AIDS Has a Woman’s Face

1. AIDS Has a Woman’s Face UNAIDS/W.Phillip CMCH AP

2. “Women are the backbone of society. Therefore, keeping women healthy is not just the right thing to do; it’s the smart thing to do. The simple truth is that empowering women and girls to protect themselves and their families from AIDS is key to turning the tide.”-Dr. Peter Piot, UNAIDS Executive Director

3. A Global Problem • HIV is no longer affecting primarily men. Now, twenty-five years into the epidemic, women account for nearly half the 40 million cases worldwide. • Since 1985, the percentage of women among adults living with HIV/AIDS has risen from 35% to 48%. (Source: UNAIDS) • Young women make up over 60% of 15- to 24-year olds living with HIV/AIDS. (Source: UNAIDS) • Worldwide, young women are 1.6 times more likely to be living with HIV/AIDS than their male counterparts. (Source: UNAIDS)

4. Estimated Number of Women and Men Living With HIV/AIDS by Region

5. Gender and Regional Differences • The overwhelming majority of people with HIV/AIDS live in the developing world. • 98% of women, 94% of men • Sub-Saharan Africa faces devastating numbers, with a disproportionate effect on women and girls. • 77% of all HIV+ women live in Sub-Saharan Africa (Source: UNAIDS) • The Caribbean and parts of Asia are facing epidemics which are now moving from subsets of the population, IVDU and sex workers, into the general population, with women and girls particularly affected.

6. Gender and Regional Differences

7. Sub-Saharan Africa • Since 1985, the percentage of women living with HIV relative to men has increased every year. The largest effect has been seen among women 15 to 24 years old. • HIV is spreading primarily through heterosexual contact, thereby increasing the impact on women. Justgiving.com Justgiving.com Unicef

8. Sub-Saharan Africa

9. Women in Sub-Saharan Africa (Source: Seattle Times)

10. Asia and the Pacific • In the past, the mode of transmission has been mainly through injection drug use and sex work. Now, HIV transmission between spouses has become a more prominent cause of new infections. • India and China face a potential AIDS catastrophe. www.thp.org www.thp.org www.burnet.internationalhealth.edu/au www.burnet.internationalhealth.edu/au

11. Eastern Europe and Central Asia • The events of the 1990s have brought declining socioeconomic conditions and increasing inequity in the region. • The hopelessness is fueling injection drug use and unsafe sex. • Most of the IV drug users are young and sexually active, characteristics leading to an increasing prevalence of sexual transmission as a mode of transmission.

12. Latin America and the Caribbean • In the Caribbean, transmission is typically heterosexual; however in Puerto Rico, injection drug use appears to be the main source of the epidemic. • In South America, HIV is transmitted through injection drug use and between men who have sex with men, with subsequent heterosexual transmission. • In Central America infection is occurring through sexual contact, both heterosexually and among men involved with men. (Source: UNFPA)

13. Middle East and North Africa • HIV prevalence is still very low, with the exception of southern Sudan. • Young women aged 15 to 24 are more than twice as likely to be living with HIV/AIDS as young men. Bbcnews.co.uk www.unaids.org www.guide4living.com

14. High Income Countries • In both Western Europe and North America, the percentage of adult women living with HIV/AIDS is rising. • Prevention activities in high-income countries are not keeping pace with the changes occurring in the spread of HIV. • This is most evident in the marginalized portions of populations, including minorities, immigrants, and refugees. • In the U.S., African American and Hispanic women account for 25% of all women, yet 79% of AIDS cases among women. (Source: NIAID)

15. Confronting the Crisis

16. Prevention • Despite their increased vulnerability, women and girls knowless than men and boys about HIV and how it is transmitted • Effective prevention will take many forms, including: education, health services, media campaigns, behavior change, life-skills building and job training. • This knowledge is especially important for young girls, who in some countries face infection rates 5 to 6 times those of boys.

17. Knowledge • Discussion and education about sexual matters is discouraged in many cultures. • Education initiatives need to emphasize female empowerment, gender equality and male responsibility. • Programs currently demonstrating success emphasize that • Talking about sexuality and health is important • Coercion, force, and sexual violence are unacceptable • Protecting oneself from HIV is a necessity and the means to do so are available (Source: UNFPA)

18. The Power to Use Knowledge • Women need to learn how HIV is transmitted, and also how to negotiate abstinence, unwanted sex or safer sexual relations. • Economic empowerment is key. • Women are less likely to be economically dependent on men and more likely to be able to negotiate protection.

19. The ABCs • Commonly accepted methods of prevention are not successful in every country. This approach needs to be expanded to meet the needs of girls and women. • Abstinence does not work when women are coerced or forced into sexual activity. • Faithfulness does not protect women whose husbands have multiple partners or were infected before marriage. • Condoms require the cooperation of men, who may refuse to use them. They are often not used because of the desire to have children or implication of the lack of trust.

20. The Risk of Marriage • A study in Kisumu, Kenya, found that 33 percent of married girls were HIV-positive, compared to 22 percent of unmarried sexually-active girls of the same age. (Source: UNFPA) • The study also found that adolescent girls married to much older men were more likely to be HIV-positive. • Half of the women whose husbands were 10 or more years older were HIV-positive, compared to none of the women whose husbands were up to 3 years older. • In India, marriage is actually women’s primary risk factor. (Source: Russell, Sabin)

21. Violence and HIV/AIDS • One in four women may experience sexual violence by an intimate partner in her lifetime. (Source: World Report on Violence and Health) • HIV+ women are three times as likely to currently have a violent partner than HIV- women. • HIV+ women under 30 are 10 times more likely to be living with violence than HIV- peers. (Source: Tanzania, Maman, 2001) • Abusive men are more likely to have sex outside relationship and contract STD. (Source: India, Martin et.al.,1999) • Women with violent partners have 50% higher chance of being HIV+. (Source: South Africa, Jewkes et al, 2004)

22. Education • A 32-country study found that women with post-primary education were five times more likely than illiterate women to know the facts about HIV/AIDS. • Illiterate women were four times as likely to believe there is no way to prevent HIV/AIDS. (Source: Vandernoortele) • Educated women are more likely to know how to prevent HIV infection, to delay sexual activity and to take measures to protect themselves.

23. Education:A Tool Against HIV/AIDS

24. Women as Caregivers • Up to 90 percent of the care due to illness is provided in the home by women and girls. (Source: Global Coalition on Women and AIDS) • Women’s work remains unpaid and as such economically undervalued • Girls are being taken out of school to provide home-based care. • In Swaziland, school enrollment has fallen 36% due to AIDS, mostly affecting young girls. (Source: Global Coalition on Women and AIDS) • The increased workload, loss of family income and deepening poverty make women more dependent on others and worsen inequalities.

25. What Should Be Done?

26. Funding Must Work for Women • Programs must meet the needs of women while remaining culturally sensitive-through changes in prevention, treatment, community-based care, and education. • Track and monitor the flow of resources to ensure that women and girls benefit. • Ensure that forms of gender discrimination are eliminated and women’s human rights are protected.

27. Provide the Knowledge and Means to Prevent HIV Infection • Institute population-wide gender-sensitive education and advocacy campaigns. • Break the cycle of poverty, gender inequality, and vulnerability to HIV infection. • Increase access for women to both male and female condoms and provide the skills to negotiate their use. Increase the supply of clean needles and harm reduction programs for IV drug users. • Integrate HIV prevention into all health care settings.

28. Zero Tolerance for Violence Against Women and Girls • Encourage dialogue between community and religious leaders about human dignity and the negative effects of violence against women and girls. • Provide counseling services to women and girls who experience sexual violence to address the trauma and mitigate long-term consequences. • Ensure that humanitarian responses to crisis involve sexual and reproductive health services and counseling.

29. Promote Girl’s Education and Women’s Literacy • Promote zero tolerance of violence against women and sexual harassment in schools. • Provide life-skills education both in and out of school that fosters mutual respect and equality. • Ensure that curricula remove gender stereotypes, promote female leadership and self-esteem and include age-appropriate information on sexual and reproductive health and HIV/AIDS. • Expand literacy classes for women of all ages.

30. What You Can Do

31. Support the PATHWAY Act • Write to and call your Member of Congress urging them to support H.R. 5674: Protection Against Transmission of HIV for Women and Youth Act of 2006 • Goal of the PATHWAY Act • Require the President and the Office of the Global AIDS Coordinator to establish a comprehensive and integrated global HIV prevention strategy to address the vulnerabilities of women and girls • Remove the 1/3 abstinence-until-marriage prevention earmark from the U.S. global AIDS policy

32. Additional Aims of the PATHWAY Act • Increase access to female-controlled prevention methods, such as the female condom, and educational programs. • Promote services directly targeted at girls and women that go beyond the ABC model. • Promote gender equity, reduce violence against women, and de-stigmatize HIV/AIDS by addressing the issue of stigma with men, women, and children. • Ensure that women and girls have equal access and opportunity to HIV/AIDS prevention and treatment services.

33. Support US Investment in Microbicides Research • Though no proven microbicide currently exists, once development is completed, microbicides would give women the power to protect themselves from infection • Write to and call your Members of Congress and ask them to support H.R. 3854 or S. 550, the U.S. Microbicides Development Act. • Will authorize funding increases as needed • Will require the National Institutes of Health to: • Establish a branch dedicated to microbicide research • Expand and coordinate the research of all three federal branches (NIH, CDC, and USAID)

34. AIDS Advocacy Network-AAN • Mobilize! Join @ http://www.amsa.org/global/aids/ • Chance to network with local and national AIDS activists. • Speak at schools in your area • Plan events for World AIDS Day: Dec 1st • Help coordinate Global AIDS Week of Action in February

35. Sources • Women and HIV/AIDS: Confronting the Crisis, UNAIDS/UNFPA/UNIFEM, http://www.unfpa.org/hiv/women/report/ • HIV Infection in Women, NIAID Factsheet, http://www.niaid.nih.gov/factsheets/womenhiv.htm • Women, AIDS, and HIV, http://www.avert.org/women.htm • Women, Children, and HIV, http://womenchildrenhiv.org/ • Global Campaign for Microbicides, http://www.global-campaign.org/ • PEPFAR Watch, http://www.pepfarwatch.org/