Gender Disparities in HIV Prevention: Challenges and Solutions Facing the World

The "Invisible Gap" Leaving Women Behind—A Deep Divide in HIV Prevention in the West Midlands

A new report highlighting gender disparities in access to HIV prevention in the West Midlands, central England, has garnered attention. On October 11, 2025, the BBC reported a "significant" gender gap in HIV prevention, pointing out the disadvantages faced by women in the region. The article was published at 11:12 (UTC) on the same day and has since been updated.🔗 newssniffer.co.uk

It wasn't just news sites spreading the report. BBC Midlands and BBC WM (regional branches of the BBC) shared it on X (formerly Twitter), fueling regional discussions.🔗 X (formerly Twitter)

What is the "Gap"?

At the core of this gap is the gender disparity in access to pre-exposure prophylaxis (PrEP), testing, and information about HIV. A broad view of the latest situation in England shows that in 2023, only 3.1% of those newly or continuously using PrEP in specialized sexual health services were women. The imbalance in usage relative to demand (risk of infection) remains significant.🔗 National AIDS Trust

Furthermore, monitoring frameworks for public statistics reveal gender differences in testing behavior. The UK government's framework indicates that women have a higher rate of declining HIV tests compared to men, highlighting the need to optimize testing opportunities.🔗 GOV.UK

Research also shows accumulating evidence of disparities in the provision and use of PrEP across gender, ethnicity, and region. An analysis of the "PrEP-Needs Ratio" by the BMJ's Sexually Transmitted Infections journal supports the reality that PrEP services in the UK are unevenly distributed by gender, ethnicity, and geography.🔗 sti.bmj.com

The "Field" of the West Midlands

The West Midlands, centered around Birmingham, is a metropolitan area where diverse communities coexist. The UK Health Security Agency (UKHSA) compiles regional data and has released the latest "HIV Data Tables," providing foundational statistics for future detailed trend analysis.🔗 assets.publishing.service.gov.uk

Community efforts are also active. For example, Birmingham's HIV support group "Positive Peers" has been strengthening peer support systems in the region, offering assistance regardless of gender, sexuality, or background.🔗 beyondpositive.org

Why Doesn't It Reach Women?—The Dual Barriers of Structure and Psychology

International and UK studies cite multiple factors making it difficult for women to access PrEP, including healthcare providers' knowledge and attitudes, practical barriers like cost and travel time, power dynamics in intimate relationships (negotiations with partners and risk of violence), concerns about side effects, and lack of information.🔗 BioMed Central

Not limited to the UK, women's use of PrEP is globally lower than men's. In the US, data shows that in 2024, 91% of PrEP users were men, with women making up only 9%. The gender gap remains significant.🔗 AIDSVu

Reactions on Social Media—Regional Media Sparks a Flame, Stakeholders and Support Groups Raise Their Voices

The recent BBC report was quickly visualized through regional bureau posts on social media. On X, opinions such as "prevention information has been biased towards same-sex interactions" and "testing and PrEP pathways for women should be integrated into everyday healthcare (gynecology, contraception consultation, maternity checkups, etc.)" were prominent. Particularly referenced were campaigns like "PrEP Protects" by HIV Prevention England (HPE) and awareness campaigns by pharmaceutical companies focusing on women and HIV, spreading the sentiment that it's time to redesign "who prevention is for."🔗 hivpreventionengland.org.uk reports.weforum.org

(Note: Specific individual posts are not quoted, and summaries are based on trends from official accounts and public campaigns.)

What Needs to Change—Five Implementation Proposals

1. Normalizing PrEP Pathways for Women
   Incorporate PrEP consultations at the entry points of contraception consultations, maternity checkups, and STI testing. Evaluate PrEP eligibility simultaneously with HIV testing and standardize the pathway for medication explanation and follow-up.🔗 GOV.UK

2. Enhancing Cultural and Language Responsiveness
   Support community-led information dissemination tailored to the diversity of the West Midlands. Co-create expressions and channels that reach women in Black/Asian communities.🔗 BioMed Central

3. Healthcare Provider Education and Updating "Unconscious Assumptions"
   Revise the fixed notion that PrEP is "for men" and design consultations and education assuming that women (especially heterosexual women) also face high-risk situations.🔗 sti.bmj.com

4. Data-Driven Targeting
   Utilize UKHSA regional data and local attendance patterns to visualize underserved groups. Implement approaches tailored to groups with high test refusal rates (setting locations and times that lower visit barriers, distributing self-test kits, etc.).🔗 assets.publishing.service.gov.uk

5. Intermediary Support for "Voices"—Expanding Peer Support
   Connect stakeholder groups like Positive Peers with healthcare institutions and local governments to systematize support for continued visits and medication adherence.🔗 beyondpositive.org
   
   

Towards the "2030 Goal"

While the UK aims to end new infections (2030 goal), recent years have seen increases in new diagnoses among heterosexuals. Ignoring the gender gap will distance the path to this goal. Redesigning prevention for women, not just "also" for women but "for" women, was bolstered by the recent regional report and the social media whirlwind.🔗 The Sun