Monday, 01 December, 2008
Women's eNews
On Dec. 1, the 20th annual World AIDS Day, health advocates are raising the
alarm about the quadrupling of HIV-AIDS among American women and the failure
of the U.S. heath care system to address this growing pandemic.
(WOMENSENEWS)--Heidi Nass was prepared to die.
In 1995, when Nass was diagnosed with the human immunodeficiency virus that
leads to acquired immunodeficiency syndrome, most women with HIV-AIDS
succumbed to the disease in less than five years.
"Doctors had me taking 13 pills a day, including new drugs called protease
inhibitors," says Nass. "My medications gave me constant diarrhea, terrible
vomiting and drug-related pancreatitis. Physically miserable and emotionally
devastated, I didn't see how I could go on living like that."
Since protease inhibitors have been improved--and since they've proven
effective at treating HIV-AIDS--Nass' prognosis has turned around. Today,
she takes three pills daily with no noticeable side effects. She's healthy
in her body, happy in her life and productive in her work as a treatment
educator at the HIV Care Program at the University of Wisconsin in Madison.
For 280,000 HIV-positive women in the United States, new treatments have
revolutionized care, making it possible to live on for decades and to bear
children without transmitting the disease.
That's the kind of victory that HIV-AIDS activists will be celebrating today
at a World AIDS Day meeting at the Women's Resource Center at the University
of Oregon in Eugene; at a benefit featuring jazz singer Loretta Holloway in
Greenville, S.C.; at a "Girls Night Out" discussion forum in Augusta, Ga.;
and at a Black AIDS Institute gala featuring actress Sheryl Lee Ralph--and
honoring five female HIV-AIDS activists--in New York City.
But at the same time, women's health advocates are marking the 20th annual
World AIDS Day with more than a hint of frustration.
"Key scientific questions aren't even being asked," says Dazon Dixon Diallo,
president of SisterLove, an Atlanta-based HIV-AIDS advocacy organization for
women. "The disease's impact on female fertility and reproduction is barely
being addressed."
'Still Falling Through the Cracks'
"HIV-AIDS has become a chronic disease instead of a death sentence," says
Dawn Averitt Bridge, founder of the Well Project, an Atlanta-based HIV-AIDS
advocacy group for women. "Twenty years after the first World AIDS Day, this
disease still remains a crisis because women are still falling through the
cracks."
Since 1988, the incidence of HIV-AIDS has quadrupled among women, who are
the fastest-growing group of new patients. Women account for a quarter of
new infections, and inadequate prevention, screening and treatment are to
blame.
"HIV-AIDS has become a woman's disease before our eyes." says Nass. "And
poverty, racism and institutionalized sexism are making certain groups of
women especially vulnerable."
Though women account for only about a third of HIV patients in the United
States, they are in many ways more endangered by the disease than men. Due
to microtears sustained in the vagina during sex, HIV is transmitted from
men to women much more readily than it is from women to men, making women
especially vulnerable during heterosexual contact that accounts for 80
percent of their infections (with injection drug use accounting for the
remaining 20 percent).
In both sexes, HIV compromises the immune system that normally protects the
body from disease. But in women, it carries a higher risk of liver problems,
pneumonia, rashes, yeast infections and susceptibility to sexually
transmitted infections.
Women of Color at Higher Risk
For women of color--at heightened risk due to the fact that they often have
lower incomes and inadequate health care--the disease's spread is of special
concern to advocates.
Hispanic women are five times more likely to contract HIV than white women,
and African American women are 21 times more likely to do so, according to
the Atlanta-based Centers for Disease Control and Prevention.
Among black women, the disease has become so rampant that it is this group's
leading cause of death in the 25-to-34 age bracket.
Health advocates say the rapid-fire spread of HIV-AIDS among women is fueled
by the health care system's failure to address it.
Though women account for 27 percent of HIV infections, they account for just
17 percent of HIV-AIDS research subjects.
In the 1990s, studies showed diaphragms and the spermicide nonoxynol-9 did
not protect women against HIV, as previously hoped. Researchers started
developing microbicides, topical products that prevent HIV from infecting a
woman's cells and give her more control over prevention than condoms do
because she doesn't have to negotiate their use with a partner.
But under the Bush administration, the Bethesda-based National Institutes of
Health devoted only 2 percent of its AIDS budget to microbicide research,
and trials of two major microbicides failed.
'A Decade Away From a Vaccine'
"Testing the other 55 microbicides in development will take several more
years, and we're at least a decade away from the creation of an HIV vaccine
that could help women as well as men," says Anna Forbes, deputy director of
the Washington-based Global Campaign for Microbicides.
Just as in scientific research, screening measures for women are falling
short. HIV tests are not a routine part of women's health care even though
surveys by the Washington-based American Foundation for AIDS Research
indicate 67 percent of women assume they're tested for HIV when they are
screened for other sexually transmitted infections. Due to a lack of
adequate testing, the foundation reports, 25 percent of HIV-positive U.S.
women don't realize they're infected.
Gender inequities in treatment persist. Studies published in the New England
Journal of Medicine and the Journal of the American Medical Association
indicate female HIV-AIDS patients are more likely than male counterparts to
live in poverty and face barriers to health care, making them less likely to
receive protease inhibitors and antiretroviral drugs, the most effective
medications.
Along with these practical problems come the shame and stigma that seem to
hit female patients especially hard. Surveys by the American Foundation for
AIDS Research show most HIV-positive women feel isolated and conceal their
status from co-workers, friends or family members for fear of being judged.
But advocates do see some rays of hope.
New "rapid" screening tests using blood or saliva take 20 minutes, compared
to the two weeks required by older tests. Most pregnant women in the United
States are now screened for HIV during prenatal exams. Antiretroviral drugs
have helped lower mother-to-child HIV transmissions from 25 percent in the
early 1990s to less than 2 percent today.
Health advocates commend Congress for its continued funding of the Women's
Interagency HIV Study, which was launched in 1993, enrolls 3,800 women and
is co-sponsored by seven health agencies. It is the largest continuing study
of its kind in the United States to date.
They also cheer the Food and Drug Administration for putting "fast-track"
HIV-AIDS drugs on the market quickly if their makers agree to study the
drugs' effects on women.
As they look ahead, women's advocates say they would like to revise the
federal Violence Against Women Act so it funds more HIV screening and
treatment for domestic violence survivors. They also hope to pass the
Microbicide Development Act, which was introduced in the Senate in 2007 by
President-elect Barack Obama and which would establish a permanent
microbicide branch at the National Institute of Health.
Molly M. Ginty is a freelance writer based in New York City.
Women's eNews welcomes your comments. E-mail us at editors@womensenews.org.
--
Rachel M Jacobson
Program Director
Global Youth Coalition on HIV/AIDS
www.iAIDS.org | www.youthaidscoalition.org
