A girl born today in a poor community becomes part of the largest group of people to be denied basic needs and human rights: women. This inequality is reflected in the AIDS pandemic.

In sub-Saharan Africa, close to 60% of adults living with HIV and AIDS, or a total of 13.3 million adults, are women. Among those 15 to 24 years old, six times more women than men are living with HIV or AIDS in some African countries. In the past two years, East Asia has seen a 56% increase in the number of women infected with HIV, and Europe and Central Asia were not far behind with a 48% increase in infection rates in women over the same period.

Physiological and cultural factors put women at great risk for contracting HIV and AIDS. Physiologically, women are more likely to contract HIV through a single exposure because the cervix is particularly vulnerable to infection—especially from abrasions caused by violent or forced sex.

Culturally, women are often socially marginalized, denied basic legal rights, denied education, and vul¬nerable to physical and sexual abuse. In many cultures, a girl is devalued from birth, and poverty and social norms can prevent a woman from breaking the cycle of exploitation for her daughters. A girl child may be given less food, denied urgent medical care, and assigned exhausting chores. She may be forced to end her education to marry, or to work to care for a sick parent or to provide for the family. Also, when women marry, they are often left without basic legal documentation and rights. In many developing country contexts, the inheritance and property rights of women are often not enforced, and many women marry without a marriage certificate, making their claims difficult to prove to the authorities. This lack of property rights, coupled with the lack of education, gives many women few options if they are widowed or divorced. Women are substantially less likely to be educated in devel¬oping countries. Across 131 developing countries in four major regions, there is a pervasive literacy gap of 8.8%, on average, between men and women. There are 33 countries where the literacy gap between men and women is greater than 15%. In Zimbabwe, one study found that girls aged 15 to 18 who had dropped out of school were six times more likely to be living with HIV than similar girls who were still in school.

Poverty and inequality combine to pass a death sentence on millions of women worldwide. In many developing countries, women’s relationships are marked by violence, coercion, and economic depen¬dency—all which rob them of control over their relationships. Spousal abuse, which is endemic in many countries, can discourage wives from confronting their husbands about extramarital affairs or asking them to use a condom when they have sex. Also, in contexts where women and girls are afraid of being abused or forced out of their homes if they are HIV-positive, they may put off testing or treat¬ment out of fear of being discovered.