Background: Women are disproportionally affected by human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) in sub-Saharan Africa (SSA). The determinants of gender inequality in HIV/AIDS may vary across countries and require country-specific interventions to address them. This study aimed to identify the socio-demographic and behavioral characteristics underlying gender inequalities in HIV/AIDS in 21 SSA countries.
Methods: We applied an extension of the Blinder-Oaxaca decomposition approach to data from Demographic and
Health Surveys and AIDS Indicator Surveys to quantify the differences in HIV/AIDS prevalence between women and
men attributable to socio-demographic factors, sexual behaviours, and awareness of HIV/AIDS. We decomposed
gender inequalities into two components: the percentage attributable to different levels of the risk factors between
women and men (the “composition effect”) and the percentage attributable to risk factors having differential effects on HIV/AIDS prevalence in women and men (the “response effect”).
Results: Descriptive analyses showed that the difference between women and men in HIV/AIDS prevalence varied
from a low of 0.68 % (P = 0.008) in Liberia to a high of 11.5 % (P