Preventing HIV in U.S. Women and Girls: A Call for Social Action

According to author Cynthia Gómez, "The task of enabling most African-American and Latino women to remain uninfected with HIV goes well beyond how to use condoms, learning how to ask for condoms during sex through role-playing, or learning self-motivating statements such as 'I’m worth protecting from HIV.' Women who feel the need to please their man for any reason, economic or otherwise, or who use sex and drugs as coping mechanisms, need other strategies to keep themselves safe." [Footnotes are removed throughout by the editor.]

The paper "Preventing HIV in U.S. Women and Girls: A Call for Social Action" notes that despite great progress in preventing new HIV infections in the United States (US) and stabilisation in overall rates among white gay men and injection drug users, the proportion of AIDS cases in women rose from 7% in 1985 to 25% in 2008. This suggests that focusing on the individual behaviours of women to prevent HIV acquisition "is not a sufficiently effective public health strategy."

The paper reviews the history of HIV in women in the US and advocacy for women and describes the current pandemic among women. Further, it suggests that strategies may need to more broadly address the needs of women and their families and address contextual factors in which HIV risk occurs. "Existing models of behavioural risk reduction continue to be criticized because of their sustained inattention to gender roles, sexuality, cultural differences, women’s socio-economic status and power imbalances in heterosexual relationships between men and women....HIV prevention researchers continue to assert that there is a vital need for HIV prevention programs for Latina and African-American women that address gender, socio-economic status, and specific cultural issues that may exist in their environments."

The document lists individual-level, couples-level, and structural factors related to HIV risk for women. For women, some strategies should include:

• Learning about self-defence;
• Learning strategies for potential economic independence including how to start a business;
• Learning how to become an activist;
• Education on women and children’s rights to society at large; and
• Solidarity empowerment for women - how to support each other and "become owners of their own destiny."

For policy makers:

• Access to public housing and income security through public assistance and social security - (homelessness prevention); and
• Dismantling the structural barriers of racial discrimination and the underprivileged social status of women.

For men:

• Education and training for heterosexual and bisexual men on how to prevent HIV infection and for the HIV infected on tools and resources to prevent transmission; and
• Education and activism to join women in changing social norms and policies, including "how men and women interact with each other about sex."