Impact of HIV on women

Several reports have highlighted the devastating impact of HIV on women, particularly because of the patriarchal nature of our society.

For that matter, women hardly have a say in decision-making in their relationships. Impact of HIV on women in Uganda, a study by Valeria Durrant, revealed the impact of HIV on both HIV positive and HIV negative women in Uganda.

“Both afflicted and non-afflicted women are greatly affected by the AIDS scourge through their multiple roles as individuals, caregivers, and mothers. Research demonstrates that AIDS in Uganda presents severe socioeconomic implications for women as well as a higher risk for infection due to cultural expectations, subordinate status, and patriarchy in the society.

Shanura Jimbo of Uganda Network of Young People Living with HIV and AIDS and an HIV advocate, notes that HIV’s effect on women transcends medical issues. She is of the view that its impact manifests as systematic discrimination, significantly restricting access to employment, social acceptance, and overall life opportunities.

“This societal barrier, often referred to as stigma and discrimination, undermines national development goals and gender equality efforts,” she says.

Florence Buluba, executive director NACWOLA (National Community of Women Living with HIV/AIDS), points to the gender roles, which make women carry the burden of care when their loved ones are sick, as one of the effects of HIV on women.

“Most often, these women are neglected and isolated as there is usually nobody to care for them when they too are sick,” says Buluba, adding: “They are also more vulnerable economically as they are less financially empowered compared to men.”

Jimbo says women living with HIV often face economic struggles that arise from prejudiced hiring practices and job insecurity.

Even with the existence of laws protecting individuals against discrimination based on their health status, women with HIV suffer discrimination in the job market.

“Many women are either deterred from applying for jobs in the formal sector or are refused employment following mandatory or perceived health screenings. Employers often cite potential health costs, absenteeism, or pressure from other employees as reasons for exclusion,” says Jimbo.    

Additionally, women in the workforce are not exempt from discrimination as Jimbo explains. She says, “Women who acquire HIV while employed face termination or coerced resignation, especially in the private sector and non-governmental organisations.

This displacement forces them into precarious informal employment or high-risk economic activities, further increasing their vulnerability and reducing their long-term earning potential.”

Owing to fear of disclosure, women living with HIV can choose to avoid seeking promotions, advanced training or leadership roles, which to Jimbo creates an “effective glass ceiling that limits professional growth and income stability.”

Despite media efforts to end HIV stigma by making champions of those who disclose their positive status, women living with HIV continue to suffer stigma.

“The greatest non-medical challenge for WLHIV is the pervasive social stigma that marginalises them within their families and communities. The burden of this stigma is often heavier on women due to existing gender inequalities and cultural norms that disproportionately blame women for infection,” Jimbo notes.

HIV’s impact on women can also be as devastating as family rejection, especially in case women disclose their status.

“Disclosure of HIV status frequently results in divorce, eviction from the marital home, and disinheritance, especially following the death of a husband. This leaves women, particularly those in rural settings, without essential shelter and land ownership rights,” Jimbo says.

The rejection can also trickle to social gatherings, religious and community projects, leaving women feeling isolated.

“This isolation limits access to vital support networks, cooperative savings schemes, and community-driven economic empowerment programmes,” says Jimbo.

Arguably, the worst form of stigma is internalised stigma, and according to Jimbo, it is where women live with the constant threat of public rejection. This then leads to high levels of internalised stigma, manifesting as anxiety, depression, and reluctance to consistently adhere to Antiretroviral Therapy (ART). “This impacts both mental health and treatment efficacy,” she says.

It is also important to note that women are culturally disadvantaged. “Cultural practices, such as inheritance laws, which restrict the transfer of wealth and property to males only, worsen the situation,” says Buluba.

The education disparity between men and women, most especially in rural areas, also seeks to aggravate the impact of HIV on women.

Buluba says the disparity, where women are less educated compared to men, means they have limited access to HIV/AIDS information and services, and are less informed about the management of the disease.

“It is important to note that women, being more affected by HIV/AIDS than men, increase the number of children affected via mother-to-child transmission,” she says.