Rite and Reason: Responding to the worldwide Aids epidemic will not succeed until robust action is taken to eliminate discrimination against women, writes Fr Michael Kelly.
Twelve years ago, Jonathan Mann, the great human rights advocate who had charge of the global HIV and Aids programme, said that the central Aids issue is not technological or biological - it is the inferior status or role of women. "When women's human rights and dignity are not respected, society creates and favours their vulnerability to Aids," he said.
This is precisely how it has been in regions where the main route for HIV transmission is sexual activity between men and women. Women are more likely than men to be infected. They become infected at younger ages than men and as a result are likely to be younger when they die. The negative impacts of the epidemic are more extensive and intensive for them than for men.
This appears strongly in sub-Saharan Africa, where almost 60 per cent of infected people aged 15 and above are women - for every 10 infected men, there are 14 infected women.
In the region, about 6.2 million young people between the ages of 15 and 24 are HIV infected. Of these 4.7 million are young women, and 1.5 million are young men. In almost every part of the world, women tend to live longer than men, but Aids is changing that. Already in Zimbabwe, life expectancy for women is now lower than for men and a similar pattern is emerging in other countries in southern Africa.
Clearly, the epidemic represents an accelerating catastrophe for women and girls. It is as if it had singled them out for a massive and ferocious onslaught.
Physiological, sociological and economic factors play a significant role in what is happening. The physiology of the female body is such that HIV transmission from male to female is seven times more likely than transmission from female to male.
But very much that goes on in society adds greatly to women's biological vulnerability. Attitudes, practices and expectations create social and economic situations that are more significant for female HIV infection than any biological factor.
In many cultures, socially constructed images of what it means to be a man portray a picture of the controlling male. The man is seen as the main initiator of sexual activity and the dominant partner in most sexual interactions. On the other hand, stereotyped images of what it means to be a woman portray her as submissive, compliant and docile.
Images such as these lead to double standards in the area of sexuality, with promiscuity among men being more readily condoned than among women. They also lead to imbalances in decision-making power, with women almost invariably being in a subordinate role and submissive to men. A woman's lack of personal control of her sexual life is a key driver of the Aids epidemic.
Jonathan Mann spoke about society creating conditions of HIV vulnerability for women. More recently, Pope Benedict XVI deprecated "the mindset persisting in some cultures where women are still firmly subordinated to the arbitrary decisions of men". In effect, both are saying that by according an inferior status to women, the world has created an environment favourable to HIV transmission.
This means that no response to the Aids epidemic will succeed until robust, sustained and specific action is taken to reduce and ultimately eliminate the prejudice, discrimination and unequal treatment that women experience. Without a frontal attack on the injustice of gender inequality - in church, state and every walk of life - the dominance of the epidemic will continue.
Ireland has had notable success in promoting gender equality in education, an achievement that is integral to its being ranked 10th in the world in narrowing the gender gap. This success is worth sharing with other parts of the world. Building on the experience of what it took to achieve gender equality in education, Ireland has the potential to reduce one of the world's most persistent gender inequalities, the fact that 70 per cent of the 130 million children who are out of school are girls.
Doing this would equip women in their efforts against being exploited as objects. It would also equip girls with knowledge, skills, attitudes and values that would support them in living responsibly and safely in a world with HIV and Aids. And it would hasten the day when Aids no longer has a female face.
Fr Michael Kelly SJ is based in Lusaka, Zambia. He will deliver the annual Trócaire lecture at 7.30pm tonight in St Patrick's College, Maynooth.