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Conference Summary
Infectious Disease and Gender1
Jeanette H. Magnus,*
Margaret E. Greene,† and Sunita Kishor‡
*Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana,
USA; †Center for Global Health, George Washington University, Washington,
DC, USA; and ‡MEASURE DHS, ORC Macro, Calverton, Maryland, USA
Suggested
citation for this article
Worldwide, women live longer then men; however, they do not necessarily
live better, healthier lives. By the interface of sex and gender, women
are placed at high risk for increased illness related to pregnancy and
childbirth as well as chronic and infectious diseases.
Marital
Practice
Many young girls around the world are married with household responsibilities
and limited access to outside institutions and relationships. More than
30% of 15- to 19-year-old girls in west, east, and central Africa, as
well as south and central Asia are married. After marriage, the girls
are also less likely to continue education since their husband's family
usually does not invest in the education of their daughter-in-law. In
South Africa, 45% of 15- to 19-year-old unwed mothers were in school,
but only 27% of the wives of the same age were in school. Early childbearing
increases maternal death rates substantially, and an estimate of maternal
mortality ratio 3 to 7 times higher among 15- to 19-year-old women than
among 20- to 34-year-old women is conservative. The timing of marriage,
the nature of the relationship, and pressure to marry can place young
women at increased risk for disease. In most cultures, the husband is
an average of 5–10 years older, and male partners tend to be more sexually
experienced. Young women have little negotiating power and are at greater
risk of contracting sexually transmitted diseases. Recent studies suggest
that young married women are more likely to be HIV positive than their
unmarried peers. Cultural demands on the young bride and isolation from
peers, friends, and family place her at increased risk for domestic violence
and depression.
Women's
Status and Sexually Transmitted Infections
Gender represents the biologic sex of a person and the different roles,
rights, and obligations that culture and society attach to persons born
with male or female characteristics. Status, power, and rights are attached
to gender and affect the health status of women, independent of biologically
determined vulnerabilities. Women's risk of acquiring sexually transmitted
infections, including HIV/AIDS, is affected by their relative power to
want and insist on safe sex, as well as their access to information, condoms,
and other resources needed to protect themselves against infection. A
2001–2002 Zambia Demographic and Health Survey found that the odds of
having an STI or STI symptom were about twice as high for married Zambian
women who have experienced either sexual or physical spousal violence.
Also, women who said that getting permission to seek health care was a
big hurdle were more likely to have an STI than women who did not have
to obtain permission. The study found clear evidence that household-level
disempowerment of women is an important risk factor for women having an
STI.
1The following comments were made in presentations
by the above authors at the International Conference on Women and Infectious
Disease.
Suggested citation
for this article:
Magnus JH, Greene ME,
Kishor S. Infectious disease and gender [conference summary]. Emerg Infect
Dis [serial on the Internet]. 2004 Nov [date cited]. Available
from http://www.cdc.gov/ncidod/EID/vol10no11/04-0622_06.htm
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