Frequently asked questions about women, girls and HIV
ICW is the only global network of HIV positive women. We now have over 5,000 signed-up members across more than 130 countries and many other positive women whose names aren't officially on our books yet, but who read our publications and belong to the wider ICW family. There are over 19 million women now living with HIV in the world. This is over 50% of infections worldwide. In some parts of Africa around 60% of people who are HIV positive are women and the fastest growing rate of new infections in sub-Saharan Africa is amongst young women. Last year alone 1 million HIV positive women died unnecessarily because of AIDS-related illness. In the West, drugs are now available which enable the great majority of people with HIV to get back to work and return to fully productive lives. This should be the case for everyone with HIV, irrespective of their gender, their age, or where they live in the world. ICW is a global advocacy network. This means that we all work together to share information about the virus, what causes it and what makes it so bad for women, both amongst ourselves and amongst policy makers and the general public. Below you can read the answers to some FAQs about HIV and how it relates specifically to women.
1) Why is it important to look at issues for HIV positive women separately from HIV positive men?
Women often fall off people's agendas anyway - in decision making, for example. Women are the main carers and home-makers around the world, so when others fall sick women are the ones who have to double up on what they are already doing to take care of the sick also. So they often have little time for political meetings. This then means that others assume that women don’t have a place in political meetings and that “a woman’s place is in the home…” For HIV positive women the challenges are even greater - coping with their own illnesses as well, facing up to the prejudice of others around them, including other women, who think that somehow we only have ourselves to blame. Yet the great majority of our members never thought themselves to be at risk of HIV. Those that did, felt themselves powerless to protect themselves from the virus. Women also often find it much harder to access treatment of any kind, whether they have HIV or TB, malaria or other conditions, because they put themselves at the back of the queue after their children and husbands. Until recently the medical establishment has not considered the different impact that HIV and medications have on HIV positive women and men. For an example of positive change in this regard read Women and HIV -- Natural History, Prevention and Treatment: A Summary of Key CROI 2008 Research.
2) Why are so many more women dying now?
Many women for many years assumed that they couldn't be at risk because they didn't fall into the classic stereotypes presented in the early days of the pandemic by governments, NGOs and health workers, such as sex workers, women with multiple sex partners, drug users etc. What no-one had told them was that the ABC message of "abstain, be faithful, use condoms" was no protection to them, even if they had been faithfully married to the same man all their lives, if that man had been having unprotected sex with someone else. So many women are dying now because they may have been infected 10 years or so ago, without ever realising that they were at risk through their husbands. This is compounded by gender inequalities that can make it hard for women to access appropriate care, treatment and support.
3) Why are girls getting infected at a faster rate than boys of the same age?
Many girls get infected because older men prefer to have sex with teenage girls and because the walls of the vagina of a teenage girl are much more prone to tearing and infection than in an older woman. So it's a combination of biological vulnerability and social vulnerability. Lots of young women become infected because they are in vulnerable roles, for instance working as house girls for richer relatives who may abuse them, or needing to get good marks at school, so having to have sex with their male teachers to do so. Some girls even have to have sex with older boys to get help with their school work or to get basic stationery or clothing. Many girls – and married women - lack the necessary assertiveness skills to enable them to negotiate safer sex if they choose to have sex with a partner.
4) Why is there no discussion of the gender issues which seem to be driving the international virus in the UK response?
That's what we would like to know! The UK response has traditionally been led by the gay rights movement, who did fantastic work in setting up organisations like the Terrence Higgins Trust. The heterosexual epidemic in the UK has now taken off (in 2003 44% of new infections in the UK were amongst women), but we assume that just because women in the UK have the vote and have equal access to jobs (in theory) and to the law, that gender isn't an issue in the UK. But in fact 2 women a week are killed through domestic violence in the UK, we have the highest teenage pregnancy rate in Europe, chlamydia is spreading rapidly, scarcely any really good sex education around behaviour change... all the classic ingredients for HIV to take off here as it has done elsewhere in the world.
5) What can be done to combat the stigma which surrounds HIV and AIDS?
In countries like Uganda, they have really seen that enabling people to address these issues for themselves have really helped people to understand how difficult it is for couples to negotiate condom use, for instance. The workplace initiatives that organisations like the Red Cross and the Standard Chartered Bank have been doing on sex and relationships work for all its staff, British and international, has really improved everyone's understanding of the issues and made staff less judgmental and much more supportive of people with HIV. We would really like to see all agencies across government, as well as all big businesses across the globe help staff to learn for themselves in small group work what the issues are for them in their own lives. Once people understand how all this might relate to them too (such as the issues for them in their own relationships) they then become far less judgemental of others.
6) What can be done to stop men's violence against women?
Men are as caught up in traditional gender roles as women are. Many violent men come from families with violent fathers or with absent fathers. This is true anywhere - just ask the young men who are excluded from school, or who end up in prison in the UK. This isn't to excuse their violence, which of course is wrong. But they need help to understand why they turn to violence when they feel upset. It's often to do with patterns they have learnt in childhood - they've never learnt – or been taught - to deal with their frustrations in other ways. There are various initiatives now in different countries in Africa and Nicaragua where men have learnt to unlearn violence - and have seen that they can still be real men. They have learnt that their own lives have improved, as well as the lives of their friends and families around them.
7) Does sex education make more children sexually active earlier?
Does teaching a child how to ride a bicycle properly make her go out and ride it on the motorway? Again and again we have heard internationally that if sex education is taught sensitively and thoroughly in schools or youth clubs, the pupils like it, their parents like it - and their parents want their younger brothers and sisters to have it at an earlier age. A lot of good sex education is to do with developing positive behaviour such as good listening skills and mutual respect and honesty. These are skills which can be taught and practised as soon as a child starts school. The biological details can follow later, when a child is older. But if the right building blocks are in place from an earlier age, there is much more chance of the sex education being good. Children and young people have far more sense than we often give them credit for. They NEED the right information, so that they can judge and make informed choices for themselves. If we tell them don't do this, you mustn't do that, they are far more likely to rush out and try things for themselves before they are ready to.
8) What can you do to support all these issues?
a) You can read more about the issues here on this website. For instance, if you go to our “publications” pages, you can download 5 small booklets about HIV and young women, HIV and access to treatment issues for women etc. Or you can look at our latest newsletter to give you an idea about all the workshops and other activities we carry out around the world, to raise these sorts of issues amongst our members, with policy-makers and others.
b) You can write to your Member of Parliament or other elected representative, to find out what his or her party is doing both in your own country and globally about raising and addressing these issues.
c) You can find out what is happening in your own community and perhaps volunteer some time to support your local HIV-support group.
d) You can raise or donate some funds for our work – or for your own community organisation’s work – or even better, for both!
9) How can you find our more about the views and rights of HIV positive women?
Our publications page features briefing papers, tools, reports, fact sheets and press statements on microbicides, HIV testing, the female condom, UNGASS, treatment access and many more issues.
10) How can I find out more about ICW?
If you would like to learn more about ICW, or have other specific questions which you would like us to answer, do e-mail us at infoicw.org and we will do our best to reply to you shortly.
Thank you for your interest in our work.