In many parts of the world women and girls are disproportionately affected by HIV/AIDS, particularly poor women in marginalized communities. Discrimination, poverty, and marginalization are drivers of the HIV epidemic as much as the specific social behaviors that typically lead to infection.
From the onset of the AIDS epidemic, stigma and discrimination have been recognized as one of the major barriers to accessing HIV prevention, treatment, and care and support programs. What is less acknowledged is that gender inequality continues to fuel HIV transmission and women, particularly young women and girls, are at serious risk. HIV/AIDS is a preventable disease. We have the knowledge and information to prevent it, and yet its prevalence continues to spread largely because our society is plagued with discrimination.
In the United States, a quarter of all new HIV infections are among women, and women of color are particularly affected by the epidemic. The Center for Disease Control reports that HIV/AIDS was the leading cause of death for black women aged 25-34 years in 2004 – the most recent year for which such data is available. The rate of infection has continued to increase among women, particularly among African American and Latina women.
Around the world similar trends are visible. Latin America and the Caribbean, a region plagued by inequality, is no exception. While often overlooked within the global AIDS debate, the Latin American and Caribbean region is at a crucial tipping point where prevention efforts and access to HIV/AIDS treatment could determine the future of the epidemic. The increase in the number of women living with HIV in Latin America and the Caribbean is particularly alarming. In twenty-one out of twenty-three countries in the region for which UNFPA data is available, the number of women fifteen years of age and older that are living with HIV has risen and in some instances this rate has nearly doubled since 2001.
Lack of comprehensive sexuality education, misconceptions about HIV/AIDS, homophobia, gender inequality, gender-based violence, sexism and other harmful social and cultural norms are all factors in the spread and the impact of HIV/AIDS. This is particularly true for younger women who may be less likely to be able to negotiate contraceptives usage and mutual respect within relationships.
At one antenatal site in Colombia, 72 percent of women who tested HIV positive reported being in stable relationships. Prevention programs often neglect telling women that a stable relationship is no guarantee against infections. Actually the infamous ideological propaganda of the ABC actually gave the impression that being faithful was one of the major prevention strategies.
While the connection between discrimination and HIV is clear, we have not seen the financial investments or political will that are needed for halting the spread of HIV/AIDS. We need greater investments in women and girls and in public health interventions that successfully tackle the root causes of gender inequality and poverty. Governments have failed to address the complex socioeconomic problems that fuel the epidemic. Specific interventions that are urgently needed are access to high-quality comprehensive sexual and reproductive health services, comprehensive sexuality education, and stopping violence against women. If governments invest in these three things, and women and girls’ empowerment is placed at the center of the HIV/AIDS response, the epidemic can be reversed.
A widely acknowledged leader in the field of sexual and reproductive health and rights, Dr. Carmen Barroso has led IPPF/WHR since 2003. Under Dr. Barroso’s direction, the organization now combines quality health services with powerful advocacy in defense of sexual and reproductive rights. Previously, she served for twelve years as Director of the Population & Reproductive Health Program of the John D. and Catherine T. MacArthur Foundation, funding hundreds of NGOs in Africa, Asia, and Latin America and helping to bring the voices of women in the developing world to international policy fora. She was a founding member of DAWN, a network of Third World women, and of the Funders Network on Population, Reproductive Health and Rights. Dr. Barroso holds a PhD in Social Psychology from Columbia University and has been a Visiting Scholar at Cornell University.