Ending Bias Key to Stopping Spread of HIV to Women

(WOMENSENEWS)–Gender inequality is sometimes fatal, as people are learning this week at the International AIDS conference in Barcelona.

In this, the third decade of the global AIDS pandemic, stigma against women infected with HIV/AIDS is one of the single greatest challenges that face us as we try to slow the spread of this deadly disease.

We know from more than a decade of researchon women and AIDS that gender significantly colors women’s experience. An unequal balance of power between women and men restricts women’s access to information and education, economic resources, social support, and services and technologies. Stigma impedes women from knowing they are at risk, creates a barrier to testing, reduces access to treatments, hinders women’s ability to negotiate protection, and prevents individuals from providing loving and humane care to their family members and loved ones who are infected.

Gender inequality also curtails women’s sexual autonomy, increases women’s risk and vulnerability to HIV and lies at the root of women’s painful experience in coping with the discrimination associated with infection–their own or the infection of those for whom they care.

Seventy-five percent of HIV infections around the world take place through heterosexual sex. Women are especially at risk since men are eight times more likely to transmit HIV to female partners through unprotected sex than women are to transmit the virus to men. This reality is shaping a dramatic shift in gender of those who have are infected. In 1997, 41 percent of HIV-positive adults were women; in 2001 the rate had risen to 44 percent.

Throughout the world, HIV-positive men generally qualify for and are provided with greater acceptance, care and support at home, mostly from women, who are generally the caregivers.

In contrast, women with HIV are frequently blamed for their partner’s infection, denied financial support for treatment and hospital care, and frequently denied shelter in their matrimonial home. In other words, HIV positive women bear a double burden: They are positive and they are women.

Myths Prevent Early Treatment

The belief that the one who is found to be HIV positive first is the one to bring the infection home serves as a significant disincentive to HIV testing. Without knowledge that they are infected, women are unable to get early treatment for themselves or take measures to prevent others from becoming infected.

Pregnant women and nursing mothers are also harmed by this myth. Women who don’t know they are infected cannot get access to antiretroviral drugs that prevent the transmission of HIV from women to their children during pregnancy or through breastfeeding. With few resources to cope with possible abandonment and other consequences of being HIV positive, pregnant women often feel that the potential consequences of HIV testing are worse than the risk of death.

For unmarried women, the strong norm of virginity that exists in many societies restricts young women’s ability to ask for information about sex or access treatment for sexually transmitted diseases. For married women, the expectation of ever-lasting fidelity and passivity in sexual interactions automatically stigmatizes married women who try to negotiate condom use with their partners or are the first to be found to be HIV positive.

Shattering Stigma is First and Most Important Step

Inaccurate information about HIV/AIDS adds to the discrimination women face. Dissemination of accurate information is the first necessary step in effective prevention, treatment, care and support; but three decades into the global epidemic, we have failed to fulfill this single and fundamental goal. Misperceptions and myths still abound.

We now know that fear-inducing messages about AIDS that emphasize the fatality of the disease or portray HIV as the result of moral decay do little to motivate people to change their behavior. Instead, these messages exacerbate fears associated with the disease and cast infected women as immoral and somehow deserving of discrimination and death.

To further reduce stigma against women with HIV/AIDS, we need policies and laws that foster acceptance and deter discrimination. Allowing women living with HIV/AIDS to be educators and spokespersons for the prevention, care and support messages, is empowering for them. It serves to reduce the social distance between those that are infected and those who are not by personalizing the disease.

Although these alone are not sufficient, such policies and laws are essential instruments to protect the human rights of those infected and affected by this epidemic. Once we reduce stigma against women with HIV/AIDS, we will be well on our way to slowing down this epidemic.

Geeta Rao Gupta is the executive director of the International Center for Research on Women in Washington, D.C.