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Title
What explains gender inequalities in HIV/AIDS prevalence in sub-Saharan Africa? Evidence from the demographic and health surveys. |
Full text
https://escholarship.org/uc/item/2db9r55w |
Date
2016 |
Author(s)
Sia, Drissa; Onadja, Yentéma; Hajizadeh, Mohammad; Heymann, S Jody; Brewer, Timothy F; Nandi, Arijit |
Abstract
Women are disproportionally affected by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in sub-Saharan Africa (SSA). The determinants of gender inequality in HIV/AIDS may vary across countries and require country-specific interventions to address them. This study aimed to identify the socio-demographic and behavioral characteristics underlying gender inequalities in HIV/AIDS in 21 SSA countries.We applied an extension of the Blinder-Oaxaca decomposition approach to data from Demographic and Health Surveys and AIDS Indicator Surveys to quantify the differences in HIV/AIDS prevalence between women and men attributable to socio-demographic factors, sexual behaviours, and awareness of HIV/AIDS. We decomposed gender inequalities into two components: the percentage attributable to different levels of the risk factors between women and men (the "composition effect") and the percentage attributable to risk factors having differential effects on HIV/AIDS prevalence in women and men (the "response effect").Descriptive analyses showed that the difference between women and men in HIV/AIDS prevalence varied from a low of 0.68% (P = 0.008) in Liberia to a high of 11.5% (P < 0.001) in Swaziland. The decomposition analysis showed that 84% (P < 0.001) and 92% (P < 0.001) of the higher prevalence of HIV/AIDS among women in Uganda and Ghana, respectively, was explained by the different distributions of HIV/AIDS risk factors, particularly age at first sex between women and men. In the majority of countries, however, observed gender inequalities in HIV/AIDS were chiefly explained by differences in the responses to risk factors; the differential effects of age, marital status and occupation on prevalence of HIV/AIDS for women and men were among the significant contributors to this component. In Cameroon, Guinea, Malawi and Swaziland, a combination of the composition and response effects explained gender inequalities in HIV/AIDS prevalence.The factors that explain gender inequality in HIV/AIDS in SSA vary by country, suggesting that country-specific interventions are needed. Unmeasured factors also contributed substantially to the difference in HIV/AIDS prevalence between women and men, highlighting the need for further study. |
Subject(s)
Humans; HIV Infections; Health Surveys; Prevalence; Risk Factors; Sexual Behavior; Sex Factors; Sex Distribution; Adolescent; Adult; Middle Aged; Africa South of the Sahara; Cameroon; Uganda; Malawi; Swaziland; Ghana; Female; Male; Health Status Disparities; Blinder-Oaxaca decomposition; Gender inequality; HIV/AIDS; Sub-Saharan Africa; Eswatini; Public Health; Public Health and Health Services |
Coverage
1136 |
Publisher
eScholarship, University of California |
Type of publication
article |
Source
BMC public health, vol 16, iss 1 |
Rights
public |
Identifier
qt2db9r55w |
Repository
Berkeley - University of California
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Added to C-A: 2020-02-03;09:26:29 |
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