A distressing characteristic of the impact of HIV/AIDS has been its cruel exploitation of the unequal gender relations and the threat of domestic violence that exist in many developing countries. The virus has no sympathy for the weak position of young women to negotiate safe sex or no sex. Married women are exposed to the infidelities of their husbands, especially those whose work takes them away from home. As if these relational risks were not enough, women are much more susceptible than men to transmission of the virus during sex with an infected partner.

HIV positive mothers will now get treatment for themselves and their families © United Nations' Integrated Regional Information Network

As a result, in the 15-24 age group in sub-Saharan Africa, 75% of people living with HIV/AIDS are women. This profile and its underlying causes have galvanised the efforts of international women's groups and strengthened the call for HIV programmes to integrate with broader reproductive health services. In consequence a controversial morality dimension unsettles the humanitarian fight against AIDS. Its most extreme manifestation is the continued refusal of the Roman Catholic church to countenance the use of condoms. And US PEPFAR funding still carries some conditions imposed by religious conservatives which bias its prevention programmes towards abstinence rather than safe sex. Apart from naivety, the flaw in these impositions is the presumption that the balanced gender relations found in the West are replicated in poor countries.

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