Last week marked the 30th anniversary of what we recognize as the beginning of the HIV/AIDS epidemic. In the subsequent days, we've seen stories measuring progress, touting the newest prevention methods, and updating the statistics. However, in all the talk, there has been one core aspect of HIV/AIDS that has been absent: that women comprise 50 percent of those living with HIV globally, 60 percent of those infected in sub-Saharan Africa and that 72 percent of all young people living with HIV/AIDS in southern Africa are girls between the ages of 15 and 24.
In recent years, the U.S. has been a leader in the fight against HIV globally, commendable in their funding for treatment but unforgivable in their denying women access to tools and information to prevent HIV and unintended pregnancy, perpetuating a dangerous fallacy that marriage is reliable protection against HIV infection.
Here at home, women have fared no better. In the U.S., women account for nearly 30 percent of those living with HIV.* Yet the U.S. National HIV/AIDS Strategy issued in July 2010 has no gender strategy. In fact, women barely appear in the U.S. National HIV/AIDS Strategy and its implementation plan. This is striking given national strategic plans on HIV and AIDS in southern and eastern African countries highlight women, girls and gender equality as key to the fight.
However, this is not to say simply adopting a gender strategy will ensure women receive the prevention, treatment and care they need. In a recent analysis of 20 African national strategic plans for HIV and AIDS where women, girls and gender equality feature prominently, most strategies focused not on women's health, but on prevention of vertical transmission of HIV to newborns. The majority failed to provide an effective approach to tackling gender inequalities, to meaningfully advance women's rights, and to link HIV with other sexual and reproductive health services. The same shortcomings are true for the gender strategy of the US. global AIDS strategy in PEPFAR (President's Emergency Plan for AIDS Relief).
With such deficiencies in the PEPFAR gender strategy and national strategies of these African countries, why then bother with a gender strategy for the U.S. National AIDS Policy?
For decades, global agreements, political declarations, and national plans and strategies have given women throughout the world tools to fight for our rights. Without a written document outlining a government's commitment to women, words are mere rhetoric. We need tools for advocacy, to hold our governments accountable. Right now, women in the U.S. do not have a stated commitment from our government for women and HIV. No strategy for how the government is going to slow the infection rate among women -- especially among women of color and women who are living in poverty. We need a strategy to hold this administration (and future administrations), members of Congress, governors and local leaders accountable.
The Obama administration should commit to do right by women and put them at the center of its HIV/AIDS agenda at home and overseas. It should go beyond prevention of HIV transmission to newborns to preventing new infections among women and treating and caring for the women who are infected. And at the heart of it all, the U.S. must focus on the central roles that gender inequality, denial of reproductive rights, poverty and violence play in fueling the epidemic. This commitment must be demonstrated through bold gender strategies and robust funding for women.
HIV is global. We have to take what we have learned from PEPFAR and the global community and apply it to the U.S. That's what will make the response to HIV as global as the epidemic.
*This blog was updated on June 16, 2011 to reflect the most current statistics.