-based HIV/AIDS prevention education.
- Well-implemented school-based HIV/AIDS prevention programmes have shown to reduce key HIV/AIDS risks, particularly when they go beyond the provision of information, and help young people develop knowledge, attitudes and life skills needed to protect themselves against HIV/AIDS. HIV/AIDS education should include discussions of gender roles, rights and responsibilities to help boys and girls understand and address stereotypes, gender bias, power relations and discrimination. Skills-based HIV/AIDS education uses participatory approaches to involve both children and young people in active learning experiences that can go well beyond HIV/AIDS to include other health and personal development issues.
- Schools can also provide access to livelihood skills education, to help ensure wage-earning opportunities to young girls and women, thus reducing economic dependence.
- Schools need to ensure that they actively fight against harassment, violence, and sexual abuse. Special security measures and behaviour protocols must be ensured to protect the rights of children and young people in education systems.
- Schools must work to reduce discrimination girls and young women face at school, by enforcing appropriate policies and practices.
Other important measures to protect girls and young women from HIV/AIDS and its effects include:
- Addressing the denial, discrimination, complacency that act as barriers to taking action to address HIV/AIDS;
- Fostering equal partnerships and participation between boys and girls, young men and women;
- Promoting equity among boys and girls, young men and young women in care-giving for relatives with HIV/AIDS (i.e. promoting the participation of boys and men in family life);
- Making sure that HIV/AIDS-related messages do not reinforce gender stereotypes or other biases related to HIV status, race, religion or culture.
- Ensuring stronger home-school-community partnerships to better coordinate education with other complementary strategies such as supportive policies and legal frameworks, access to condoms, to STI prevention and treatment services.
The information herein was adapted from:
UNAIDS, 2002. AIDS Epidemic Update.
UNICEF, UNAIDS, WHO, 2002. Young People and HIV/AIDS.
UNAIDS, 2001. Children and Young People in a world of AIDS.
Chesterfield R, Enge KI, Martinez-Enge P, 2001. Girls' Education and Crisis. Prepared for USAID, Global/Women in Development. Girls' Education Monitoring System.
UNAIDS, 2001. AIDS Epidemic Update.
UNAIDS, 2001. Resource Packet on Gender and AIDS.
UNAIDS, 1998. Gender and HIV/AIDS. Technical Update. UNAIDS Best Practice Collection: Technical Update Geneva: UNAIDS, September, 1998. www.unaids.org
HIV/AIDS Education: A Gender Perspective, Tips and Tools. A set of training materials intended for teachers and other educators in formal or non-formal settings. The critical need for educators to understand gender and HIV/AIDS issues is a central theme, and assisting them to apply a gender analysis to classroom materials, strategies, and methodologies is the main objective. UNICEF, 2002. http://www.unicef.org/lifeskills/index_documents.html
Gender, HIV and Human Rights: A Training Manual. UNIFEM, 2000.
UNICEF Life Skills-Based Education website:
Girls, HIV/AIDS and Education. UNICEF paper.
Briefing Notes on Gender and HIV/AIDS, 2003
HIV/AIDS Education: A Gender Perspective, Tips and Tools (English)
For French and Spanish documents, please see: References - Technical and Policy Documents.