By Nabila El-Bassel
The theme of World AIDS Day 2012 is “Getting to Zero” because HIV scientists now believe that the end of the AIDS epidemic may occur within our lifetimes. This theme came about due to several recent prevention and treatment advancements that provide concrete hope:
- Rapid scale-up of Anti-Retroviral Therapy and prevention efforts have saved millions of lives.
- HIV infection rates have decreased in many heavily affected countries.
- The number of AIDS-related deaths have also decreased.
- And, most importantly, research findings have shown that Anti-Retroviral Therapy can prevent new infections. “Treatment as prevention” is our strongest weapon to stop the spread of HIV.
Nevertheless, I have concerns about our ability to achieve “Getting to Zero” for the population of women and girls who use or inject drugs (IDUs), female sex partners of male IDUs, and sex workers. More than 30 million people are living with HIV worldwide, over half of whom are female. Despite a decline in new infections over the past decade, 2.5 million people were infected with HIV last year alone. HIV infections continue to rise among drug-involved women, especially in Asia, Eastern Europe, and other countries.
AIDS sufferers and potential AIDS victims who are female face stigma, discrimination, gender-based violence, gender inequality, financial dependencies, incarceration and less access to employment. Drug-involved women and girls face economic difficulties: unemployment rates are high, job access is limited, and income-generating interventions are rarely incorporated into services to prevent HIV infection.
Given the size of the population and its unique needs, what does “Getting to Zero” mean for at-risk women and girls?
The strategy elucidated by Secretary of State Hillary Clinton at last summer's International AIDS Conference in Washington emphasized a serious commitment to vulnerable women and girls. Yet it remains to be seen whether resources for this new prevention strategy will address the structural and macro risk environments that increase their HIV vulnerabilities.
Thursday's report from the President's Emergency Plan for AIDS Relief (PEPFAR) outlined how progress could continue at current spending levels—and how faster progress would be possible if other donors and hard-hit countries could increase investments. But it did not provide satisfying answers to my questions about why at-risk women and girls haven't received as much attention as other key populations in the past, and what portion of HIV prevention funding will be spent on prevention, access to treatment and research for them in the future.
Without addressing such factors affecting this key population in the fight against HIV, the epidemic becomes much harder to fight. The "Getting to Zero" goal mandates a call to action for this often hidden and neglected population.
Dr. Nabila El-Bassel is the Willma and Albert Musher Professor of Social Work at the Columbia University School of Social Work. She leads the Social Intervention Group and the Global Health Research Center of Central Asia, which have a research mission of targeting women and girls, along with other key underserved populations, in the US and other countries.
Img: AIDS ribbon photo courtesy of Lammy831 on Flickr.