Disproportionate impact of sexually transmitted diseases on women.Worldwide, sexually transmitted diseases (STDs STDS - Submarine Tactical Display System STDS - System Transition and Deployment Strategy STDS - Systems Technology Departmental Services) and HIV affect women more than men. This gender differential is greater in developing countries than in industrialized countries, and biological, social, cultural, and economic factors all contribute to the gender differential in STD/HIV. Larger mucosal surface area, microlesions caused during sex (particularly forced sex), and the presence of more HIV in semen than in vaginal secretions all contribute to women's greater vulnerability to STDs and HIV. Their sex partners' behaviors also put women at risk for STDs and HIV. Culturally, men are expected to have multiple sex partners, including sex workers, and women may risk abuse or suspicion of infidelity if they refuse sex or request protection. Financial and material dependence on men renders women economically more vulnerable to STDs and HIV. Often women are under pressure to find a husband or bring home money, which in the absence of viable alternatives leads them into sex work. Effective prevention of STDs and HIV necessitates large-scale social, cultural, and economic changes and female-controlled prevention, such as microbicides 1. a substance that destroys microbes. 2. a substance that destroys infectious agents, including also viruses; sometimes used specifically for that used to prevent transmission of sexually transmitted diseases.microbici´dal mi·cro·bi·cide (m. Address for correspondence: Sevgi Aral, Division of STD Prevention, Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. The CDC is the federal agency responsible for administering national programs for the prevention and control of communicable and vector-borne diseases and for developing and implementing programs for dealing with environmental health problems., 1600 Clifton Road, Mailstop E02, Atlanta, Georgia 30333, USA; fax: 404-639-8608; email: soal@cdc.gov Sevgi O. Aral, * Sarah Hawkes, ([dagger]) Ann Biddlecom, [(double dagger]) and Nancy Padian [(section]) * Centers for Disease Control and Prevention, Atlanta, Georgia, USA; ([dagger]) London School of Hygiene and Tropical Medicine tropical medicine, study, diagnosis, treatment, and prevention of certain diseases prevalent in the tropics. The warmth and humidity of the tropics and the often unsanitary conditions under which so many people in those areas live contribute to the development and dissemination of many infectious diseases and parasitic infestations. Much has been achieved in combating such typical tropical diseases as yellow fever, amebic dysentery, and filariasis (elephantiasis)., London, United Kingdom; ([double dagger]) Alan Guttmacher Institute, New York City, New York, USA; and ([section]) University of California at San Francisco, San Francisco, California, USA |
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