Thirty-four years into the epidemic, women and girls are still overlooked in almost every aspect of federal, state and local HIV/AIDS policy, funding and care. Yet we continue to be infected and we continue to die. One in 5 new HIV infections in the US are among women. AIDS diagnoses among women in the US have tripled since the mid 1980s. In certain parts of the nation, like the South, where poverty and lack of access to healthcare fuel the epidemic, that number can rise to 30%. In Sub-Saharan Africa women comprise 58% of the epidemic.
In 2010, the Obama Administration issued a visionary plan, the National HIV/AIDS Strategy (NHAS), which set forth strategies to reduce new infections, increase access to care, and reduce related health disparities — yet it failed to set forth any strategy regarding women and girls. Despite using the word “women” sixty or more times in the document, its authors failed to articulate any strategy to reduce new HIV infections among women or address their barriers to care.
Despite the tragic oversight in the NHAS, there was little public outcry. Few spoke up about the implications of this public health crisis for women, their families and their communities. Not even ACT-UP, known for its vigorous activism and “Silence = Death” mantra, protested this deadly lack of attention to women and girls. Can the lack of interest in women and girls be chalked up to just neglect? Or is it part of the larger war against women’s reproductive rights?
This year the administration is due to report on the results of the initial plan and update it. Initial reports are that it will again be silent regarding women and girls. It is inconceivable that in this age of promising biomedical prevention such as PrEP and PeP, the evolution of Medicaid redesign and promising new care models, the fate of women and girls will again be ignored.
Are our mothers, daughters, sisters, nieces and granddaughters so expendable? Are they merely collateral in the epidemic where 86% are infected through heterosexual sex despite new biomedical prevention that could reduce or even end new infections among women and girls? Why is there no public concern that over the half the population is being overlooked in public efforts to end the most devastating plague of our time?
When women are disabled by illness, communities are put at risk. As major caregivers of their children and often other generations within their families, a woman’s inability to carry on creates hardship and crises that extend well beyond HIV/AIDS. It’s time for HIV/AIDS activists, policy makers and others to demand that women and girls matter. If the administration issues a revised “National HIV/AIDS Strategy” this year without addressing women and girls, activists must stand up. Silence is no longer acceptable.