Women Face ‘Vicious Cycle’ of Poverty, HIV Threat, JAMWA Op-Eds Say
This summer's issue of the Journal of the American Medical Women's Association features two op-eds examining women and HIV/AIDS:
- Noting that women make up just under 50% of the roughly 34 million global HIV cases, UNAIDS Executive-Director Dr. Peter Piot writes that women are subject to a "vicious cycle of HIV risk" and "vulnerability" to the disease and that "[a]dressing the social and economic circumstances of women and girls is key to the effectiveness of a sustained AIDS response, as are strategies that address relations between men and women." Some of the strategies that Piot proposes to tackle HIV/AIDS among women include supporting women's organizations and "women-led civil society responses," which help to "provide a direct voice for HIV-positive women"; voluntary testing and counseling for both men and women, as well as couples; increasing the availability of drugs that prevent vertical transmission, a step that can also serve as a "platform for extending HIV care to women as the necessary infrastructure for HIV testing and care is made more widely accessible"; and increasing educational opportunities for girls. Piot concludes that meeting the targets for reducing the incidence of AIDS set forth in last month's U.N. General Assembly special session will be impossible "until and unless responding to AIDS becomes a central plank in worldwide efforts to empower women, and, correspondingly, that gender becomes a central consideration across the totality of AIDS responses" (Piot, JAMWA, Summer 2001).
- In a second editorial, Dr. Stephanie Nagy-Agren, an assistant professor of internal medicine at the University of Virginia School of Medicine and chief of the Infectious Diseases Section of the VA Medical Center in Salem, Va., writes that "AIDS is inextricably tied to the status of women," as 90% of adults worldwide who are "newly infected with HIV have acquired the infection from heterosexual exposure." She notes that a "paradox exists" with respect to AIDS and women, as their "low socio-economic status facilitates the heterosexual spread" of the disease and "then ties women to their caring roles, limiting their access to education" and their potential to earn a living -- a situation that one observer in Kenya described as a "vicious cycle of structural poverty." Nagy-Agren advocates that health workers "promote public health concurrent with gender-influenced health," including encouraging pregnant women to undergo HIV testing and to take antiretroviral drugs if infected. Looking at the United States, she says that "adolescent women, particularly those of African-American descent, need intervention with intensive, focused prevention efforts before risk behaviors are initiated as well as access to care when they test positive." Noting that the progress of women as a social group is invariably tied to their overall health, Nagy-Agren concludes, "While we women work to improve the gender framework that circumscribes our health and well-being, AIDS continues to penetrate the fabric of our societies, threatening to reverse developmental strides we've attained to date" (Nagy-Agren, JAMWA, Summer 2001).