Understanding the Female Face of the HIV Epidemic
While men continue to account for the majority of new HIV infections in the U.S. each year, women cannot be forgotten when it comes to addressing the epidemic. This is especially relevant to African-American women who make up 13 percent of the female population, but almost 75 percent of new HIV infections among women each year.
This is a sentiment echoed in a recent report by the Foundation of AIDS Research (amFAR).
Their Women and HIV/AIDS in the US: Fast-Tracking the End of an Epidemic Issue Brief highlights how women are affected and what needs to be done to address the specific issues that make women more vulnerable for HIV infection.
“Luckily there is good news when it comes to HIV and women,” Susan J. Blumenthal, MD, told BET.com. “We have seen serious decreases among women over the years thanks to life-saving medicines, investment in research, public health campaigns and awareness and testing initiatives."
But before we celebrate, more work still needs be done in making sure more women do not fall in between the testing, treatment and research gap.
While we know that women are biologically more vulnerable to HIV infection, there are social and structural factors that put women at risk. The report illuminated that:
—While 88 percent of people know that they are positive, only 45 percent are engaged in care and only 32 percent are virally suppressed. This is particularly important because viral suppression lessens the likelihood of the virus being transmitted to others.
—Black women and girls were 14 times more likely to die from AIDS-related causes compared to white women.
—Most of these infections (84 percent) among women occur through heterosexual sex and 16 percent due to IV drug use.
So knowing this information, what can be done to address how gender, race and class intersect with HIV rates? Blumenthal emphasizes that serious changes need to be made in the following areas:
—Ensuring women are adequately represented in clinical trial research and having clear and concrete data on this research.
—Developing prevention technologies specifically for women such as successful microbicides and promoting PrEP among women. Also hopefully seeing prevention tools that can address both HIV and HPV, making it easier for women to be empowered with one method.
—Creating more interventions for women facing HIV as a result of violence.
—Increasing access to women’s reproductive healthcare and making that care accessible.
— Advocating for Medicaid expansions for the dozens of states that have refused it in the U.S.
“We need to integrate primary health care with reproductive care and make it more accessible to women through the help of mobile health vans and community health centers, especially for those who don’t have many means of transportation to travel far for care.”
She added, “Also, the Affordable Care Act expanded access for preventive health by co-pay free screenings for STDs, HIV, reproductive health and even interpartner violence. But for the women who live in states where Medicaid hasn't been expanded, especially in places where HIV rates are particularly high, they will miss out on life-saving testing, treatment and care. This only puts women more at risk.”
And while more women have to empower themselves around sex and condom use, amFAR is also clear that this conversation around women and HIV cannot be one-sided. It must stress the need for men to be involved, especially given how gender inequality and violence put women further at risk for HIV transmission.
“Given that such a large number of HIV infections among women are from heterosexual sex, we must engage men in conversations about HIV, condom use, violence and for them to be virally suppressed. But we also must emphasize on the need for men to take care of their families and the women in their lives and themselves. We have to teach young people what healthy and empowering relationships look like.”