Why are women at risk of acquiring STIs and HIV infection?

Women are disproportionately affected by sexually transmitted infections (STIs) and HIV/AIDS due to a combination of biological, socio-cultural, and structural factors. These factors contribute to increased vulnerability to infection, limited access to prevention and treatment services, and barriers to negotiating safer sexual practices. Understanding the reasons why women are at risk of acquiring STIs and HIV infection is crucial for designing targeted interventions and addressing health disparities. Several key factors contribute to women's heightened vulnerability:

1. Biological Factors:

   • Women are biologically more susceptible to STIs, including HIV, due to the structure and composition of their genital anatomy. The mucous membranes of the vagina and cervix provide a larger surface area for viral and bacterial pathogens to enter the body compared to the penile urethra in men.
   • Additionally, hormonal changes during the menstrual cycle, pregnancy, and menopause can alter vaginal pH, mucosal integrity, and immune responses, potentially increasing susceptibility to STIs and HIV infection.

2. Gender Power Imbalance:

   • Gender inequalities and power imbalances within sexual relationships often undermine women's ability to negotiate safer sex practices, including condom use and contraceptive choices.
   • Social norms and expectations regarding gender roles and sexuality may restrict women's autonomy and decision-making authority regarding their sexual health, leading to increased risk of unprotected sex and exposure to STIs, including HIV.

3. Violence and Coercion:

   • Gender-based violence, including intimate partner violence, sexual coercion, and rape, is prevalent worldwide and exposes women to heightened risks of STIs and HIV infection.
   • Survivors of violence may face barriers to accessing sexual and reproductive health services, disclosing their HIV status, and negotiating safer sexual practices, further exacerbating their vulnerability to infection.

4. Economic Disempowerment:

   • Economic factors, including poverty, limited educational opportunities, and unequal access to resources, contribute to women's vulnerability to STIs and HIV infection.
   • Economic dependence on male partners or transactional sex for survival may limit women's ability to negotiate safer sex, access healthcare services, and protect themselves from exploitation and coercion.

5. Limited Access to Healthcare:

   • Structural barriers, such as inadequate healthcare infrastructure, limited availability of sexual and reproductive health services, and stigma associated with seeking STI/HIV testing and treatment, hinder women's access to essential healthcare services.
   • Women in marginalized populations, including sex workers, transgender individuals, migrants, and indigenous communities, face intersecting barriers to healthcare access, exacerbating their vulnerability to STIs and HIV infection.

6. Stigma and Discrimination:

   • Stigma surrounding STIs and HIV/AIDS perpetuates fear, shame, and silence, discouraging women from seeking testing, treatment, and support services.
   • Fear of judgment, discrimination, and social exclusion may prevent women from disclosing their HIV status, accessing prevention tools such as condoms and PrEP, and seeking care for STIs and other reproductive health issues.

7. Vertical Transmission:

   • Pregnant women living with HIV face the risk of transmitting the virus to their infants during pregnancy, childbirth, or breastfeeding, highlighting the intergenerational impact of HIV/AIDS.
   • Without access to prevention of mother-to-child transmission (PMTCT) services, antiretroviral therapy, and obstetric care, women and their infants are at heightened risk of HIV transmission and adverse health outcomes.

In conclusion, women are at increased risk of acquiring STIs and HIV infection due to a complex interplay of biological, socio-cultural, and structural factors. Addressing gender inequalities, promoting women's empowerment, expanding access to comprehensive sexual and reproductive health services, and combating stigma and discrimination are essential for reducing women's vulnerability to STIs and HIV/AIDS and advancing gender equality in health.