Inspired – and alarmed – by my colleague Lisa Kays’s blog post earlier this week about off-the-charts HIV/AIDS rates in the District of Columbia, I read the Department of Health’s recent report.
The report is powerful for what it includes – and what it doesn’t.
What it does include: voluminous statistics about the HIV/AIDS epidemic in the District, including trends, clinical indicators, geography and its effects on several “selected subpopulations.”
What it does not include: any real or sustained focus on women or illumination of the differences in the disease between women and men and the related implications for prevention and treatment.
For example:
- While more men are living with HIV/AIDS in the District, women still make up more than one-quarter of those infected. In addition, between 2003 and 2007, women’s share of new HIV/AIDS cases increased (from 28.9 percent to 30.1 percent), while men’s share decreased.
- While sex is the main mode of transmission for both men and women, women’s infection is driven much more significantly by injection drug use. Among people living with HIV/AIDS in the District, injection drug use was the mode of transmission for more than one-third of the women (35 percent) but less than one-fifth (19.2 percent) for men.
- HIV/AIDS among women in DC is almost totally an epidemic of people of color. Nearly all of the women living with HIV/AIDS here (94.2 percent) are African-American or Latina, compared to three-quarters (76.5 percent) of men.
The report does not contain a dedicated section focusing specifically on women, despite more than 4,000 women (adults and adolescents) living with HIV in the city in 2007. “Special populations” with about the same or (even) fewer members do have their own sections.
Other notable oversights:
- The report avoids discussing the potential role of incarceration in the spread of HIV in the District, including among women. One study, for example, exploring such a link, concluded that higher incarceration rates among black men explained the lion’s share of the racial disparity in HIV/AIDS infection between black women and women of other racial and ethnic groups (based on data from 1980 to 1996). Notably, the District has the highest black-to-white ratio of incarceration of any state in the country, according to The Sentencing Project.
- While the report touts syringe exchange, condom distribution, HIV/AIDS testing and its AIDS drug assistance programs as effective responses to the epidemic, it does not discuss other needed interventions. A shortage of community-based addiction treatment (waiting lists are common) and other basic health services and the financial and other challenges facing local AIDS-service organizations (such as Whitman-Walker Clinic) undoubtedly hamper access both to prevention and treatment for all DC residents, including women.
Please add my voice to those calling for immediate response to this public health emergency – and don’t forget the women.
Gwen Rubinstein is a Program Officer at The Women’s Foundation.
