Around the world, people who have HIV are living longer with the condition. Fewer people are developing AIDS and the number of people who die from AIDS-related causes is on the decline.

But girls and women across the globe continue to face barriers to protecting themselves from the risk of HIV. Persistent gender inequality prevents many of them from exercising control over their own lives. In turn, this puts girls and women at increased risk of contracting the virus and potentially developing AIDS.

For girls and women to lead lives free of HIV and AIDS, more work needs to be done to address the cultural, social, and economic inequalities that block them from making their own choices and protecting their health. With greater freedom and financial independence, girls and women are better able to safeguard their wellness and reach their full potential.

The impact on young women

In many parts of the world, HIV disproportionately affects adolescent girls and young women between the ages of 15 and 24 years old. For example, girls and women between those ages make up only 10 percent of the general population in sub-Saharan Africa. But according to UNAIDS, they account for about 25 percent of HIV cases in the region.

Adolescent girls and young women also account for the majority of new HIV diagnoses among young people in Eastern Europe, Central Asia, and the Caribbean, reports UN Women.

In many cases, gender inequality puts them at greater risk.

Economic inequality and violence

Women in many communities around the world have fewer opportunities than men to earn an income and live independent lives. This economic inequality can push girls and women to form intimate relationships with older men who have resources available to share. Because HIV is more common in older men than younger men, that puts women in those relationships at increased risk of contracting the virus.

For example, a recent study in the Journal of the International AIDS Society found that in South Africa, women who have sex with older men are significantly more likely than other women to contract HIV.

Poverty also pushes some women to trade sex for money, food, or other resources. That raises their risk of exposure to sexually transmitted infections, including HIV. According to UNAIDS, women who do sex work are ten times more likely to contract HIV compared to the general population.

When women have lower social status and fewer financial resources than men, it reduces their bargaining power in relationships. That can make it harder for them to refuse sex or insist that their partners wear condoms.

Moreover, domestic violence affects millions of women around the world. In some regions, the World Health Organization reports, women whose partners are violent towards them are 1.5 times more likely to contract HIV compared to other women.

Barriers to education and healthcare

UNAIDS warns that globally, only 3 in 10 adolescent girls and young women have a full and accurate understanding of HIV. In many countries, girls don’t have the same access to education that boys do. That can negatively affect their ability to understand health information, as well as their ability to earn an income and make their own choices about their future.

Many girls and women also face barriers to accessing health services that could help them prevent or manage HIV. UNAIDS states that in 29 countries, for instance, women need to get permission from their husbands before they can access sexual or reproductive health services. In at least 79 countries, young people must get permission from their parents or legal guardians before they can use those services.

Girls and women in rural areas tend to have even less access to education and health services than those in city areas. In sub-Saharan Africa, for example, UNAIDS reports that adolescent girls and young women in rural regions are less likely than those in city areas to have an HIV test. They’re also less likely to say that they use modern methods of birth control. And in general, they tend to have less decision-making power over their own health.

Work in progress

According to a recent report from UNAIDS, the number of people who died from AIDS-related causes around the world dropped by 34 percent between 2010 and 2017. Last year, AIDS-related illnesses killed fewer than 1 million people — the lowest number this century.

Much of that change has been driven by the wider availability of antiretroviral therapy, the most effective treatment for HIV. When people with HIV receive antiretroviral therapy, they’re less likely to develop AIDS or to die from AIDS-related causes. They’re also less likely to pass the virus to someone else.

Thanks to domestic and international fund-raising campaigns, more people than ever before can access antiretroviral therapy. This has benefited many girls and women across the globe, as well as their wider communities.

But more work remains to be done. In 2016, about 17.8 million women were living with HIV, and many still can’t access treatment. That year alone, 1.7 million new HIV diagnoses were reported among adults, and roughly half of those were among women.

The takeaway: Gender equality is essential

Around the world, girls and women still face high rates of economic inequality, domestic abuse, and barriers to education and health services. These factors raise their risk of contracting HIV and potentially developing AIDS.

Empowering girls and women to reduce their personal risk of HIV and AIDS means ensuring they have equal access to education, healthcare, and opportunities to earn their own income. They also need to be able to live free from the threat of intimate partner violence.  

Great progress has been made on many fronts — but more work needs to be done. By working towards equality, communities can empower girls and women with the resources they need to manage their health.