The role of women in the society has been the focal point of sociologists and anthropologists around the world for many years. Women are seen as disadvantaged and most vulnerable in many aspects of life. Unfortunately, this is also reflected in the clinical statistics surrounding sexually transmitted diseases and also in the area of reproductive health.
The number of women living with HIV/AIDS has been on the increase worldwide and Nigeria is no exception. Both the low status of women and gender issues place them at risk. Therefore, more specific and comprehensive interventions are needed to respond to the causes of womenâ€™s vulnerability and risk. Issues that need serious attention include: sexuality, family, culture and empowerment, self-esteem, negotiating skills, violence and interventions in various community settings. The burden of caring for AIDS orphans usually falls on women, thereby creating extra demands on their time and resources, especially in poor families. Efforts to alleviate these consequences especially in poor families are necessary. The vulnerability of women also extends to the case of female sex workers. In many societies, sex work is illegal, resulting in clandestine practices. Nigeria, with a constitution that is silent on sex work is no exception. As a result, sex workers, brothel operators, implementing partners, and even policy makers are uncertain of the legal status of sex work. Nigeria is guided by two legal frameworks: the penal code, which operates in northern Nigeria, and the criminal code which operates in southern Nigeria . Both codes criminalize sex work and therefore hinder advocacy efforts on behalf of workersâ€™ rights. The adoption of the Muslim Sharia law in some parts of northern Nigeria has resulted in sex work going underground or relocating to other, more conducive environments, making it more difficult to reach Female Sex Workers (FSW) with interventions .
Female sex workers are characteristically poor, marginalized, and stigmatized. They lack both formal education and empowerment. Frequency of sex with multiple partners place them at high risk of HIV infection, as they often engage in unprotected sex and other risky sexual behaviour. Researches have shown a high and rising HIV prevalence among sex workers who are said to be the major reservoir of HIV infection. In some states, such as Lagos, the rates have increased from 2% in 1988-1989 to 12% in 1990-1991 to a whooping 70% by 1995-1996. A behavioural surveillance report conducted in 2000 reported that knowledge of HIV prevention methods was low among FSWs who also had a low uptake of HIV testing: only 24% reported having had an HIV test and learning the result. The HIV/AIDS crisis has become an added burden to women, and it affects them disproportionately. In discussing female vulnerability to the HIV/AIDS pandemic, Professor Gary Hopkins and colleagues from Loma Linda University, California, also attributed the spread of HIV/AIDS to the dramatic increase in adolescent females engaging in premarital sexual intercourse over the decades studied from 1970. This very much applies to the Nigerian situation. From their study, well over a quarter of girls aged 15-19 admitted to premarital sexual activity with the highest increase in the 15 year old. About 4.5 percent of the 15 year old girls engaged in premarital sex in the 1970â€™s, the figure leaped to 25.6% some two decades later. The same study shows that one in every six young girls in the high school has experienced sexual intercourse with at least five different partners. Similar results were obtained in other research into adolescent sexual behaviour .
Outside youthful sexual activity, rape, especially gang rape is one of the major attitudes carrying the risk of HIV infection . As regards reproductive health, Titi Salaam observes that fertility regulation, STD prevention, child survival and safe motherhood are a dream in Nigeria; this is because of the failure of the Nigerian government to provide free and functional healthcare to the people as a social service among others. In Nigeria, she further observes that not less than 500,000 women die from complications arising from pregnancy and about 200,000 die from abortions. Reproductive health counseling for women and adolescent girls is crucial to overcome these problems