AIDS: a Straight Women’s Health Crisis
“All control is thine. . . .” I wrote this in my journal, looking in a mirror at a reflection that had somehow changed. A foreign antibody called HIV stared back at me. A middle-class, married mother of three living in a small town, I was supposed to be immune. But in April 1994, I, a faithful wife with no “risk behaviors,” was stunned to be handed a diagnosis of HIV. I left my doctor’s office suddenly stripped of control, with no useful information about the virus or what to expect.
Helplessness turned to anger as I slowly learned about how my life and family would be directly affected by the special plight of women with AIDS--women like me. It took contracting HIV for me to discover that we are at heightened risk for AIDS, we comprise more than half of the AIDS cases nationwide and we die of it faster than men do.
New studies by the Centers for Disease Control confirm an alarming trend toward the feminization of AIDS: In 1995-96, new drug treatments such as protease inhibitors helped bring the overall death rate from AIDS down 19%, but not for women or minorities. AIDS deaths among women increased 3% in the first half of 1996. AIDS is now spreading fastest among heterosexual women of child-bearing age, shooting up 63% from 1991-1995.
As one of that 63%, I find these gender discrepancies in AIDS transmission and mortality rates appalling but, sadly, no longer surprising. I now know that committed heterosexual relationships, even marriages, offer women no safe haven from this disease. I contracted HIV because my husband was unfaithful and had a history of drug abuse. I learned the hard way.
Along with the new CDC numbers, the jury came in on America’s efforts to target and reach women like me with AIDS education and prevention. The verdict: shocking failure. Most heterosexual women still feel that if they aren’t promiscuous and don’t use intravenous drugs, they aren’t at risk. Unfortunately, experience taught me that this is a fatal assumption.
I now know that we are more at risk than men because the physiological facts of sex make male-to-female AIDS transmission much, much more likely than the other way around. Women are also more likely to play submissive roles in heterosexual relationships, which can lead to abuses, not the least of which is a partner’s infidelity or failure to know or reveal his HIV status. Between the years of 1991 and 1995, the greatest increase in HIV transmission was among women who contracted it from male partners.
I now know that we are more at risk because we tend to be caregivers to boyfriends, husbands and children before we seek care ourselves. As a result, women generally are diagnosed with AIDS at a later stage of the disease than men, making us less treatable and less eligible for free research trials of AIDS drugs that otherwise cost up to $15,000 a year.
I now know that we are more at risk because even when we do obtain the drugs, they work less well. We suffer gender-specific side effects from the new drug cocktails--severe diarrhea, nausea, blinding headaches, menstrual malfunctions, breast tenderness--making drug regimens harder for women to follow and less effective.
The CDC studies are telling us what we suspected but now must face with harsh precision: Despite women’s special risks, America’s partially successful war on AIDS has observed a social hierarchy in which women are last in line for drugs and information that can combat the disease effectively. For all that we have achieved, this is the bottom line reflected in our allocation of resources on life-and-death issues and in the results they produce. American life expectancy is at an all-time high, overall AIDS mortality is down, we have effective therapies and recently we learned that a new AIDS vaccine is on the horizon. But AIDS rages unchecked among women; women and minorities fail to benefit from drug advances and that rising AIDS deaths in women are bucking the national trend.
The need to shift our priorities is evident. Targeted education programs for women, drug research protocols geared to women, unflinching public discussion of HIV transmission to women and other gender-specific AIDS issues are long overdue. The feminization of AIDS is not new, but the fact that new research has focused media attention affords an opportunity to recognize it for what it is: a straight women’s health crisis.
