ABSTRACT

In the AIDS community, the word "gender" is usually employed to mean women; gender-specific causes of HIV vulnerability among men are much less often considered. In recent years, scholarly articles, media reports, and major AIDS organizations have increasingly painted marriage as an institution that is highly risky to women in terms of HIV infection. Unfortunately, the disproportionate concentration of international health and development aid for the single disease of HIV/AIDS may mean that Namibia, Tanzania and Ethiopia with serious gender inequalities and high rates of gender-based violence, but with low HIV prevalence, receive little attention from Western donors. The IMAGE trial, demonstrated decreases in gender-based violence although HIV incidence did not decline. A cluster randomized trial of the Stepping Stones HIV prevention program similarly found decreases in gender-based violence but no decrease in HIV incidence. Thus, halting the spread of HIV in the medium to long term requires increasing the length, stability, and mutual faithfulness of marriages or unions.