As we celebrate the 27th annual World AIDS Day, it is encouraging to note the most recent trends of worldwide reductions in new HIV infections and AIDS-related deaths. However, the gains charted against the “disease that changed everything” are not equally distributed. In fact, the HIV/AIDS crisis has markedly widened gaps of inequality in health and well-being the world over. HIV/AIDS remains a leading factor contributing to health declines in poor nations, where over 95% of the 33.2 million individuals infected with HIV reside. The spread of HIV/AIDS has been especially detrimental to women in poor nations and, in fact, represents the leading cause of death among women of reproductive age. The number of women infected with HIV has increased dramatically in recent years—young women in less developed nations are about twice as likely as men to become newly infected with HIV. Theories of gender inequality provide clear insights into such dynamics, as a wide body of literature highlights the harmful consequences of inequalities in decision-making and control of or access to resources for women. In particular, women in less developed nations face barriers to many educational and health resources, including schools and contraceptives.
The deleterious combination of gender-based inequalities, poverty, malnutrition, lack of education, and inadequate health resources poses acute threats to the well-being of women in the less developed world; indeed, these factors are interconnected dimensions of strife that co-occur and exacerbate one another in ways that severely compromise the health and longevity of women in poor nations. What has been underexplored—and what we find to be a critical factor compounding the spread of HIV/AIDS among women—is the influence of environmental losses on women’s health. In short, environmental degradation exacerbates women’s rates of disease (HIV/AIDS) and death (lowered life expectancy) in myriad ways, as elaborated below.
HIV/AIDS, women, and the environment
The crux of the connection between women’s health and the environment largely centers on gender norms reflected in the household division of labor in which women are typically charged with providing vital resources to the household that are derived from the natural environment.
Indeed, women supply the bulk of food, water, and other basic necessities for family members; as resource scarcity complicates these tasks, the health and well-being of the family is jeopardized and women themselves become increasingly vulnerable to disease. As one example, the productivity of women in less developed nations relies near exclusively on subsistence farming; thus declines in soil fertility and supplies of clean water compromise their ability to provide for themselves and the household. Environmental declines undoubtedly constrain food production and malnutrition potentiates susceptibility to many infectious diseases, including HIV/AIDS. Women’s needs for such basic provisions are characteristically subsidiary to men’s, making them disproportionately vulnerable to malnutrition and associated declines in immunity when food and water are scarce. In some cases, severe hunger may increase the likelihood of risky sexual behavior and HIV transmission among women who resign to trading sex for needed household resources. Moreover, resource scarcity reduces the prospects for women to generate income from handicrafts and other cottage industries that rely heavily on natural resource inputs. The additional constriction to earning money posed by ecological decline worsens women’s health insofar as they become entrenched in poverty, which is consequential given the general view that poverty is a major culprit in perpetuating HIV transmission.
As we move forward and strive to eradicate the HIV/AIDS epidemic, we must recognize the strong connections between environmental degradation and the health and well-being of women.
As women endeavor to fulfill their household duties in light of resource scarcity, they must travel longer distances over increasingly dangerous terrain to secure food, fuel, and fiber. Resource constraints that shift formerly inconsequential tasks, such as walking to a nearby source to draw water, to hours-long (or even days-long) searches are not only physically strenuous, thus directly impacting women’s health, but also place restrictive demands on women’s time that limit opportunities for educational and economic pursuits that would otherwise contribute to their empowerment. Additionally, there is accumulating evidence that high rates of HIV are found in areas with extensive contact with contaminated water—as supplies of clean water become increasingly scarce, women are more likely to come into contact with and, ultimately, resort to using water that is infested with worms and parasites that compromise overall health by intensifying susceptibility to and progression of life-threatening infections. This is particularly harmful to women as they are more likely to encounter contaminated water in the course of their daily lives and, as a result, experience urogenital inflammation that is a risk factor for HIV infection.
Empirical analysis of the dynamics outlined above confirms that women in less-developed countries are unduly harmed by ecological losses that exacerbate hunger, reduce the availability of public health resources, lower their autonomy, and contribute to the spread of HIV/AIDS and attendant reductions in female life expectancy. In this view, resource scarcity bears a wide range of deleterious effects on the health of women, thus informing our central conclusion that environmental losses are strongly associated with women’s health, in direct and indirect ways. This implies that developmental and epidemiological approaches to improving women’s health may benefit from incorporating environmental dimensions as a key area of concern.
The principal conclusions of our research center on the efficacy of incorporating ecofeminist frameworks into global perspectives on health, gender inequality, and the environment. As we move forward and strive to eradicate the HIV/AIDS epidemic, we must recognize the strong connections between environmental degradation and the health and well-being of women. Failing to account for the interconnected nature of these dimensions could lead to severely underspecified models. We strongly advocate that practitioners and policy makers seeking to address current health crises in poor nations adopt holistic approaches that account for the synergies among social, economic, and ecological dimensions.
Headline image credit: Woman watering crops Africa by skeeze. CC0 public domain via Pixabay.