Gender Inequality as a Barrier to Utilization of Services in Mother to Child Transmission of HIV/AIDS in Pakistan
This study examines gender inequality as a barrier to utilization of services in mother to child transmission of HIV/AIDS in Pakistan. The study uses a feminist approach to explore the barriers related to gender inequality during the uptake of HIV treatment. The data was collected from 26 medical practitioners and 10 HIV positive mothers through in-depth interviews. HIV positive mothers were found to have experienced discrimination in their treatment, difficulty in traveling from far off areas to the special clinics, and they expressed having the least family support as HIV patients.They also experienced inequality in terms of the use of ARV prophylaxis, autonomy in reproductive choices, sexual priorities, disclosure, stigma, agency and intimate partner violence. Furthermore, they emphasized the need for sensitization and counseling of male spouses. The study concludes that the gender inequality grossly affects the uptake of HIV treatment among HIV positive mothers. It is thus recommended that there is a need to incorporate gender inclusive policy and practice to eliminate the vertical transmission of HIV in Pakistan.
-
Gender Inequality, HIV/AIDS, Mother to Child Transmission, ART, VCCT
-
(1) Asma Zafar
Institute of Social and Cultural Studies, University of the Punjab, Lahore, Punjab, Pakistan
(2) Muhammad Ramzan
Assistant Professor, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Punjab, Pakistan
(3) Ahmed Usman
Assistant Professor, Institute of Social and Cultural Studies, University of the Punjab, Lahore, Punjab, Pakistan
- Adedimeji, A., Abboud, N., Merdekios, B., & Shiferaw, M. (2012). A Qualitative Study of Barriers to Effectiveness of Interventions to Prevent Mother-to-Child Transmission of HIV in Arba Minch, Ethiopia. International Journal of Population Research, 2012, 1-7. https://doi.org/10.1155/2012/532154
- Beegle, K., & Ozler, B. (2006). Young women, rich (er) men and the spread of HIV. The World Bank, Washington, DC. Mimeo.
- Bruce, J., & Clark, S. (2004). The implications of early marriage for HIV/AIDS policy. New York: Population Council. https://doi.org/10.31899/pgy22.1000
- Bruyn, M. D., Jackson, H., Wijermars, M., Knight, V. C., & Berkvens, R. (1995). Facing the challenges of HIV/AIDS/STDs: a gender- based response.
- Bruyn, M. De. (1992). Women and aids in developing countries: The XIIth international conference on the social sciences and medicine. Social Science & Medicine, 34(3), 249-262. https://doi.org/10.1016/0277- 9536(92)90267-t
- Campbell, C. A. (1995). Male gender roles and sexuality: Implications for women's AIDS risk and prevention. Social Science and Medicine, 41(2), 197-210. https://doi.org/10.1016/0277- 9536(94)00322-K
- Carr, R. (Ed.). (2008). Promoting Gender Equality in HIV and AIDS Responses: Making Aid More Effective Through Tracking Results. United Nations Development Fund for Women (UNIFEM).
- Connelly, L. M., & Peltzer, J. N. (2016). Underdeveloped Themes in Qualitative Research. Clinical Nurse Specialist, 30(1), 52- 57. https://doi.org/10.1097/nur.000000000 0000173.
- Darlington, C. K., & Hutson, S. P. (2017). Understanding HIV-Related Stigma Among Women in the Southern United States: A Literature Review. AIDS and Behavior, 21(1), 12-26. https://doi.org/10.1007/s10461- 016-1504-9
- Davis, N. W., & Meyer, B. B. (2009). Qualitative data analysis: A procedural comparison. Journal of Applied Sport Psychology, 21(1), 116-124.
- Decker, M. R., Seage, G. R., Hemenway, D., Raj, A., Saggurti, N., Balaiah, D., & Silverman, J. G.(2009). Intimate Partner Violence Functions as Both a Risk Marker and Risk Factor for Women's HIV Infection: Findings From Indian Husband-Wife Dyads. JAIDS Journal of Acquired Immune Deficiency Syndromes, 51(5), 593-600.
- Duffy, L. (2005). Culture and context of HIV prevention in rural Zimbabwe: the influence of gender inequality. Journal of Transcultural Nursing, 16(1), 23-31. https://doi.org/10.1177/104365960427 0962
- GarcÃÂa-Moreno, C., Jansen, H. A., Ellsberg, M., Heise, L., & Watts, C. (2005). WHO multi-country study on women's health and domestic violence against women. World Health Organization.
- Ghanotakis, E., Peacock, D., & Wilcher, R. (2012). The importance of addressing gender inequality in efforts to end vertical transmission of HIV. Journal of the International AIDS Society, 15(4(Suppl 2)). https://doi.org/10.7448/ias.15.4.17385
- Gillespie, S. (2008). Poverty, food insecurity, HIV vulnerability and the impacts of AIDS in sub? Saharan Africa. IDS Bulletin, 39(5), 10-18. https://doi.org/10.1111/j.1759- 5436.2008.tb00490.x
- Girma, M. (2016). Effectiveness of prevention of mother-to child transmission (PMTCT) procedures in pregnant HIV infected women and their exposed infants at seven health centers in Addis Ababa, Ethiopia (Doctoral dissertation, lmu).
- Gourlay, A. (2015). Improving the usage of prevention of mother-to-child transmission of HIV services in rural Tanzania (Doctoral dissertation, London School of Hygiene & Tropical Medicine).
- Greig, A., Peacock, D., Jewkes, R., & Msimang, S. (2008). Gender and AIDS: time to act. AIDS, 22(Suppl 2), S35-S43. https://doi.org/10.1097/01.aids.000032 7435.28538.18
- Guide, A. U. O. (2010). Integrating Gender Issues into HIV/AIds Programs (Issue September). WHO.
- Jewkes, R., Sikweyiya, Y., Morrell, R., & Dunkle, K. (2011). The relationship between intimate partner violence, rape and HIV amongst South African men: A cross-sectional study. PLoS ONE, 6(9), 1-6.
- Khan, A. (2017). Strategic Framework for Prevention of Parent to Child Transmission (PPTCT) of HIV in Pakistan. https://www.nacp.gov.pk/repository/howwe work/Publications/PPTCT Strategy ( Final).pdf
- Lee, Y., Park, J., Min, M., Lee, Y., Yu, Y., Shim, M. K., & Kim, M. G. (2021). Gender Equity and Vertically Transmitted Infections: A Country- Level Analysis across 153 Countries. Health Equity, 5(1), 23-29. https://doi.org/10.1089/heq.2020.0097
- Mbonu, N. C., Van den Borne, B., & De Vries, N. K. (2010). Gender-related power differences, beliefs and reactions towards people living with HIV/AIDS: an urban study in Nigeria. BMC public health, 10(1), 1-10. https://doi.org/10.1186/1471-2458-10- 334
- Mojola, S. A. (2011). Fishing in dangerous waters: Ecology, gender and economy in HIV risk. Social Science and Medicine, 72(2), 149-156. https://doi.org/10.1016/j.socscimed.2010 .11.006
- Nyamhanga, T., Frumence, G., & Simba, D. (2017). Prevention of mother to child transmission of HIV in Tanzania: assessing gender mainstreaming on paper and in practice. Health policy and planning, 32(suppl_5), v22- v30. https://doi.org/10.1093/heapol/czx080
- Orb, A., Eisenhauer, L., & Wynaden, D. (2001). Ethics in qualitative research. Journal of nursing scholarship, 33(1), 93-96
- Oskouie, F., Kashefi, F., Rafii, F., & Gouya, M. M. (2017). Qualitative study of HIV related stigma and discrimination: What women say in Iran. Electronic Physician, 9(7), 4718-4724. https://doi.org/10.19082/4718
- Piot, P., & Director, U. E. (2008). AIDS: exceptionalism revisited. Lecture Presented at London School of Economics and Political Science. London: UNAIDS.
- Pulerwitz, J., Amaro, H., Jong, W. D., Gortmaker, S. L., & Rudd, R. (2002). Relationship power, condom use and HIV risk among women in the USA. AIDS care, 14(6), 789-800. https://doi.org/10.1080/095401202100 0031868
- Qazi, S. (2019). Study on Review of HIV Treatment , PPTCT & Pediatric Services. September.
- Richards, H. M., & Schwartz, L. J. (2002). Ethics of qualitative research: are there special issues for health services research?. Family practice, 19(2), 135-139.
- Richardson, E. T., Collins, S. E., Kung, T., Jones, J. H., Tram, K. H., Boggiano, V. L., Bekker, L. G., & Zolopa, A. R. (2014). Gender inequality and HIV transmission: A global analysis. Journal of the International AIDS Society, 17, 1-5. https://doi.org/10.7448/IAS.17.1.19035
- Sa, Z., & Larsen, U. (2008). Gender inequality increases women's risk of HIV infection in Moshi, Tanzania. Journal of Biosocial Science, 40(4), 505-525. https://doi.org/10.1017/S00219320070 0257X
- Sadati, A. K., Taheri, V., Joulaei, H., & Hemmati, S. (2019). Experience of stigma by women infected with HIV by their husbands: A qualitative study. International Journal of High Risk Behaviors and Addiction, 8(1), 1-7. https://doi.org/10.5812/ijhrba.69185
- Saeed, A., & Farooq, S. (2017). https://doi.org/10.1016/j.jana.2017.03.0 10
- Sia, D., Onadja, Y., Hajizadeh, M., Heymann, S. J., Brewer, T. F., & Nandi, A. (2016). What explains gender inequalities in HIV/AIDS prevalence in sub-Saharan Africa? Evidence from the demographic and health surveys. BMC Public Health, 16(1), 1-18. https://doi.org/10.1186/s12889-016- 3783-5
- Strebel, A., Crawford, M., Shefer, T., Cloete, A., Henda, N., Kaufman, M., & Kalichman, S. (2006). Social constructions of gender roles, gender-based violence and HIV/AIDS in two communities of the Western Cape, South Africa. SAHARA: Journal of Social Aspects of HIV/AIDS Research Alliance, 3(3), 516-528.
- Thaweesit, S., & Sciortino, R. (2020). The invisible intersectionality of female gender in Thailand's response to the HIV epidemic. Culture, Health and Sexuality, 22(7), 762-777.
- Theobald, S., Morgan, R., Hawkins, K., Ssali, S., George, A., & Molyneux, S. (2009). Integrating gender into HIV/AIDS programmes in the health sector. Health Policy and Planning, 32(suppl_5), v1-v3
- Tiessen, R. (2005). Mainstreaming gender in HIV/AIDS programs: Ongoing challenges and new opportunities in Malawi. Journal of International Women's Studies, 7(1), 8-25.
- Türmen, T. (2003). Gender and HIV/aids. International Journal of Gynecology & Obstetrics, 82(3), 411-418.
- UNAIDS, (2021). Global HIV & AIDS statistics- Fact sheet. https://www.unaids.org/en/resources/fact- sheet.
- WHO. (2009). Integrating gender into HIV/AIDS programmes in the health sector. Health Policy and Planning, 32(suppl_5), v1-v3.
- World Health Organization. (2011). Gender mainstreaming for health managers: a practical approach. Geneva: World Health Organization.
- Yourkavitch, J., Hassmiller Lich, K., Flax, V. L., Okello, E. S., Kadzandira, J., Katahoire, A. R., ... & Thomas, J. C. (2018). Interactions among poverty, gender, and health systems affect women's participation in services to prevent HIV transmission from mother to child: A causal loop analysis. PloS one, 13(5), e0197239.
Cite this article
-
APA : Zafar, A., Ramzan, M., & Usman, A. (2021). Gender Inequality as a Barrier to Utilization of Services in Mother to Child Transmission of HIV/AIDS in Pakistan. Global Sociological Review, VI(IV), 29-37. https://doi.org/10.31703/gsr.2021(VI-IV).04
-
CHICAGO : Zafar, Asma, Muhammad Ramzan, and Ahmed Usman. 2021. "Gender Inequality as a Barrier to Utilization of Services in Mother to Child Transmission of HIV/AIDS in Pakistan." Global Sociological Review, VI (IV): 29-37 doi: 10.31703/gsr.2021(VI-IV).04
-
HARVARD : ZAFAR, A., RAMZAN, M. & USMAN, A. 2021. Gender Inequality as a Barrier to Utilization of Services in Mother to Child Transmission of HIV/AIDS in Pakistan. Global Sociological Review, VI, 29-37.
-
MHRA : Zafar, Asma, Muhammad Ramzan, and Ahmed Usman. 2021. "Gender Inequality as a Barrier to Utilization of Services in Mother to Child Transmission of HIV/AIDS in Pakistan." Global Sociological Review, VI: 29-37
-
MLA : Zafar, Asma, Muhammad Ramzan, and Ahmed Usman. "Gender Inequality as a Barrier to Utilization of Services in Mother to Child Transmission of HIV/AIDS in Pakistan." Global Sociological Review, VI.IV (2021): 29-37 Print.
-
OXFORD : Zafar, Asma, Ramzan, Muhammad, and Usman, Ahmed (2021), "Gender Inequality as a Barrier to Utilization of Services in Mother to Child Transmission of HIV/AIDS in Pakistan", Global Sociological Review, VI (IV), 29-37
-
TURABIAN : Zafar, Asma, Muhammad Ramzan, and Ahmed Usman. "Gender Inequality as a Barrier to Utilization of Services in Mother to Child Transmission of HIV/AIDS in Pakistan." Global Sociological Review VI, no. IV (2021): 29-37. https://doi.org/10.31703/gsr.2021(VI-IV).04