The International Center for Research on Women (ICRW) says increasing attention is being paid to women and girls in the world's response to the HIV/AIDS pandemic. But it says the focus on these groups as being particularly vulnerable to the disease is still not enough. The organization is hoping this will change at the International AIDS Conference set to start in Mexico City on Sunday. VOA's Darren Taylor reports.

The face of AIDS is that of a woman, say women's groups

Kimberly Ashburn, a public health specialist and gender and HIV/AIDS expert at the ICRW in Washington, says the Mexico deliberations must have a sustained focus on women and girls, with good reason.

"There [are] increasing (HIV infection) rates among women, and women are over 50 per cent of new infections now, globally. The face of the epidemic is increasingly that of a woman and a young girl."

She adds that young girls, especially in Africa, where she's worked, are "three times as likely in their age categories as boys to become infected with HIV."

Experts say the disease has claimed millions of lives, with two million people dying last year alone, and 33 million people are currently living with HIV - mostly in sub-Saharan Africa.

Laura Nyblade, a lead researcher at the ICRW, says it's taken a long time, but the female face of HIV/AIDS is finally being revealed, in initiatives such as the United States' President's Emergency Program for AIDS Relief (PEPFAR), for example, which in its revised form has included a section addressing the specific vulnerabilities of women and girls to HIV.

"Historically, the epidemic has had a certain face to it which has been more around men who have sex with men, and gay men," says Nyblade.

Ashburn agrees, pointing out that it wasn't until 1993 – more than 12 years after scientists first discovered the disease – that women were included in AIDS research.

"There's a history there of how women in health, in particular, have been secondary," she comments.

Nyblade says such ignorance of women and how they're affected by HIV/AIDS persists today, because "women tend to not get the services and recognition, in all facets of life, so the imbalances between women and men in terms of power and access to resources just plays into all of this."

The ICRW points out that impoverished women are especially susceptible to HIV infection because they're often compelled to have unprotected sex with men in exchange for the economic support supplied by these relationships.

Ashburn's research has concentrated on HIV, violence and property rights in South Africa and Uganda.

"There's generally a gender-based power dynamic that creates risk for women," she says, explaining that many women in Africa have more important priorities, such as food and shelter, than negotiating with partners to use condoms.

Ashburn's study found that in places in Africa where women were permitted to inherit and own property and as a consequence usually had more economic security, they were far more empowered to protect themselves in various ways against contracting HIV.

 
'Stigma is itself stigmatized'

 
Nyblade is an expert on gender and HIV-related stigma. As a public health demographer, she has over fifteen years of experience in HIV and AIDS research throughout Africa and South and South-east Asia and has shared her knowledge at previous international AIDS conferences.

According to Nyblade, HIV-positive women around the world continue to suffer stigma and discrimination, and therefore "social isolation."

"Poor women particularly are extremely dependent on social networks…on their families, on their neighbors, (for very basic needs such as) to borrow salt, to get a sick child to the hospital," she explains.

But, continues Nyblade, they're often shunned and lose access to that support when it becomes known that they're HIV-positive.

She says women she's interacted with identify gossip about their HIV-status in their communities as a "critical form of stigma…. We don't often think of gossip for example as a form of stigma related to HIV, but in our work across the globe and…in multiple countries in Africa, that's one of the things that women fear the most. And the minute gossip starts around, 'Is that person HIV-positive; how did they get it; they must have done something bad,' those (social) networks break down."

Nyblade plans to use her time in Mexico City to focus on matters like this.

"Things have improved (with regard to the stigmatization of HIV-positive women) but we're still at a level that's fairly unacceptable," she says. "Stigma is still highly prevalent and it still impacts everything we do, so it affects prevention, it affects individuals' ability to protect themselves and their children, or transmission (of HIV) from mother to child, for example."

Nyblade says the discrimination against HIV-positive women has far-ranging implications and can result in women refusing to be tested for HIV: "If they do get tested, it often impedes their ability to disclose that status, particularly to their intimate partner." This, she adds, can have devastating consequences.

She's also witnessed the harmful effects of stigmatization of HIV-positive people in South Africa, where people are crushing their antiretroviral pills "to hide the fact that they're taking medication, and that has implications for dosing, or people missing doses, because they're in a situation where they haven't disclosed their status because they don't want people to know that they're living with HIV, so they skip doses."

Nyblade says groundbreaking research has been completed in recent years on HIV and stigma, but that these efforts have been "quite small and scattered across the globe."

The Mexico City conference, she maintains, offers those concerned an opportunity to coordinate their efforts around discrimination against people living with HIV/AIDS. She acknowledges that it's difficult to achieve this.

"Stigma is (itself) stigmatized in a sense; it's a very sensitive issue. You cannot talk about stigma if you're not going to talk about issues of gender inequality, sex, sexuality; these are difficult things to talk about, but we have to talk about them, and we've found ways that you can do this quite comfortably – even with groups, for example, of religious leaders."

Critics often call gatherings such as the International AIDS conference mere "talk shops" that offer little in the way of positive action once they've concluded. But Nyblade and Ashburn are convinced that the event is worthwhile.

"These conferences allow for individuals who would never be able to meet each other to meet and to network. And that leads to stronger partnerships and we learn from each other and that strengthens our response (to HIV/AIDS)," Nyblade says.

Ashburn expects the Mexico event to be a venue where those involved in the HIV/AIDS sector will "put the pressure on one another; it's a way of checks and balances. The conference is also a venue to make sure that we are holding our investigators as well as our funders accountable for their activities and their response to HIV."

Nyblade says the conference offers a reminder that, as much as many people complain of "AIDS fatigue" and want to ignore the disease, "this epidemic is still present and it's still with us and we still have to pay attention to it."

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