I commend the report for having a wide scope including prevention , treatment, testing, poverty, stigma and discrimination and much more. It is very pragmatic and not only has it included ‘priorities for action’ but also more specifically: ‘Four things we want to see in four years time’ for each heading’. However, as I turn one page after the other my initial sense of approval and admiration lessens considerably. Page after page it seems that the reality of women living with HIV is not included in those challenges. . Women are mentioned about three times… but only as an appendix as in : African men and women.
In the final page the report claims: ‘We listen to people living with, and affected by, HIV and those who support them and we put the needs and rights of HIV positive people at the heart of everything we do”… So did they listen to women??… Why should they listen to women..?
Well maybe because 35% of people living with HIV in the UK are women! Women’s infection have grown enormously in the past 10 years. In 1997 women accounted for only 25% of new diagnosis while in 2006 they had reached 40% of new diagnosis (HPA 2007). Doesn’t this ring any alarm bells?
I am not aware of any consultation of women living with HIV by NAT to find out what were our challenges and recommendations. Since I am deeply involved with most organizations of women living with HIV in the UK I think I would have heard about it.
If such a consultation had taken place areas which would greatly benefit from a gendered approach might have included (but there is more):
It is widely acknowledged that women globally are more vulnerable to HIV because of their anatomy as well as socio-economic and cultural circumstances: especially gender inequities and gender violence. A gendered approach wouldn’t just benefit women but also men. Understanding how gender roles make both men and women more vulnerable to HIV needs to come at the centre of the debate around prevention in the UK.
Testing HIV positive and disclosure to partner can be extremely difficult for women who can often experience violence rejection and abuse as a result. More research is needed in this area. But can generic testing and supporting services offer appropriate protection and support to women vulnerable to abuse and violence?
Stigma and discrimination
Stigma and discrimination don’t exist in isolation but are often multilayered. Homophobia and racism have been acknowledged to play a central role to compound HIV related stigma and discrimination, but so does sexism and this needs to be more widely acknowledged.
Research around HIV treatment has been carried out mainly on men, most clinical trials only include about 20% of women. As a consequence women often experience more side effects then men. There is a need for more investment in treatment research which will benefit women and that looks beyond Mother to Child Transmission.
Those are just a few ideas around some of the headings used by NAT in the report, but almost every section could include a gendered perspective.
I understand that consultations are not always easy, but I wonder if the NAT could at least have used Poz Fem report Women HIV and Sexual Health in the UK as a reference. This report was produced by HIV positive women this year during a consultation to review the National Sexual Health Strategy. The report gave as a key recommendation that the approach of the Strategy should be gendered in line with UK laws around equality and in line with international recommendation such as Millennium Developmental Goal 3 on Gender equity.
It makes me extremely sad and angry that influential leading organizations such as NAT that holds as one of its strategic aims ‘equitable access to treatment, care and support for people with HIV’ has appeared to have totally ignored PozFem recommendations and how gender issues impact on the whole society…
There is a lot more to be said but I would really like to hear from other people living with HIV how they feel about the report’ HIV … all grown up’? Do you think it reflects your challenges and experiences? Speak up! Otherwise others will do it for you…