Women and poor communities are affected by HIV/AIDS more severely than any other group.

The pandemic is a health crisis of epidemic proportions and has revealed deep inequalities over its 30 year history. It is no surprise that one of the poorest regions in the world, Eastern and Southern Africa, is home to 67% of all people living with HIV worldwide.

HIV and AIDS have had a devastating impact on the world's women. In 2009, 50% of those living with HIV/AIDS were women , while in sub-Saharan Africa women account for approximately 60% of HIV infections . Women are more vulnerable than men to HIV infection because of power inequalities in relationships, but they also are more greatly affected by the impacts of HIV and AIDS.

Socioeconomic, cultural and political power disparities, and the burden of care placed on women also contribute to this imbalance. Despite their productive and reproductive contributions to their households, women are often dependent upon men for income and assets which translate to long-term security. Women and children are often left vulnerable after the deaths of their husbands and fathers when there is no will, or they do not have the appropriate documents to claim their inheritance (such as birth and marriage certificates). The stigma of HIV often exacerbates this situation because when men die women are easily blamed for bringing HIV into the household, whether it is true or not. Women who lack shelter are more likely to take risks to provide for themselves, such as transactional or commercial sex. Women in violent relationships are also more at risk for HIV infection, and also less likely to leave those relationships without their own income or assets.

Grassroots women in poor communities in Africa began responding to HIV/AIDS before it was even identified

For grassroots women, HIV entered their homes and communities as a mysterious sickness that demanded a response.Existing health systems could not absorb the many people falling sick, and women began caring for their husbands, children, parents, friends and neighbors and for widows and orphans left behind. Without attention and usually without outside support, they became home-based caregivers.

Home-based caregivers provide critical, innovative and often the only services for people living with HIV/AIDS and affected by HIV/AIDS in their communities.

They provide palliative care, treatment for opportunistic infections and psychosocial counseling while also initiating locally appropriate and culturally sensitive stigma-reduction and awareness raising campaigns, providing nutritional counseling and promoting food security. They also link people to other services including clinics and hospitals, mortuaries, feeding programs and to resources such as bursary funds for orphans and other community development funds where they are able.

Home-based caregivers must deal with the lack of basic services while providing critical care and support.

The lack of access to clean water and sanitation, for example, has a much harsher affect on HIV positive people and those who care for them than on the rest of the population. Lack of transportation is a grim reality for caregivers trying to transport their neighbors to a distant hospitals.

HIV is not just a health issue - it encompasses all aspects of daily life.

Home based caregivers know that access to basic services, sanitation and transportation, land and housing, livelihoods, food security, and governance are all interconnected in the fight against HIV/AIDS. However, the majority of funded HIV work focuses on treatment and medical research. This further marginalizes the women administering these treatments and distracts from the importance of development in the context of HIV/AIDS.

HIV and AIDS have become a big business.

The global health and development community has responded to the pandemic in force. An estimated 15.6 billion dollars per year now goes into fighting HIV and AIDS.

Unfortunately, the majority of money to fight AIDS is not reaching the home based caregivers who are providing services no one else is. Grassroots women remain marginalized within decision-making processes such as community and national AIDS councils and are unable to access the funds or be represented in decision-making bodies.