By Efua Andoh (Public Interest Communications)
Women and girls living with HIV in America are mothers, daughters, sisters, and friends. Women and girls affected by the epidemic – particularly those of color –deserve a voice and their unique needs and challenges require attention. In honor of National Women and Girls HIV/AIDS Awareness Day, here is a quick review of 7 things everyone should know about the impact of HIV/AIDS on women and girls.
1. HIV impacts the lives of hundreds of thousands of women and girls
An estimated 280,000 people (24% of the over 1.1 million living with HIV in the U.S.) are women and girls and they account for 1 in 5 new infections. Women are most likely to be infected through heterosexual sex (84% of new infections in 2010), followed by injection drug use (16%). Women comprised one quarter of deaths among people with an HIV diagnosis in 2010.
2. Women of color are particularly at risk
Black and Latina women have been especially hard hit by the epidemic. In 2010, Black and Latina women accounted for over 75% of new HIV infections among women. The rate of new HIV infections among African-American women was 20 times that of white women, and the rate among Latinas was 4 times the rate of white women. In fact, the CDC estimates that 1 in 32 African American women and 1 in 106 Latina women will be diagnosed with HIV in their lifetimes compared with 1 in 526 white women.
3. Young women form the bulk of new infections
In 2010, more than half of new infections among women were among those aged 25 to 44 – women ages 25-34 accounted for the largest share (29%), followed by those ages 35-44 (25%) and 13-24 (22%). However, newly infected Black women and Latinas are more likely to be younger than white women – 23% of new infections among Black women and 21% among Latinas were among 13-24 year-olds, compared to just 16% of new infections among white women.
4. Women living with HIV get inadequate care
Only 41% of women with HIV are retained in regular care, 36% are prescribed antiretroviral therapy (ART), and 26% are virally suppressed. On top of that, an estimated 15% of women living with HIV are undiagnosed. They experience barriers to care that are socioeconomic and structural (e.g., poverty, cultural inequities) and often place the needs of their families above their own.
5. HIV impacts the reproductive health of women
Women with other sexually transmitted infections are at increased risk for contracting HIV. And women with HIV are at increased risk for developing or contracting a range of conditions such as human papillomavirus (HPV), which can lead to cervical cancer, and severe pelvic inflammatory disease (PID).
6. Intimate partner violence (IPV) puts women at risk of contracting HIV
Compared to women who have not experienced violence, women with a history of IPV are more likely to report HIV risk factors, including unprotected sex, and injection drug use and alcohol abuse. Women who experience IPV are also less likely than other women to display high levels of self-efficacy for HIV prevention and more likely to miss health care appointments.
7. Violence is especially prevalent for women living with HIV and adversely impacts their management of the disease
According to a White House report, a 2012 meta-analysis found that over half of women living with HIV had experienced IPV, considerably higher than the national prevalence among women overall (55% vs. 36%). Among women living with HIV/AIDS, trauma, abuse and violence are associated with less use of antiretroviral medication, decreased medication adherence, and increased risk of death. What’s more, HIV infection may trigger or augment physical violence against women. One large study reported that over 1 in 5 women living with HIV reported physical harm following their HIV diagnosis, with half of these events attributed to being HIV-positive. Transgender women living with HIV should not be overlooked – a systematic review found a mean of 58% of transgender women reported violence at home, with a mean HIV prevalence of 28% according to a 2008 review of HIV studies.
What can be done?
APA supports national policies that:
Increase screening for HIV for women and girls in the context of mental health and substance abuse prevention and care service delivery systems.
Increase funding for behavioral and social science research on disparities in HIV prevalence among African American women, including attention to the factors that facilitate HIV transmission, (i.e., trauma and interpersonal violence), and interventions to prevent HIV infection and improve adherence to treatment regimens.
Invest in comprehensive school-based sexuality education that includes HIV/sexually transmitted infection (STI) education and risk reduction strategies for young people, particularly girls of color.
American Psychological Association (2010). National recommendations for prioritizing mental and behavioral health in federal implementation efforts. Retrieved from: http://www.apa.org/about/gr/issues/hiv/national-hiv-aids-strategy.aspx
Centers for Disease Control and Prevention (2014). HIV among women fact sheet. Retrieved from: http://www.cdc.gov/hiv/risk/gender/women/facts/index.html
Centers for Disease Control and Prevention (2012). HIV surveillance supplemental report. 17(4). Retrieved from: http://www.cdc.gov/hiv/pdf/statistics_hssr_vol_17_no_4.pdf.
Kaiser Family Foundation (2014). Women and HIV/AIDS fact sheet. Retrieved from: http://kff.org/hivaids/fact-sheet/women-and-hivaids-in-the-united-states/
The White House (2013). Addressing the intersection of HIV/AIDS, violence against women and girls, and gender–related health disparities. Interagency working group report. Retrieved from http://www.whitehouse.gov/sites/default/files/docs/vaw_master_report.pdf