Access to Medical Treatment

Pages133-135

Page 133

The Issue

Women living with HIV may be routinely subjected to social barriers that decrease their ability to access treatment. Economic factors play a significant role, as women are more likely than men to lack money to pay for medication or transportation to treatment facilities. Women also traditionally assume greater domestic responsibilities, reducing their ability to travel to receive health care. These factors may be exacerbated by gender-based stigma and discrimination directed toward women living with HIV. For example, families with limited resources and multiple HIV-positive members may pay for treatment for the men only. Furthermore, because women may face persecution and violence if their HIV status is revealed, many refuse to seek testing or treatment. However, it should be noted that WHO/UNAIDS data indicate that women's access to treatment is similar to their share of total infections in many countries.

Legal and Policy Considerations

Gender-based disparities in treatment access raise difficult questions about the most effective way to change underlying social norms that negatively impact women. Prohibiting or criminalizing discriminatory behavior is one option to address these disparities. UNAIDS and OHCHR have urged countries to enact antidiscrimination laws that prohibit gender-based discrimination and reduce the vulnerability of women to HIV infection and the impact of HIV and AIDS. Most countries with rising HIV prevalence have laws against sexual violence and rape (see Topics 7.3, 7.5), and some have adopted more progressive property inheritance laws (see Topic 7.2). However, inadequate enforcement undermines the impact of these laws and leaves many HIV-infected women fearful of disclosing their status or seeking treatment. Other inequalities are less susceptible to punitive redress: if a family with limited resources chooses to treat male rather than female members, criminal sanctions are not an appropriate legal response.

These realities call for comprehensive strategies that build governments' capacity to enforce effective laws and create incentives to modify discriminatory practices. To break the economic dependency that puts them at risk, women and girls need greater access to education, income-generating programs, and job training opportunities. Governments can encourage microfinance programs, which have...

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