Abstract #140  -  Gender inequality: Differences between men and women living with HIV/AIDS. Results from the AIDES & toi survey
Authors:   Presenting Author:   mr Christian Andreo - AIDES
Additional Authors:  Ms. Daniela  Rojas, Mr.  Jean-Marie Le Gall, Ms. Graciela Cattaneo, Ms.  Cynthia Benkhoucha, Ms. Joanne Otis, Mr. Martin Blais, Mr. Bruno Spire, Mr. Vincent Pelletier,
Aim: The AIDS epidemic has a special impact on women, in particular because of their assigned role, socio-economical situation and vulnerability to HIV infection. We hypothesized that HIV-positive men and women catered for at AIDES, the largest community-based HIV organization in France, would differ when compared in several socio-demographic, behavioral, clinical and stigma-related variables.
Method / Issue: A cross-sectional nation-wide survey, filled out by 2434 respondents, was carried out in May 2007. During one week, a self-administered questionnaire was systematically offered to every person in contact with AIDES. The questionnaire includes standardized items concerning socio-demographics, health status and quality of life, sexuality, use of the organization and HIV stigma and disclosure. Statistical comparisons were made between groups using independent Student-t-tests and chi-square tests.
Results / Comments: 265 heterosexual HIV positive men and 357 heterosexual HIV positive women fulfilled the questionnaire. No significant differences were observed in relation to being unaware of the HIV serology (6.3% for men vs. 4.5% for women). Regarding family structure, men and women were found to be in couples in about 63% of cases and women reported having children in a larger percentage than men (73.2% vs. 59.2%; p<0.001). Concerning access to work, men and women only differed in relation to part-time jobs, more frequently reported by women (15.1% vs. 4.2%; p<0.001). As for accommodation, men were more likely to have unstable housing (35.2% vs. 22.8%; p<0.001). Regarding experienced discrimination in the last two years, men and women reported being discriminated against in 52% of the cases. When asked to specify in which settings they experienced discrimination, significant statistical differences were found for the �intimate relationships� settings (38.5% for women vs. 27.8% for men; p<0.05). In relation to this issue, the fear of stigma and a real stigma score was estimated (1: �no stigma� - 4: �stigma�). Men and women obtained the same result for lived stigma; however, women reported more expected stigma than men (3.02 vs. 2.87; p=0.01). Concerning biological markers, women were significantly less aware of their viral load (18.3% vs. 12.7%; p<0.05) and men reported more frequently treatment failure than women: detectable viral load (27.1% vs. 18.3%; p=0.009) and CD4 cell counts <200 (19.3% vs. 12.8%; p< 0.05). Finally, results showed statistical differences regarding the activities provided by AIDES where men and women preferred to participate. Women were more likely to participate in support groups than men (26.9% vs. 18.1%; p=0.006) and to ask for support and information at the local offices of AIDES (37.5% vs. 25.3%; p=0.001).
Discussion: As said before, improving quality of life in PLWHA is still a main concern. The stigma processes linked to HIV infection as the access to comprehensive medical information, especially for HIV positive women, deserve special attention. The current results show complex relationships between gender and inequalities. Further research is needed in order to clearly state the circumstances which create vulnerability situations linked to gender, such as financial autonomy, work access, marital status or childhood.
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