In the next five minutes, another 25 women and girls will be infected with HIV. They are students, housewives, teachers, mothers, and more. HIV/AIDS programs have failed them, just as they have failed the 17 million women currently living with HIV/AIDS, and the countless others who have already died. We must do better.
Let’s take a look at the failure and its causes. In 2001, governments of the world declared that we would empower women and girls against the pandemic. When the world’s governments and civil society again convene at the United Nations next week they need to recognize that the situation is worse for women and girls today than it was five years ago. Infection rates among women and girls are rising in all regions, not only sub-Saharan Africa, because policies and funded programs to empower and protect them have not been a priority.
Girls and young women are the epicenter of this pandemic. The majority are married and do not have the option to negotiate “safer” sex. They are beaten or divorced if they ask their husband or partner to use a condom. They don’t even get their fair share of the health services and education needed to prevent or treat HIV, or to learn their HIV status.
To reflect these realities, we must shift HIV/AIDS policy and budget priorities dramatically. Today, a new social movement has mobilized to do just that, engaging activists from the global North and South, some living with HIV/AIDS and many who are not, from separate, often competing constituencies. This broad coalition agrees on and is promoting an action agenda – With Women Worldwide: A Compact to End HIV/AIDS – to bring about needed change in HIV/AIDS policies and budgets.
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These changes in the agenda are not rocket science, but they do require generating political will and jettisoning social taboos. They aim to end the circumstances that make girls and women so vulnerable to HIV/AIDS ― discrimination, violence, early marriage and pregnancy, weak health services (especially sexual and reproductive health), the refusal of families and societies to educate young people about sexuality and safer sex, and our failure to teach them to relate to each other on the basis of equality and respect for human rights.
Working to make antiretroviral drugs available is important and a moral imperative. Prevention is as well. Prevention, which until now has focused on condom distribution and men who have sex with men, sex workers, and intravenous drug users, needs to be expanded to address the real-life circumstances of girls and women.
We need a real commitment, backed by resources, to ensuring sexual and reproductive health services for all women, in particular because these are the health services women most often seek out – they provide a perfect entry point for addressing HIV prevention among those who would not think about it otherwise, or who can’t access HIV services directly because of stigma and discrimination. These services need to include confidential, voluntary HIV counseling, testing, and support, as well as greatly increased access to subsidized female condoms, and development of microbicides and vaccines. Prevention budgets must also finance comprehensive sexuality education programs for all young people, that promote gender equality, girls’ empowerment, and mutual respect, not just information about HIV and the warning, “sex is dangerous ― abstain.”
Sex is both a part of healthy human relations and, unfortunately, a life and death matter. Bold, visionary leadership is desperately needed to promote prevention for all and by all.