Women and AIDS in Africa: demographic implications for health promotion

The population pyramid in most African countries is symmetricalwith a broad base. However, in urban areas, one finds a prominentone-sided bulge caused by the migration of young males (aged18–35) into the cities for employment. The prevalenceof HIV infection in urban populations in Africa is highest inthe 25–35 year old age-group in males and in the 15–25year old age-group in females. This difference is due to thefact that on average, sexual partnerships are formed betweenolder men and younger women. The distortion of the urban populationprofile caused by male migration results in an overall 1:1 female:maleprevalence ratio of infection. However, as the epidemic spreadsinto the larger rural population, the absolute size of the mostseverely affected younger female population is larger than thesize of the older male population, which eventually resultsin a higher number of infections in women. This excess of female morbidity from HIV infection has importantimplications for the social and the economic role of women insociety. It also adds fuel to an emerging epidemic of paediatricAIDS. Health promotion strategies to address this issue shouldinclude: (1) public policies designed to narrow the male:femaleage-gap of sexual partnership formation; (2) policies addressingthe economic migration patterns of the male work force and;(3) policies to narrow the base of the general population pyramid.