Failed Health Policies and Colonial Legacies: The Case of U.S. HIV/AIDS Prevention and the Vulnerability of Kenyan Women

Introduction: Kenyan women are disproportionately affected by HIV/AIDS compared to their male counterparts. In 2003, George W. Bush implemented the President's Emergency Plan for AIDS Relief (PEPFAR) in an effort to tackle the soaring HIV incidence rates in a number of developing countries, including Kenya. However, by ignoring the historically-determined social, economic, and political factors underlying women's HIV vulnerability, the bill fails to effectively tackle the growing pandemic. Methods: A thorough review of the literature to identify relevant sources and policy analysis of H.R. 1298. Results: By adhering to biomedical and cultural models of HIV/AIDS, the bill that authorized PEPFAR, H.R. 1298, fails to recognize and address the gender inequality at the root of women's HIV vulnerability. In order to fully understand Kenyan women's risk of infection, a thorough examination of the impact of colonialism on contemporary women's societal position is needed. While Kenyan women had a lesser social status than men prior to colonial rule, British colonists imposed laws that further undermined their property and ownership rights and restricted their economic options. These laws have all had a lasting impact on contemporary Kenyan women's experience in the existing economic, education, legal, and health care systems, which in turn affects their vulnerability to HIV infection. Conclusion: In order to be truly effective against the spread of HIV/AIDS in Kenya and other areas of the world, policies such as PEPFAR should adopt a woman-centered transformational and structural model of HIV prevention that tackles colonial legacies.