9th March is the National Day for Women Living with HIV. Let's talk about gender inequities when it comes to HIV and women’s health.
HIV disproportionately affects women globally, especially those with intersectional identities including First Nations women, transgender women, culturally diverse women and women experiencing poverty and homelessness.
Yet women are often left out of the conversation when it comes to HIV prevention, treatment and research. Globally, it’s time to end the gender inequities when it comes to HIV and sexual health.
Here’s how we can do it:
1. Stop stigmatising women who ask for an HIV test.
In 2020, almost half (48%) of all women diagnosed with HIV were diagnosed late (more than 2 years after transmission). We commonly hear that women often feel stigmatised when asking for an HIV test and feel the need to justify their request to be tested.
Health professionals must encourage rather than discourage HIV testing. By making HIV tests a routine part of a sexual health check up for women, we can reduce the stigma and prevent late diagnoses, which can lead to further health complications for women.
2. Increase representation of women in health campaigns.
HIV awareness campaigns have historically not adequately represented women. This is evident in recent data from Australia on new transmission rates over the past decade which show that while HIV transmission rates have decreased among men who have sex with men (MSM), rates for women have remained unchanged.
"There is a dearth of images of women in public health campaigns designed to educate the community about HIV. Imagery that includes a young woman, a transgender woman or even a heterosexual couple is conspicuously lacking. We all need to begin a conversation about HIV to reduce the silence and secrecy around women living with HIV."
Jane Costello, CEO Positive Life NSW
3. Improve access to HIV prevention globally.
"About 10 per cent of people living with HIV in Australia are women, yet the lived experience of women with HIV today is still mired in ignorance and invisibility and we continue to be invisible in the HIV prevention messaging. If we are serious about working towards eliminating HIV transmission, then we all need to talk about the different ways that HIV affects and impacts the lives of all women."
4. Improve access to quality HIV care and treatment.
The needs of women living with HIV are different. A 'one size fits all' approach does not work. To improve health outcomes for women living with HIV, we must provide women with specialised care and support, in services that are also appropriate for families and children.
5. Provide and promote culturally appropriate care.
We need to take into account the diverse needs and experiences of women from different communities and tailor sexual health services accordingly.
6. Include women in HIV research and clinical trials.
Despite being 54% of the global population of PLHIV, women represent just 11% of participants in research.
"There are gaps in the research on women and HIV and gender differences that are specific to the female body. This lack of information feeds into a misunderstanding about the efficacy of HIV antiretroviral medication in relation to women…”
7. End HIV criminalisation laws.
HIV criminalisation laws do nothing to help in the global response to HIV. The laws discourage HIV testing, prevent treatment, increase transmission rates, discourage disclosure and fuel HIV stigma and discrimination.
8. Women living with HIV controlling their own narratives.
We need to keep fighting stigma and discrimination that disproportionately affects women living with HIV, so that we can create safe space for them and support women to control their own narratives when it comes to all matters relating to HIV.
Improving health equity for women when it comes to HIV and sexual health is everyone’s responsibility. And it’s going to take a multi faceted approach.
It's essential that we continue to challenge HIV stigma & discrimination, provide women living with HIV with quality, culturally appropriate care and support that's tailored to their unique needs and increase representation of women in health campaigns, research and clinical trials.
But most important of all, we need to create the space for women to lead in the global response to HIV.