May 19 is National Asian & Pacific Islander HIV/AIDS Awareness Day and World Hepatitis Day. This blog post is one of a series on the impact of HIV and Hepatitis B in Asian & Pacific Islander communities. As A&PIs, you may not believe that you are at risk for these diseases, but you are. Follow our posts throughout the week for different perspectives and stories from our community.
Women and HIV. Let us first start there. While men who have sex with men are still disproportionately affected, the number of women at-risk and living with HIV has sky-rocketed at a dangerous and alarming rate. The CDC’s 2007 surveillance report reveals that 31% of new HIV diagnoses are women – ten to fifteen years ago, this number was under 10%. Overall, women account for an estimated one third of national HIV/AIDS cases. Approximately 80% of new infections are attributed to high-risk heterosexual contact, meaning heterosexual contact with a person known to have, or to be at high risk for, HIV infection.
Those are the statistics, but what do those statistics mean? Women are most likely infected through their partner, be it a boyfriend or a husband. What irks me about the descriptor “high-risk heterosexual contact” is that it can create the assumption that HIV-positive women choose to sleep around, have multiple partners, are prostitutes, and use drugs. For many women, this is not the case – it is a boyfriend or a husband, who may or may not know their status, who is the source of “risk.” For women who engage in sex work and injection drug use, choice is not always an option – there are other factors at play.
There is a low perception of HIV risk among women and in society. One reason for this perception is the idea of monogamy as mentioned above. Women are turned away from HIV-testing sites, gynecologists and primary care doctors do not always discuss the risks of HIV with their patients, care for those living with the disease can be incompetent, and HIV/AIDS is branded as a disease for those types of women. As a result, many women are late-testers meaning they get an HIV test or show up at the hospital once they show signs of AIDS; or women are diagnosed during pregnancy when HIV tests are routinely given. The number of women incarcerated for knowingly transmitting the virus is also increasing. If you are thinking what I am thinking, you are scratching your head in confusion and frustration too. Ultimately, the neglect in prevention and care for women is a violation of basic human rights.
For Asian and Pacific Islander women, the statistics are frightening. The diagnosis of HIV/AIDS in females aged 15-39 years for Asians and Pacific Islanders jumped from 55% in 2001 to 66% in 2004. For American Indian and Alaskan Natives, the HIV/AIDS diagnosis rate increased from 52% to 68%. Asian and Pacific Islander women make up a small percentage of the overall HIV infection rate for women, however the rise in incidence sheds light on how this epidemic will affect Asians and Pacific Islanders in the coming decade. Within three to four years, the incidence rate jumped 10-16%. As mentioned by stupplebeen’s blog, two-thirds of A&PIs have never been tested – for A&PI women, I have a strong feeling that this rate is higher. The power dynamics of gender and culture can play a role for A&PI women and HIV risk. There is the stereotype of submission and obedience to men in addition to the taboo topic of sexuality and sexual assertion. Sex is not talked about within communities and within families. This makes it harder to negotiate with a partner. This is a can of worms that deserves its own book.
For my point of view, there is a beauty to this increasing epidemic among women and especially A&PI women. Don’t get me wrong – my heart breaks every time I read the statistics and hear the stories. What I have seen, however, is the rise in women’s voices. There is a movement that has started at the grassroots level and now is making headway at the national policy level. It is a group of individuals, organizations, networks, and communities infected and affected by HIV/AIDS that is rallying the White House, rallying the CDC, and demanding policy be put into place to stem the epidemic amongst women. For more information on policy recommendations given to the Office of National AIDS Policy for the National AIDS Strategy, click here. For information on the U.S. Positive Women's Network, click here. While there are many future hurdles to get over, bringing women together to rally for their health, their sexual freedom, their children, and their families is breaking down stigma, taboo, and shame. It is increasing understanding and with understanding we can kick this epidemic’s butt!