Women Are Bound to Get AIDS

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"Why is it girls have to always be polite and say yes, when boys can just say no and walk away?" My 10-year old daughter said these chilling words to me after describing how she had been stuck doing a task at school when she really wanted to do something else. I cringed inside, because I knew just what she meant. Girls are indeed brought up to be nicer than boys, and I know from a lifetime of experience that being a push-over doesn't serve women well. And I cringed even more deeply because I had just read Lars Kallings' devastating critique of the HIV/AIDS pandemic in the March issue of The Journal of Internal Medicine, in which he blames the powerlessness of girls and women to say "no" to unwanted or unprotected sex as a major factor keeping HIV alive. We'd like to believe that infectious diseases are biological and that we contract them because of bad luck. Got the flu? Poor you must have touched a germ-covered door knob. Or because we happened to be in the wrong place at the wrong time, such as working close to sick birds. But as infection and mortality rates show, human behavior molded by culture is the real culprit in the spread of HIV. It starts with our evolutionarily determined drive to reproduce, which, Kallings points out, "dominates over altruistic behavior." Since HIV is transmitted primarily through sexual activity, and we'd rather have sex than think about the consequences, right off the bat all humans are at risk. Culture is also supposed to mitigate our basic animal instincts, and yet the cultural lens has only helped HIV take hold. And this is especially true for women and girls. The females of our species are at great risk for HIV because they know nothing; millions of girls live in cultures where education is reserved for boys, and girls are kept in the dark about everything, especially sex. In Bolivia, Kallings writes, 74 percent of young women know nothing about HIV/AIDS or they are seriously unclear about the virus. Apparently, across Asia, most women don’t even know how babies are born. Women are also repressed by cultural traditions, historical or religious, which render them powerless and subjugated to men. A husband in those cultures can have sex with others, bring HIV back home, and there's no way a woman can refuse his wishes or ask that he use a condom. That's why across the world, almost half the victims of HIV are women; those who still think of HIV/AIDS as a homosexual disease are not only uninformed, they are ignoring the global plight of women as well. And when those women become pregnant, the HIV virus can be transmitted vertically to their infants. Thirty-two percent of the pregnant women in Botswana and 26 percent of the pregnant women in South Africa are reported to be HIV-positive. If their infants live, they could eventually join the legion of orphans that now populate HIV-infected countries. They become citizens with no parents, no families and no culture that anyone would recognize. Culture, in the case of HIV/AIDS, is harming, not helping. And the Western belief that science will put an end to this pandemic, and that girls and women in our culture are free to say "no" whenever they want, is just as culturally wrong. Like other cultures, we also need to teach our daughters that it's OK to say "no," freely and often, because saying "no" is the best way for a woman to survive in any culture.

Meredith Small is a professor of anthropology at Cornell University, and the author of "Our Babies, Ourselves". She is a contributor to Live Science.