Half the sky: turning oppression into opportunity for women worldwide by Nicholas D. Kristof & Sheryl Wudunn

Author:Nicholas D. Kristof & Sheryl Wudunn [Nicholas D. Kristof & Sheryl WuDunn]
Language: eng
Format: epub
Tags: Roman
ISBN: 9780307387097
Published: 2010-09-15T08:30:35+00:00

Studies on the impact of abstinence-only programs aren’t conclusive and seem to depend to some extent on the ideology of those conducting the study. But on balance, the evidence suggests that they slightly delay the debut of sexual activity; once it has been initiated, however, kids are less likely to use contraception. The studies suggest that the result is more pregnancies, more abortions, more sexually transmitted diseases, and more HIV. Advocacy groups like the International Women’s Health Coalition fought heroically for evidence-based policies on sexual health, and Congresswoman Carolyn Maloney battled tenaciously for UNFPA programs, but the White House wasn’t listening. Finally, President Barack Obama—shortly after taking office—announced that he would end the “gag rule” and restore full funding to family planning groups and to UNFPA.

One of the premises of the abstinence-only campaign had been that Africa’s AIDS problem was a consequence of promiscuity, but that may not have been true, particularly for African women. Emily Oster, an economist at the University of Chicago, notes that about 0.8 percent of American adults are infected with HIV, compared to 6 percent of adults in sub-Saharan Africa. When she examined the data, she couldn’t find any indication that Africans are more promiscuous. In fact, Americans and Africans report a similar number of sexual partners (although some experts believe that in Africa they are more likely to be concurrent rather than consecutive). The biggest difference, Oster found, was that transmission rates are much higher in Africa than in America. For any given unprotected sexual relationship with an infected person, Africans are four or five times more likely to get HIV themselves.

That higher rate can be explained in part because Americans get treated for genital sores; Africans often don’t. At any one time, 11 percent of Africans have untreated bacterial genital infections, and these sores allow for easy transmission of the virus. Public health experts widely acknowledge that one of the most cost-effective ways to treat HIV is to provide free checkups and treatment for such STDs. Oster notes that when AIDS prevention resources are devoted to treating STDs, the cost per year per life saved from AIDS is only about $3.50.

In any case, for women the lethal risk factor is often not promiscuity but marriage. Routinely in Africa and Asia, women stay safe until they marry, and then they contract AIDS from their husbands. In Cambodia, a twenty-seven-year-old former prostitute told us of her struggles with AIDS, and we assumed that she had caught the virus in the brothel.

“Oh, no,” she said. “I got AIDS later, from my husband. In the brothel, I always used condoms. But when I was married, I didn’t use a condom. A woman with a husband is in much more danger than a girl in a brothel.”

That’s an exaggeration, but it underscores a central reality: AIDS is often a disease of gender inequality. Particularly in southern Africa, young women frequently don’t have the power to say no to unprotected sex. Teenage girls, for example, often become the baubles of middle-aged men, and so HIV spreads relentlessly.

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