It's Time We Include Women in the Conversation Around HIV

Despite major advancements in the HIV/AIDS response, it continues to be a major global public health issue and the leading cause of death globally among women of reproductive age. In the United States, one in four people living with HIV are women. It is a stark reminder that progress towards ending the HIV epidemic has been unevenly distributed and there is still much work to be done, as women represent half of all adults 15-49 years living with HIV worldwide. We must remember, however, that women have the collective power to come together and change the course of HIV. Ending the HIV epidemic requires all of us to embrace women of all experiences at the forefront of change.

This National Women and Girls HIV/AIDS Awareness Day’s theme is “YOU. ME. WE. Changing the Face of HIV.” One change we must make is to expand access to PrEP, a daily pill taken to prevent HIV, for women. According to the CDC, only 7 percent of women who could benefit from PrEP have been prescribed the medication. If you are sexually active, talk to a health care provider about your options to prevent or manage HIV, as most diagnoses in women are attributed to heterosexual sexual contact.

Unfortunately, funding to market PrEP to women has lagged behind when compared to campaigns directed at gay white men. We must continue to change the HIV narrative and include those who have  also been carrying the burden of HIV, especially Black cisgender and transgender women.

According to a recent report from the CDC, an estimated 14 percent of transgender women were living with HIV, and specifically, 62 percent of Black transgender women and 35 percent of Latinx transgender woman were HIV-positive.

We must do better for women when it comes to HIV prevention, treatment, and care. The testing rates among cisgender women remain low with a staggering one in nine women who are unaware of their status, and although 92 percent of transgender women are aware of PrEP, only 32 percent of transgender women in a CDC study reported using PrEP. Women are survivors of many “isms,” and phobias — misogyny, sexism, racism, homophobia and transphobia, and oppression under the gaze of the patriarchal white supremacy system, all of which have a detrimental effect on our health and well-being.

HIV testing creates an opportunity to access prevention and treatment services, which should be part of an annual routine health visit. We must not let stigma and fear interfere with our ability to know our status and feel empowered to make decisions around our sexual health. PrEP is 99 percent effective when taken as prescribed in reducing HIV transmission through sex. It is a safe and proven HIV prevention strategy and can be used along with condoms to prevent other sexually transmitted infections.

For women living with HIV, maintaining an undetectable viral load by taking antiretroviral medication is the most effective way to prevent transmission of HIV to sexual partners: undetectable equals untransmittable, U=U. We must continue to strengthen our efforts by ensuring all women and girls have access to HIV prevention services, testing, affordable treatment, and high-quality care and support services.  

Unification through our collective struggle has the potential to bolster our calls to action and create systemic change from the federal level through the passage of the PrEP Coverage and Access Act and by supporting women who are in the crosshairs of the HIV epidemic. Make this women’s history month your time for liberation, free yourself of the stigma and fear, free yourself from doubts, free your loved ones from the misconceptions around HIV, and most importantly, do not be a bystander in your sexual health journey. Put on your favorite bold lip and let’s speak truth to power as we build a more inclusive approach to ending the HIV epidemic once and for all.

Vanessa A. Castro is the Associate Director of the HIV & Health Equity Program at the Human Rights Campaign Foundation and received a Master’s in Public Health and Master’s in Public Affairs from the University of Michigan.

Tori Cooper is the first black transgender woman to be appointed to the Presidential Advisory on HIV/AIDS, has been an HIV advocate for over two decades, and is the Director of the Transgender Justice Initiative at the Human Rights Campaign Foundation.