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Gender disparities in the age patterns of HIV infection in Africa

Jacob A. Adetunji, PhD, Office of Population and Reproductive Health, Bureau for Global Health, USAID, GH/PRH/PEC, Rm. 3.06-25, RRB, Washington, DC 20523, 202 712-4095, jadetunji@usaid.gov

Background Although the prevalence of HIV/AIDS is known to be higher among women than men, recent evidence suggests that a marked age-specific gender disparity exists in the distribution of the epidemic. This paper investigates this age-specific gender disparity and its determinants.

Data and Methods The study is based on population-based nationally representative sero-survey data collected in Mali (2001), Zambia (2002) and Kenya (2003). Dry blood spots from finger pricks were collected from consenting adults between ages 15 and 49 using a single-use, spring-loaded, sterile lancet and were tested for HIV.

Results The prevalence of HIV infection was higher among women by 50% in Mali, 40% in Zambia and 90% in Kenya. In Mali, women age 30-39 were thrice as likely to be HIV positive as adolescents; the ratio was 8:1 among men. Marked age-specific risk ratios of infection exist between men and women: in Mali and Zambia, adolescent women had 4 times the infection rates among adolescent men. In Kenya, the ratio was 7 times to 1. Women aged 20-24 had 4-5 times the HIV infection rate of men. The higher risk of infection among women tends to correlate with the preventive behavior such as condom use with non-cohabiting partner.

Conclusion Although HIV-infection rates in Africa may have been male-led, women now carry a heavier burden of HIV infection than men. Younger women carry a much heavier HIV infection burdens than men. The implications of these findings for program interventions are discussed.

Learning Objectives:

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

HIV/AIDS, Malaria, TB: From Prevention to Treatment

The 132nd Annual Meeting (November 6-10, 2004) of APHA