GENEVA - The proportion of women of working-age living with HIV/AIDS is increasing in all regions of the world, according to the ILO Programme on HIV/AIDS and the World of Work. Its latest report "Women, girls, HIV/AIDS and the world of work", December 2004, published for World AIDS Day 2004, says the proportion of women among adults living with HIV/AIDS rose from 43 per cent in 1998 to 48 per cent in 2003, and continues to grow. In sub-Saharan Africa, women represent 57 per cent of all HIV-positive adults, and three quarters of young people living with HIV are women and girls. On World AIDS Day, ILO Online spoke with Odile Frank of the ILO/AIDS programme about the impact of HIV/AIDS on women and the world of work.

What are the effects of HIV/AIDS on the labour force?

An estimated 37 million people of working age have HIV, and by next year as many as 28 million workers will have been lost to the global labour force since the start of the epidemic due to HIV/AIDS ( Note 1). In the absence of increased access to treatment, the losses will increase to 74 million by 2015, making HIV/AIDS one of the biggest causes of mortality in the world of work. There is growing recognition of the impact of HIV/AIDS on national economies, but clear evidence now that women are bearing the largest share of costs.

How do you explain the worldwide increase in the proportion of women living with HIV/AIDS?

Most people who are infected with HIV or who die of AIDS in developing countries are now women. The risk of transmission is greatest for girls and women: worldwide, women represent 60 per cent of new HIV infections. In the current context of poverty, lower levels of education and limited access to resources, young women and girls 15 to 24 years are at higher risk of HIV infection than young men and boys. In Africa and the Caribbean, there are now up to twice as many young women as men living with HIV, and in parts of eastern and southern African countries, there may be six times as many young women as men who are infected with HIV. In some areas, already more than one-third of teenage girls are infected.

The feminization of the epidemic is even more pronounced in Sub-Saharan Africa - why?

In Sub-Saharan Africa the gender gap in prevalence started earlier and widened rapidly. Africa has a young population and it is principally young people who are becoming infected with HIV. Africa cannot afford to lose young women in such large numbers. Young women are essential to Africa's growing economies, as well as to family building, community care and the education of future generations. Together, young men and women account for half of all new HIV cases globally, but more than two-thirds are in Africa.

How does this affect development prospects in these countries?

Because the young are becoming HIV positive at a faster rate than the general population, future as well as present human capacity is undermined and progress in sustainable development is jeopardized. Young men and women are the new generation of the labour force that should produce and consume goods and services, as well as the entrepreneurs and innovators of tomorrow. The high prevalence of HIV among them means that the size of the labour force will be drastically reduced, that many will struggle to work when they are ill, and that their children will lose the care and guidance of parents.

Many of these young persons are already caring for ill and dying relatives. In 2003, there were more than 12 million children in Africa who had lost one or both parents to AIDS, and most of these orphans were motherless. Young people, particularly young women and girls, also pay a high price for living in a world with HIV/AIDS when duties of care and of finding work force them to drop out of school. In most cases girls are the first to have their education interrupted or ended. As a result, they are less prepared for the world of work, and they are at risk of impoverishment as well as HIV.

Does their low status in society and in the labour market raise women's risk of HIV?

The greater the gender discrimination in societies and the lower the position of women, the more negatively they are affected by HIV. The main threat to women lies in the fact that it is not their own behaviour that puts them at risk, but that of men. Women's low social status is the driving force of their greater risk of being infected with HIV. Dependence, poverty and fear of impoverishment raise their odds of becoming infected.

Does physical and sexual violence also play a role in the world of work?

Women may be exposed to the risk of sexual harassment and abuse at the workplace. They face pressure to have sex in return for being hired or promoted, or to avoid dismissal. Research in one African country's coffee, tea, and light manufacturing industries found that women experienced violence and harassment as a normal part of their working lives. Over 90 per cent of the women interviewed had experienced or observed sexual abuse in their workplace and 70 per cent of the men viewed sexual harassment of women workers as normal and natural behaviour.

In a climate of daily violence against women, just the anticipation and fear of violence may prevent them from refusing sex, or from insisting on the use of condoms or other forms of safer sex.

How can societies avert the loss of productive women though HIV/AIDS?

We need to act on more than one front. The challenge is to pursue two parallel lines of action simultaneously. There is an urgent need to address the problem of AIDS now, and women must have their fair share of treatment. At the same time, it is essential to address the root causes of HIV transmission, and prevention remains key. A path to reverse the actual trend has already been traced; it now needs political will, determination and appropriate resources. Poverty eradication, transformation of workplace practices, keeping girls in school, job training, and attacking the root causes of women's low status through legislation are as essential to reduce HIV transmission as raising women's awareness of the risk of transmission and giving them the direct means of prevention.

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Note 1 - "HIV/AIDS and work: global estimates, impact and response", 2004, International Labour Organization, available at www.ilo.org/aids and at www.ilo.org/publns.