HIV Risk Behaviors and Gender Dynamics in Sexual Health

The transmission of HIV remains closely tied to a spectrum of sexual behaviours and the power relations that shape them. Practices such as inconsistent condom use, multiple and age-disparate partnerships, transactional sex and low uptake of pre-exposure prophylaxis contribute to ongoing incidence in diverse settings. Gender norms and relationship power inequities influence negotiation of safer sex, stigma surrounding prevention tools and adherence to antiretroviral therapy. Women and gender minorities often face constrained agency in sexual decision-making and heightened vulnerability to intimate partner violence, while constructions of hegemonic masculinity can normalise risk-taking practices. Intersectional factors including age, socioeconomic status and gender identity further modulate exposure to risk and access to services. A holistic response requires combining behavioural interventions with structural approaches that transform gender relations, reduce stigma and expand equitable access to prevention and treatment.

Research from Nature Portfolio

A recent global analysis quantified the burden of unsafe sexual practices in over 200 countries, demonstrating that HIV-related mortality and disability-adjusted life years are disproportionately high among women and in low-resource regions. The study showed that both age-standardised mortality and disability rates attributable to unsafe sex have declined in correlation with socioeconomic development, yet remain elevated in sub-Saharan Africa. By disaggregating data by age, gender and sociodemographic index, the work underscores critical hotspots for intervention and the need for policies that prioritise gender-sensitive prevention and care strategies.

HIV Risk Behaviors and Gender Dynamics in Sexual Health publication trend

The graph below shows the total number of articles in hiv risk behaviors and gender dynamics in sexual health across all publications each year (not limited to Nature Index journals).

Technical terms

Disability-adjusted life year (DALY): A metric combining years of life lost and years lived with disability to quantify overall disease burden.

Age-standardised rate (ASR): A rate adjusted to a standard age distribution, allowing comparison across populations with different age structures.

Antiretroviral therapy (ART): A combination of medicines used to suppress HIV replication and restore immune function.

Relationship power inequity: A state in which one partner has disproportionate control over decisions affecting sexual activity and health.

Transactional sex: Sexual activity in exchange for money, goods or services, often reflecting economic vulnerability.

References

1. Global disease burden attributed to unsafe sex in 204 countries and territories from 1990 to 2019: results from the Global Burden of Disease Study 2019. Scientific Reports (2023).
2. Supportive couple relationships buffer against the harms of HIV stigma on HIV treatment adherence. BMC Public Health (2023).
3. Epidemiology, risk factors, and prevention strategies of HIV, HPV, and other sexually transmitted infections among cisgender and transgender youth: a narrative review. Frontiers in Public Health (2024).