AIDS, sociology of 109

their apparent physical and emotional invul
nerability. A disregard for their own health
and that of their sexual partners puts men in
danger. Young men have the greatest number
of unprotected sexual acts, are most likely to
inject drugs, are most likely to engage in male
sex work, and to be the victims of male to
male sexual violence. On the other hand, older
men may seek very young women as partners
and wives because they believe they are less
likely to be HIV positive, thus placing young
women at increased risk of becoming infected.
Women have less access than men to edu
cation and economic resources, which signifi
cantly reduces their capacity to fight HIV, but
at the same time women are often positioned
as vectors of HIV. In some societies, there is a
belief that women and girls should be both
ignorant about sex and passive during sex.
Lack of knowledge of sexual matters is often
viewed as a sign of purity and innocence, and
prevents young women from seeking informa
tion about sex. On the other hand, girls are
often pressured by boys to have sex as a proof
of love. Data on HIV transmission indicate
that in much of Africa and in countries such
as India, most married women are infected as
a consequence of normal marital sexual rela
tions with their husbands. It is estimated that
some 60 to 80 percent of African women in
steady relationships who become infected with
HIV have one sexual partner their husband
or regular partner.
Womens subordinate place and the empha
sis on womens innocence make it difficult for
them to discuss sex and safe sex openly with
their partners. Women may also have little
control over how, when, and where sex takes
place, which considerably constrains their abil
ity to insist on safe sex. Further, violence
against girls and women, including rape,
exacerbates their susceptibility to HIV, and
this increases in times of conflict and war.
People living with HIV and AIDS are parti
cularly subject to stigmatization and discrimi
nation in society, including in the workplace
and in access to government services. Funda
mental human rights, such as the right to non
discrimination, equal protection and equality
before the law, privacy, liberty of movement,
work, equal access to education, housing,
health care, social security, assistance, and
welfare, are often violated based on known or
presumed HIV/AIDS status. The Commission
on Human Rights in 2001 and again in 2002
confirmed that access to AIDS medication is a
key component of the right to the highest
attainable standard of health, enshrined in the
Universal Declaration of Human Rights, the
International Covenant on Economic, Social,
and Cultural Rights, and the Convention on
the Rights of the Child.
On a political level, the response to the AIDS
pandemic is hindered by countries which do
not recognize freedoms of speech and associa
tion, nor the right to information and education
by infected and affected groups and by civil
society as a whole. Respect, protection, and
fulfillment of human rights are central to the
AIDS agenda, and equally, HIV/AIDS needs
to be at the center of the global human rights
agenda.
While some uncertainties remain as to why
some countries have a higher prevalence than
others, and why some countries have managed
to reduce prevalence levels radically, it is evi
dent that a successful response to HIV is
dependent on a human rights approach that
empowers civil society and ensures the com
munities have a secure place within the national
dialogue. In general, in the developed world
and also, in some instances, in the developing
world, where a modern public health approach
has been adopted, an approach in which com
munities encourage and support individuals,
understood as rational agents, to reduce harm
to themselves and others, and where people
have access to prevention education and treat
ment, HIV transmission has been slowed. On
the other hand, economic and social disadvan
tage and civil disruption, and associated mar
ginalization and stigma, increase vulnerability
to HIV.

HIV TREATMENTS

The issue of human rights is central to treat
ment access: all who are infected with HIV
have the right to treatment. In the developed
world where most people living with HIV
have access to these therapies, there has been
an 80 percent fall in deaths related to AIDS.
In the developing world, however, only