Why National Women and Girls HIV/AIDS Awareness Day Matters to Maternal Health

There’s a rumor that’s held traction for years that since reliable treatment options are now available, HIV/AIDS is no longer a threat, especially not to heterosexual, monogamous women. It’s rumored that since antiretroviral medications make HIV a chronic disease instead of a death threat, women don’t have that much to worry about anymore. It’s an ugly rumor, to be sure, primarily because it’s a blatant lie.

While it’s true that HIV/AIDS testing, treatment and ongoing healthcare has been a major game-changer that no one could have predicted would be so successful, the truth is that in the US, women account for one in four new HIV diagnoses and deaths caused by AIDS. Globally, HIV prevalence among young women aged 15–24, is twice that of young men. In sub-Saharan Africa, 57 percent of adults with HIV are women, and young women are more than three times as likely to be infected as young men. Globally, women are at least twice as likely to acquire HIV from men during sexual intercourse than men are from women.

Bottom line, HIV/AIDS is alive and well and still infecting women like crazy. In addition, it’s a major contributing cause to maternal death, by some reports killing 42,000 pregnant or recently delivered mothers per year. How many healthcare workers are exposed to HIV/AIDS by caring for infected mothers? How many children are orphaned and families destroyed? The statistics are daunting, even today, in the age of antiretroviral therapies.

March 10th was National Women and Girls HIV/AIDS Awareness Day, an annual event coordinated by the Office on Women’s Health at the US Department of Health and Human Services. Thousands of people, organizations, and public health officials came together to get the word out that HIV/AIDS is a major threat affecting women and girls. The event mission was simple:

• Tell women and girls how to prevent HIV/AIDS
• Get more of them to get tested
• Provide services to those living with the disease
• Do whatever it takes to reduce the impact of HIV/AIDS

HIV/AIDS dramatically impacts maternal mortality rates. The majority of HIV-related maternal deaths occur in the developing world, where women often lack the resources, education, money and power to access healthcare services and where 99% of maternal deaths occur. Women with HIV/AIDS are at greater risk of dying from opportunistic infections, hemorrhage and hypertensive disorders, which are the three leading causes of maternal mortality. But pregnancy also offers gateway opportunities to save women’s and children’s lives. Even in areas where women can get healthcare, HIV testing is surrounded by stigma and fear, which prevents people from getting tested. When women are tested, receive antiretroviral medication and supportive health care, however, the chances for survival are excellent. And if they receive those services before or during pregnancy, their child has a 98% chance of not contracting HIV during birth or breastfeeding. Currently, however, only about a third of pregnant women get the HIV/AIDS healthcare they need.

According to the US Department of Health and Human Services Office in many countries, women and girls are at greater risk of HIV/AIDS due to gender inequality, discrimination, and stigma. They lack the skills or power to talk with sexual partners about abstinence, monogamy, and condom use. Many face sexual or physical violence, are blamed for causing AIDS and ostracized once its known they’re HIV positive. Without access to prevention and healthcare services, women may not be able to avoid getting pregnant, which increases their chances for health complications and maternal death. In addition, pregnant women may not have access to the antiretroviral therapy they need to prevent passing HIV to their babies.

Among HIV positive women who do access prenatal healthcare, one of the most important interventions that are reducing maternal death and mother-to-child transmission of HIV is routine HIV testing during pregnancy. When test results are returned to women along with counseling and treatment options (especially when connected to services that make treatment affordable), that woman, her baby and family all benefit. The trickle down affect from one test is powerful. In 33 countries, HIV incidence dropped by more than 25 percent between 2001 and 2009; 22 of those countries are in sub-Saharan Africa.

In areas where women receive HIV/AIDS health care, including antiretroviral medications, we’re anticipating the possibility they’ll give birth to an AIDS-free generation relatively soon. But if we’re truly going to achieve that and make lasting headway in reducing/controlling HIV/AIDS and related maternal deaths, then violence, poverty, inequality and the lack of basic rights among women must be addressed because the trickle down affect of those measures would be more powerful than any other treatment modality available.

Resources:

Trends in Maternal Mortality: 1990 to 2008
Estimates developed by WHO, UNICEF, UNFPA and The World Bank

Women andHIV/AIDS: Confronting the Crisis
A Joint Report by UNAIDS / UNFPA / UNIFEM

US Department of Health and Human Services Office of Women’s Health
HIV/AIDS — Women are at risk