Who run the world? Girls?: A review of the literature on Theory of Gender and Power and HIV-risk in women

Background: Caribbean women have the second highest percentage of people living with HIV/AIDS in the world, with sociocultural drivers such as forced/coerced sex, transactional sex, and cultural norms, greatly increasing their risk. Few Caribbean studies have addressed this gender disparity by incorporating theory that explains HIV risk from a gendered perspective such as the theory of gender and power (TGP). Purpose: To review published studies that use TGP to assess women’s HIV risk behavior. Implications of incorporating TGP in research on Caribbean women’s HIV risks are addressed. Methods: A literature search was conducted in January 2014 using electronic databases and the keywords “Theory of gender and power" AND “HIV”.  Studies explicitly stating the use of TGP to assess HIV risk in women were included. Forty-nine articles were initially yielded. Of those, 29 review articles, books, dissertations and duplicates were excluded. One study did not meet the inclusion criteria as it didn't assess any HIV-risk outcomes. Results: Nineteen studies were reviewed, with the majority being quantitative and targeting women of color. Four studies were conducted internationally. Overarching themes will be presented in more detail. Conclusions: HIV interventions using TGP strongly suggest increased HIV-protective behaviors, and the potential to achieve reductions in STIs and HIV in women. All studies highlight strong associations between gender and power differentials and HIV-risk behaviors in women. Evidence based research using TGP is deemed feasible and necessary in order to further address the associations between social norms that govern gender relationships and HIV-risk behaviors in Caribbean women.