Gender Disparity in HIV Prevalence: A National-Level Analysis of the Association between Gender Inequality and the Feminisation of HIV/AIDS in sub-Saharan Africa

Abstract

The HIV pandemic in sub-Saharan Africa is often described as undergoing a ‘feminisation’ in which female HIV prevalence exceeds that of male in most age groups and countries. However, much of the variation between countries in the female-to-male (FTM) ratio of HIV prevalence remains unexplained. This paper uses information from DHS, World Bank, UNDP and UNAIDS to identify correlates of the FTM ratio at the country level, with a focus on gender inequality. The FTM ratio is investigated overall and for two age groups. Divergent results by age suggest that the influence of particular mechanisms depend on the age group in question, with epidemiological and demographic variables in particular demonstrating strong associations with the FTM ratio for 25-49 year olds. The mechanisms influencing gender disparity in HIV prevalence between younger adults remain unclear, with few significant correlates observed for the 15-24 age group.