Human Immunodeficiency Virus (HIV) is a serious public health problem that affects millions of people worldwide. It is estimated that approximately 37.7 million people were living with HIV at the end of 2020, with 1.5 million new infections and 690,000 AIDS-related deaths globally. In the fight against HIV, understanding the risk factors and populations most vulnerable to infection is critical. One of the key questions in HIV research is whether one gender is more vulnerable to HIV than the other.
Gender and HIV Vulnerability
Biologically, women are more vulnerable than men to HIV infection. Women have a larger surface area of mucous membranes, the moist tissues that line body cavities, such as the vagina, cervix, and rectum, that are prone to HIV transmission. During vaginal sex, the virus can easily enter the cervix and spread to the uterus, fallopian tubes, and ovaries. In addition, menstrual bleeding, genital sores or inflammation, and other vaginal infections can also increase HIV transmission risk.
Furthermore, women and girls are also more likely to experience violence, coercion, or lack of control in their sexual relationships, making it difficult for them to negotiate condom use or refuse sex. Gender-based violence and discrimination can also interfere with women accessing HIV prevention services, HIV testing, and treatment.
On the other hand, men have lower HIV acquisition risk via vaginal sex compared to women, but are more likely to acquire HIV through other modes of transmission such as blood transfusion, sharing of needles for injections, or unprotected anal sex with other men. Men who have sex with men (MSM) have a much higher risk of HIV infection than heterosexual men due to the higher prevalence of HIV among MSM, higher rates of unprotected anal sex, and increased risk of sexually transmitted infections (STIs).
Vulnerability by Age
Young people, especially adolescent girls, are also a vulnerable population at risk of HIV. Adolescents have limited experience with sex, and are more likely to have unprotected sex and engage in risky sexual behavior. The HIV prevalence among adolescent girls aged 15-19 years is four times higher than that of adolescent boys in the same age group. This vulnerability is due to age-specific risk factors such as early initiation of sexual activity, sexual coercion and violence, and difficulty accessing HIV prevention and health services.
Moreover, pregnant women living with HIV can transmit the virus to their infants during pregnancy, delivery or breastfeeding, thus making the children vulnerable to HIV as well. Prevention of mother-to-child transmission (PMTCT) programs aim to provide antiretroviral therapy and other interventions to prevent HIV transmission from mother to child but can often be difficult to access in low-income settings.
In conclusion, HIV remains a significant public health challenge, and understanding the vulnerability of different populations is essential to develop effective HIV prevention and treatment strategies. While both genders are at risk of HIV, women and girls are biologically and socially vulnerable to HIV due to biological factors, gender roles, and social inequalities. Adolescents, and young men who have sex with men are also at heightened risk of HIV. Therefore, targeted and tailored HIV prevention interventions and services should be developed to address the unique needs of these populations, including access to HIV testing, counseling, treatment, and other critical health services.
What gender is more at risk for HIV?
In the United States, gay, bisexual, and other men who have sex with men are the population most affected by HIV. According to the Centers for Disease Control and Prevention (CDC), of the 30,635 new HIV diagnoses in the U.S. in 2020, 68% (20,758) were among gay and bisexual men. This group is therefore considered to be at significantly higher risk for contracting the virus than other populations.
There are a number of factors that contribute to the increased risk of HIV among gay and bisexual men. One of the primary reasons is that anal sex is more likely to result in the transmission of HIV than other forms of sexual activity. This is because the lining of the rectum is prone to tearing during sex, and HIV can enter the bloodstream through these small tears.
Another important factor is the prevalence of sexually transmitted infections (STIs) among this population. People who have other STIs are more likely to contract HIV if they are exposed to the virus. Additionally, some STIs (such as herpes or syphilis) can cause painful sores or lesions that can increase the risk of HIV transmission.
Finally, there are a number of sociocultural factors that contribute to the increased risk of HIV among gay and bisexual men. For example, this population is more likely to be marginalized and experience discrimination, which can lead to reduced access to healthcare and less trust in healthcare providers. There may also be stigma surrounding HIV in these communities, which can discourage people from getting tested and seeking treatment if they do contract the virus.
It is worth noting that while gay and bisexual men are at the highest risk for HIV in the U.S., they are not the only populations affected by the virus. Other populations that are disproportionately affected by HIV include people who inject drugs, transgender individuals, and Black and Latinx communities. It is important to address HIV in a way that takes into account the unique risk factors and needs of these different populations.