Donna Shalala says Protect women, families from HIV
Protect women, families from HIV
BY KATHLEEN CRAVERO and DONNA E. SHALALA
www.unaids.org
www.miami.edu
Mercy was a teenager when she got married to an older man. Mercy knew about AIDS. But she never took drugs and was faithful to her husband, so she didn't think that AIDS could affect her. Then, during her second pregnancy, her worst nightmare came true -- she was told she was HIV-positive.
She was terrified to tell her husband. She knew he would blame her. Only when her baby grew sick did she explain that both she and the baby had AIDS. Mercy's husband responded just as she feared, with anger and violence. She was thrown out of her house, fired from her job and ostracized from her community.
Mercy's beautiful daughter is now dead and so is her husband. But she's quick to say: ''This isn't just my story -- it's the story of women with AIDS everywhere.''
Today, in sub-Saharan Africa, 60 percent of those with HIV are women and 75 percent of young people infected are girls. In America, AIDS is the leading cause of death among African-American women ages 25-34 -- and Miami has the largest per capita number of women with AIDS nationwide. The fastest growing increases of women with HIV are now found in Eastern Europe and Asia.
In many countries, women are the fabric of family and society. If there's one place in this epidemic where our efforts will yield real results, this is the place. Empowering women and girls to protect themselves and their families from AIDS is key to turning the tide.
What we call the ''ABC'' prevention strategy -- Abstain, Be Faithful, Use Condoms -- is a good start, but not enough. Women are getting infected not only because they lack information, but because they also lack the options to keep themselves safe.
We teach that abstinence until marriage can prevent AIDS, yet we live in a world where girls are often married off as children. We tell women to be faithful, but know their partners often aren't. We tell them to use condoms, but know their partners often won't. We tell them to support their families, but know they often lack tools and opportunities to do so, except through risky behaviors.
In a study in Zambia, only 11 percent of women believed that they had the right to ask their husbands to use a condom -- even if they knew he was unfaithful or HIV-positive. A health survey in Rwanda revealed that nearly 50 percent of men and 67 percent of women agreed that refusing sex or voicing your opinion are acceptable reasons for domestic violence.
If women had the option to choose marriage, rather than have it forced on them; to decide when and with whom they have sex; to negotiate condom use; to live their lives free from violence; to earn incomes adequate to feed their families -- their ability to protect themselves from HIV would be real.
The Global Coalition on Women and AIDS was recently launched by UNAIDS and a wide range of partners to advocate for AIDS strategies that work for women -- something we call ABC plus. Here are some of the pluses:
• Reducing violence against women increases their ability to access services, negotiate safer sex and take advantage of education and employment. Reducing violence against women prevents HIV.
• Protecting the property and inheritance rights of women helps keep their children in school and food on the table without the need to engage in risky behaviors. Protecting women's property rights prevents HIV.
• Ensuring women's access to healthcare keeps them strong and healthy enough to care for their children, attend work and school and keep families intact. Ensuring women's access to healthcare prevents HIV.
• For women who aren't in a position to say No, whose partners won't be faithful or use condoms or who are too beaten up or beaten down to ask, prevention methods that they control are essential. Making microbicides and female condoms a reality for women prevents HIV.
• Keeping girls in school as long as possible will increase their ''right to abstain,'' their knowledge and negotiating skills and make them safer. Keeping girls in school prevents HIV.
• And supporting women with loans to start a small business of their own will increase their economic security and go a long way toward improving the lives of their families. Providing women with a fair shot at job opportunities prevents HIV.
For women and girls like Mercy from Miami to Mombasa, the United Nations, United States and all of us must join forces to help make these strategies a reality -- not just on World AIDS Day, but everyday.
If we value women, and if we are committed to stop AIDS, it's the right thing to do and the smart thing to do.
Kathleen Cravero is the deputy executive director of UNAIDS and leads the Global Coalition on Women and AIDS. Donna E. Shalala is president of the University of Miami.
