|
World AIDS Conference Begins July 7th
Background Information for a Reporter’s Notebook
June 26, 2002 - In two weeks, as many as 15,000 participants will gather in Barcelona, Spain for the 14th International AIDS Conference, which runs July 7-12, 2002. Convened by the International AIDS Society (IAS), a professional society for scientists, health care, public health workers and other engaged in HIV/AIDS prevention, control and care, the meeting has emerged as one of the most important annual public health gatherings.
In the coming weeks, Planetwire will offer features on some of the key issues surrounding this international gathering and its underlying subject matter – the rapidly expanding global HIV/AIDS crisis. Planetwire’s features are intended to inform reporters and others interested in focusing on some of the most profound issues shaping and/or surrounding the epidemic, some of which have received less than deserved attention in the media.
Planetwire features will include:
BACKGROUND ON THE CONFERENCE
The International AIDS Conference was originally conceived as a means of enabling AIDS researchers to compare notes, share research and work together to advance scientific research on the disease. Over time, however, the meetings have taken up policy and other issues related to responding to the pandemic. Special attention will be given to progress made by governments in fulfilling the political and financial commitments made at the 2001 UN Special Session on HIV/AIDS, which set ambitious goals for prevention, treatment, care and research efforts.
The UN Special Session represented a key watershed in the history of the global response – the point at which the disease emerged fully as the greatest public health challenge in history, and as one of the primary global issues of our time.
In particular, the UN Special Session resulted in the launch of the Global Fund for HIV/AIDS, TB and Malaria which has helped to galvanize new commitments from donor nations and political resolve in the countries and regions most affected.
The theme of the XIV International AIDS Conference is “Knowledge And Commitment For Action,” which was selected to reinforce the idea of reviewing and utilizing the knowledge gained through science in service of action. To learn more about the Conference, click here.
ISSUE FOCUS – THE FEMINIZATION OF THE HIV/AIDS EPIDEMIC
Since it was first noted in a 1981 informational bulletin issued by the US Centers for Disease Control and Prevention, HIV/AIDS has progressed from being a seemingly remote concern for gay men in the United States and emerged as a global pandemic of crisis proportions. The epidemic is no longer primarily associated with homosexual activity – 75% of all new infections are now the result of heterosexual sex. As a result the scale of the AIDS crisis has grown dramatically, particularly in the 1990s. Today, the death toll is approaching 25 million and the disease has become for many countries much more than a public health issue – extending to hopes for economic development, social progress and political stability. And tragically, the ravages of HIV/AIDS are most acute in many of the poorest nations on Earth, most especially in sub-Saharan Africa. It is also growing rapidly in the Caribbean, Eastern Europe and parts of Asia.
Among the many changes in the direction of the epidemic, is its increasing impact on the lives of women. The first documented female case of AIDS occurred in 1982. Where women once accounted for only a fraction of infections, now almost 50% of the 40 million people living with HIV/AIDS are women. Responding to the global HIV/AIDS crisis is crucial to saving women’s lives.
WOMEN AND AIDS
According to the latest data released by UNAIDS, 17.6 million women and 2.7 million children were living with AIDS at the beginning of this year. In addition, women accounted for 47% of new infections and more than one-third of all deaths in 2001. In sub-Saharan African, where almost 75 % of all people infected with the AIDS virus are located, women account for 55% of all infected people.
Women – especially young women and girls – are emerging as the most vulnerable to HIV infection. Recent studies have found that women are considerably more susceptible to the virus than males. Women’s risk of infection stems from a combination of biological, social and economic realities.
Physiologically, the UN Population Fund reports that women are 2-4 times more susceptible to infection than men. This is because the lining of the vagina is highly vulnerable to the virus and semen is typically the most virulent carrier of the virus.
Women are also placed at high risk through a variety of social realities. In many cultures, women are socialized to be submissive on matters related to sex and therefore lack the power or standing required to discuss contraception, understand and pursue sexual health and/or negotiate safe sex. In contrast, it is socially acceptable (if not expected) in many cultures for men to be sexually promiscuous, placing their wives and female partners at greater risk. The gender gap in basic education also factors into women’s vulnerability, as educational status is one of the most powerful determinants of an individual’s reproductive health status. Women and girls are also less likely to receive sex and reproductive health education, especially in cultures that consider such information as synonymous with promoting promiscuity. Finally, the relative acceptability of violence against women also makes them vulnerable to sexual abuse.
Unequal economic opportunity also factors into women’s risk of infection. Women’s inability in certain countries to own land, property and other discriminations make women dependent on men economically. This is another factor influencing women’s inability to negotiate safe sex and protect reproductive health in dealings with husbands and other men. The lack of economic opportunity also forces some women to engage in high-risk behaviors, such as prostitution, in order to earn income. This kind of “sex for survival” is all too often the only recourse for women who have been widowed by AIDS and ostracized by their family and friends. Adolescent girls who have been orphaned by AIDS are also susceptible to sexual exploitation.
THE IMPACTS OF HIV/AIDS ON WOMEN, FAMILIES AND SOCIETY
The feminization of the HIV/AIDS epidemic has profound implications for girls, women, their families and their communities. Among these is loss of educational opportunities for girls. In many developing countries, cultural traditions make girls less likely to be given the opportunity to attend school. Typically, when a parent is infected with AIDS, girls are the first to be pulled out of school to help with household duties and income generation. Similarly, the burden of the disease falls disproportionately to women, who in some cases are expected to care for children, the elderly and those suffering from the effects of the AIDS. There are 13 million AIDS orphans around the world, the overwhelming majority in sub-Saharan Africa.
All too often, women are scapegoated and stigmatized for problems associated with AIDS. When a man gets sick, he is likely to blame his wife or partner, often with violent consequences. That is why those women with the autonomy to do so are reluctant to participate in testing programs.
When they are found to be infected, families, friends and communities often ostracize and/or shun women as promiscuous or unsanitary. And those women that are sick often find it difficult or impossible to gain access to services for treatment and care, not to mention housing, employment and/or insurance coverage. Finally, prevention programs are often designed to address at-risk behaviors that have nothing to do with women’s circumstances: cultural traditions discourage women from having multiple sex partners, as men do, and women are less likely to use intravenous drugs.
At the household and community level, the implications of women being infected with the virus can be especially profound. Women collect the water, the fuel and other household necessities and prepare family foods. If they are sick, these tasks go undone and families struggle. More broadly, women’s extensive involvement in agriculture in many developing countries means that their illness and absence from the fields can have profound implications for food security at the household and community levels.
Finally, infected women face the wrenching challenge of trying to ensure that their newborn children are not infected with the virus. More than 2 million AIDS infected women give birth each year, resulting in the transmission of the virus to 700,000 newborns each year. Mother-to-child transmission is overwhelming means of infection in children.
WOMEN AND HIV/AIDS PREVENTION EFFORTS
In order to help prevent the spread of the disease and the serious deleterious impacts of HIV/AIDS spread among women, relevant gender considerations must be integrated into prevention and the international response effort.
First and foremost, it is essential that broad-based efforts to enhance the status of women – including educational efforts, as well as initiatives to enhance the social, legal and economic rights – must be part of prevention strategies. Especially important are efforts to break down socio-cultural barriers -- traditions that fly in the face of basic human rights and effective prevention programs. Most centrally, the imbalance in power between men and women in sexual relations needs to be addressed: women must be able to discuss their reproductive and sexual health concerns and needs and have access to the information and services needed to protect themselves.
To add to their biological, economic and social vulnerability to HIV/AIDS infection, women are also at risk as a result of the limited contraceptive choices and prevention technologies available to them. Sexually active women essentially have two choices to protect themselves from infection – the male or female condom. If a man does not want to use a condom, women are at risk for infection. There is a pressing need to enhance research on microbicides and other women-controlled methods of preventing HIV/AIDS infection (and unwanted pregnancy).
Finally, as prevention efforts begin to integrate gender considerations, the roles and responsibilities of men must not be overlooked or diminished. Too often the acknowledgement of gender dynamics related to the HIV/AIDS epidemic result in overemphasis on the risks and response strategies appropriate to women, while overlooking one of the most important responses of all – educating men to take the concerns and issues related to their wives and partners into consideration and encouraging them to take greater responsibility for their sexual behavior.
WOMEN AT BARCELONA
At the 14th International Conference on AIDS, a variety of women-focused activities will be organized under the auspices of Women At Barcelona, a project sponsored by the Women’s Caucus of the International AIDS Society, which is organizing the overall Conference. Since 1992, the Women’s Caucus has sponsored events at the major international AIDS conferences to highlight women’s perspectives and viewpoints. These efforts continued through last year’s Durban Conference, where the Women’s Caucus organizes its first all-day satellite conference to bring the perspectives of real women, in the field, to the overall meeting.
Women At Barcelona will do three things:
1. Pre-Conference Satellite Meeting on July 7 – this all-day activity with highlight Prevention; Treatment/Care; Caregiving/Support; and Advocacy issues looking through a women’s lens.
2. Dinner Symposium on July 11 – this event will feature a debate on “Controversial Issues Related to Women and AIDS”.
3. Training for women participants
In addition, a local organizing group will organize a series of briefings and community events related to women. In what sounds like a powerful effort, the local organizers are constructing a “Wall of Recognition” where women can post pictures, stories and perspectives on the global crisis and local issues.
For more information on Women At Barcelona, click here.
past features
|
RH Reality Check
Connect to the reproductive health blogosphere
