Gender is one of the factors that influence exposure to illnesses. Women in most societies are at the periphery and thus face the most discrimination. This section provides a literature review on the relationship between HIV and gender, focusing on stigma and discrimination, psychosocial pressures, and prevalence.
HIV and gender: Stigma and Discrimination
Researchers in different parts of the world have studied how HIV and gender are related. Zinyemba et al. examined the effects of HIV on school attendance among boys and girls (Zinyemba et al., 2021). The study was done in Zimbabwe. Women are disproportionately affected by different illnesses in society compared to men, and the researchers aimed to validate whether girls were most concerned with HIV. The participants were between 6 and 18, taken from a nationally representative sample comprising approximately 11,673 children (Zinyemba et al., 2021). The collected data from the survey was analyzed using the decomposition linear multivariate analysis. The results indicated a significant difference in school attendance for boys and girls infected with HIV (Zinyemba et al., 2021). HIV-positive girls were most affected by being HIV positive. Therefore, this study shows that HIV-positive females are more marginalized than their male counterparts.
Zimbabwe is a low-income country; ideally, it would be expected that these disparities between gender and HIV manifest. In response, researchers have also delved into HIV and gender discrimination in liberal countries (Magno et al., 2019). Magno et al. systematically reviewed different articles to evaluate the correlation between bias associated with gender identity and how it affected exposure to HIV/AIDS (Magno et al., 2019). Further, the researchers aimed to identify which policies could be implemented to reduce higher exposure of some gender to HIV and AIDS. The researchers used five articles, including PubMed, Scopus, Web of Science, Science Direct, and LILACS, published between 2004 and 2018.
Similar to the findings by Zinyemba et al., the researchers found that women and transgender were more exposed to discrimination within the family and public spaces (Zinyemba et al., 2021; Magno et al., 2019). Transgender women in liberal countries such as Japan and the United States faced discrimination in schooling and public spaces. Others found it difficult to reveal their gender identity due to the stigma they encountered due to their gender. With pervasive discrimination, access to healthcare also became a crucial issue for women and transgender women. Consequently, it was difficult for transgender women to access HIV treatment and services in their communities.
Further, transgender women hardly accessed testing and counseling services for the general population, unlike the general population (Magno et al., 2019). This systematic review confirmed a positive relationship between gender and HIV. Gender can influence access to testing, treatment and prevention services, and counseling (Magno et al., 2019). Therefore, gender adversely affects exposure to HIV and treatment outcomes.
According to the researcher, HIV-positive individuals face discrimination because of their status. The study was undertaken to determine whether discrimination was real in hospital settings. The number of participants was 400 (Alaqil & Alshouibi, 2019). The researchers found that some dentists had negative attitudes toward people infected with HIV (Alaqil & Alshouibi, 2019). Therefore, they had negative attitudes when dealing with HIV-positive patients. Alaqil & Alshouibi also found the presence of stigma in dental services (Alaqil & Alshouibi, 2019). Mahamboro et al., also found discrimination in healthcare facilities (Mahamboro et al., 2020). Women were more frequently subjected to moral judgment than men. Thus, most studies are consistent that while men and women may experience discrimination for being HIV-positive, the level of discrimination among females is higher.
HIV and Gender: Psychosocial Pressures
HIV is associated with a sense of fear. It is one of the infections that can lead to moral judgment by part of society where people do not have enough education about the disease. Further, because of the nature of the virus and the experiences infected persons endure, there are higher risks of psychosocial pressure. These psychosocial issues disproportionately affect women, men, and transgender and gender-diverse people. Researchers have found a positive correlation between gender and exposure to numerous infections, including HIV (Kalateh Sadati et al., 2018; Newcomb et al., 2019). Kalateh Sadati et al., aimed to determine the psychosocial encounters of women infected with HIV and AIDS (Kalateh Sadati et al., 2018). Their study was necessitated by the fact that women were most vulnerable to various forms of discrimination than their male counterparts (Kalateh Sadati et al., 2018). The study incorporated ten Iranian women who were HIV-positive. The study was qualitative, and the researchers collected information from participants using focus groups. Data analysis was accomplished using conventional data analysis methods. The authors’ findings were similar to Magno et al., because, their content analysis revealed that women encountered discrimination, stigma, and self-stigma (Kalateh Sadati et al., 2018; Magno et al., 2019). Not only was discrimination among women manifest in their homes, but it was also revealed in the health sector, where health workers stigmatized the women (Kalateh Sadati et al., 2018). The study is consistent with other findings that HIV-positive men and women experience different societal vulnerabilities.
Newcomb et al., study focused mainly on Transgender and Gender Diverse people (TGD) (Newcomb et al., 2019). The authors’ study objective was to determine the health issues that affected transgender youths and young adults. In addition, the study intended to categorize the health issues the groups were facing (Newcomb et al., 2019). Another objective was to find the relationship between gender-related variables, health issues, and psychosocial variables. The study was longitudinal, with data derived from Chicago. Participants in the study were 1079 with an average age of 20.8 years (Newcomb et al., 2019). One of the findings was that depression and suicidal ideation was high among TDG youths with HIV (Newcomb et al., 2019). Further, some youths resorted to substance abuse to deal with their HIV conditions. Also, TGD people experienced worse health outcomes compared to cisgenders. This study shows that the psychosocial experiences of HIV-infected persons will vary depending on their age and even their surroundings (Newcomb et al., 2019). Psychosocial pressures are more prevalent among people who identify as transgender and diminished in cisgender persons.
In the early years of the HIV outbreak, the rate of infections was unprecedented in many countries. With the virus being novel, many countries grappled with ineffective initiatives and preventative approaches. However, the infection curve has almost flattened in the last few decades, with new infections being lower. Researchers have investigated the epidemiology of HIV and how it varies between genders. In particular, Girum et al., researched the current HIV epidemiology trends among men and women in Ethiopia (Girum et al., 2019). The study objective was to identify whether there were differences in the current infection rate between men and women in Ethiopia. Understanding the infection pattern between men and women would inform government policy-making in Ethiopia.
