COULD YOU STAY HIV FREE IN EXTREME POVERTY?

Biology is just one of many factors that influence the spread of HIV/AIDS. Structural drivers, defined by UNAIDS as the social and structural factors, such as poverty, gender inequality, and human rights violations...that increase peoples vulnerability to HIV infection play an underestimated role in how HIV/AIDS spreads from person to person. To see just how influential these structural drivers can be, keep reading.

IMAGINE THIS.
you are a female living in extreme poverty.
Like most women living in extreme poverty, many aspects of your life are out of your control. You married before you were fifteen, and had your first child in the same year. Luckily, your marriage was consensual, and you wanted your child very much.

1 out of 7 girls in developing countries

[The Huairou Commission: Women, Land and Secure Tenure: The HIV/AIDS Connection]

Women and children are often left vulnerable after the deaths of their husbands and fathers when there is no will, or they do not have the appropriate documents to claim their inheritance (such as birth and marriage certificates).

get married before age 15

[girl effect fact sheet]

Your husbands family reclaims the land.

between 1/4 and 1/2 of girls in developing countries become mothers before age 18 globally, percentage of forced first sex among girls younger than 15 is between 11-48%
[UNAIDS]

[girl effect fact sheet]

Because of the de facto laws on land rights, your husbands family reclaims the land that you and he once farmed, leaving you without a means to support yourself and your child.
One in four widowed women in Tanzania also suffer from HIV

[2007-2008 Tanzania HIV/AIDS and Malaria Indicator Survey]

You decide to stay with your husband.

STRUCTURAL DRIVER: land rights many Land rights laws in

You hope his condition improves with your care. By the time you recognize the telltale signs of malaria, it is too late. Your husband is dead.

developing countries limit womens access to land they rightfully own. In Zambia, more than one third of widows lost access to family land when their husbands died. [UN Africa Renewal
Article]

Recently, your husband has fallen ill and cant work.

He is constantly nauseous and has severe chills day and night. Nothing you have tried has made any difference. You are running dangerously low on money to buy food.

A lack of resources, such as land, makes women more vulnerable to domestic violence and HIV. [UN Women Womens Property
and Land Rights article]

YOU DECIDE TO:

Stay with your husband and hope his condition improves. Walk the 20 miles to a larger village in the hopes of finding medical care, leaving your child behind to check on your husband as best he can.
You know the early warning signs of malaria. You know your husband will need medicine soon or risk death. You walk the 20 miles to town where you have heard there is a free clinic, because you have a great relationship that makes it worth it.
a recent study in South Africa found that women who are beaten or dominated by their partners are nearly 50% more likely to become infected with HIV than women who live in non-violent households
[SOURCE]

OR

You try to find work around town.

You decide to try to find work around town. Unfortunately, nowhere, even the places with hiring signs, will hire you because you are a woman. There is one option available to you, you can find work in a bar as a bartender. The jobs pay fairly well, but are dangerous.

you decide to:

If you want the medicine, youll have to pay $10.00. To earn the money, you decide to:

To your dismay, you find out that the free medicine is being held by a group of thugs for profit. Try to find odd jobs you can do to earn the money. Although it disgusts you, you know you could sell sex to one of the many workers in the town to save your husband and child. You know the man will threaten you with violence if you ask to use a condom, and using a condom may also criminalize you for sex work. It is the last thing you want to do.

STRUCTURAL DRIVER: corruption as much as 85 percent of aid

flows are diverted away from their intended targets
[World Bank study]

Return home without the medicine. Try to find a job working as a bartender.

OR

OR

to be expanded in final version

You, through no fault of your own, are now HIV positive.

Your environment, far more than your own actions, has led you down a path toward becoming infected with HIV. In this limited scenario, there were many factors that stacked the deck against you: land rights laws which give your livelihood away if your husband dies, widespread misogyny towards women leading to few safe job opportunities, rampant corruption keeping you from the drugs earmarked for men and women just like you, these are all examples of the structural drivers that increase the spread of HIV.

The structural drivers of HIV are almost as damaging as HIV itself.

$
Economic
food insecurity economic mobility economic power limited livelihood opportunities

POLITICAL
land rights criminalization corruption criminal justice system alcohol availability

social
gender inequality STIGMA discrimination gender-based violence human rights violations

knowledge is the first step in the fight against hiv. spreading it is the second. share this infographic with your friends to raise awareness. visit icrw.org to learn more.