Gender Imbalance in the HIV Prevalence in Sub-Saharan Africa

Jacob A. Adetunji, U.S. Agency for International Development (USAID)

The HIV/AIDS epidemic in Africa, which was once male-led, now has a woman’s face. Using population-based HIV prevalence data from five sub-Saharan Africa countries, this paper investigates the extent of the gender disparities in HIV status and its determinants. We found that the prevalence of HIV infection was generally higher among women in all countries – by 90% in Kenya – and higher among adults. 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 and the ratio was 7:1 in Kenya. Women aged 20-24 had 4-5 times the HIV infection rate of men. Socio-cultural and biodemographic determinants of this pattern are investigated. The policy and program implications of the findings are discussed.