HIV has reached epidemic levels here in Washington, D.C., reports Susan Levine in today’s Washington Post.
Levine writes, "The first statistics ever amassed on HIV in the District, released today in a sweeping report, reveal "a modern epidemic" remarkable for its size, complexity and reach into all parts of the city. The numbers most starkly illustrate HIV’s impact on the African American community. More than 80 percent of the 3,269 HIV cases identified between 2001 and 2006 were among black men, women and adolescents. Among women who tested positive, a rising percentage of local cases, nine of 10 were African American."
Combine this with what our Portrait Project found in 2003, and it’s clear that D.C.’s HIV epidemic has a lot to gain by looking specifically at strategies that impact women. The Portrait Project found that the District of Columbia has a higher incidence (new cases) of AIDS among women than anywhere else in the country. The rate of new AIDS cases among adolescent and adult women in the District of Columbia is 10 times the national rate."
In response to the new report, Levine reports, "The administration said it wants to use the report to begin asking and answering, "What next?" Given the scope of HIV and AIDS in the District, health leaders say they can’t focus on just one aspect of the disease or one at-risk group."
I hope that this means that they will be focusing on multiple at-risk groups, and designing targeted strategies for each–and that among the top priorities will be strategies to address the growth of the epidemic among women, and particularly African American women.
Because, as is evident from previous work focusing on women and girls and teen pregnancy, investing in strategies that address the specific needs of women and girls works–particularly when it comes to matters of health.
According to the National Institutes of Health, HIV isn’t just a problem for women in terms of the statistics and their risk to infection. It also poses different, and specific health threats to them once contracted. Just some of the factors that mean that HIV impacts women differently than men in terms of exposure to the virus and health risks afterwards:
- Women are particularly vulnerable to heterosexual transmission of HIV due to substantial mucosal exposure to seminal fluids. This biological fact amplifies the risk of HIV transmission when coupled with the high prevalence of non-consensual sex, sex without condom use, and the unknown and/or high-risk behaviors of their partners.
- Women suffer from the same complications of AIDS that afflict men, but also suffer gender-specific manifestations of HIV disease, such as recurrent vaginal yeast infections, severe pelvic inflammatory disease (PID), and an increased risk of precancerous changes in the cervix including probable increased rates of cervical cancer. Women also exhibit different characteristics from men for many of the same complications of antiretroviral therapy, such as metabolic abnormalities.
- Frequently, women with HIV infection have great difficulty accessing health care and carry a heavy burden of caring for children and other family members who may also be HIV-infected. They often lack social support and face other challenges that may interfere with their ability to obtain or adhere to treatment.
Further, Advocates for Youth, a D.C.-based nonprofit organization, cites specific behavioral risks to African-American women that put them at greater risk for acquiring HIV.
The additional risks and realities relevant particularly to women in curbing this epidemic are therefore biological, social and economic–and must be addressed that way.
We have the information to do so. Now we just need the will to dedicate the resources to using that information to develop strategies that truly address the needs and challenges facing women–and putting them at risk of contracting HIV.
We have to see this not only as a health issue, but as a social and economic problem. As a reflection not only of behavioral factors, but of often unseen and little understood power dynamics and pressures. Pressures that can often only be seen through the eyes of the women facing them.
There are a number of organizations throughout our region who are looking at HIV in this way, and addressing the specific needs of women who are at-risk of, or have been exposed to, HIV. Organizations like the D.C. Women’s Collective (a Grantee Partner).
We can only hope that this latest study will lead to an increased motivation on the part of our local government and other actors to do the same, and to approach the HIV epidemic in this area from a true gender lens.
This is, perhaps, the most efficient, and surest way to turn back the epidemic. For if women are at the most risk from it, they are most likely the best people to put at the front lines in fighting it. It’s our job to see that they’re properly armed.
