HIV/AIDS: Impact for Women and Girls

1. HIV/AIDS: Impact for Women and Girls Frances E. Ashe-Goins, R.N. M.P.H Deputy Director U.S. DHHS-Office on Women’s Health

2. Office on Women’s Health Vision Statement: • All Women and Girls are Healthier and Have a Better Sense of Well-Being Mission statement: • Provide leadership to promote health equity for women and girls through sex/gender-specific approaches

3. AIDS Incidence Cases

6. No. of Persons (in thousands)

8. AIDS Rates

13. HIV/AIDS and a Woman’s Biological Makeup • Women are more likely to contract HIV from an infected male partner than vice versa; the odds range from twice as likely to 20 times more likely. • The mucous membrane in the vagina is exposed to semen for a longer duration in comparison to vaginal fluid that may enter the penis.

14. Biological Makeup cont. • The immature cervix of young women have an added degree of vulnerability from the susceptible cells. • STDs create a 3 fold risk in acquiring HIV • Open ulcers or sores around the genital or anal area create portals for viral entry

15. STD Variables April is National Sexually Transmitted Diseases (STDs) Awareness Month. • 19 million new STD infections occur each year • Chlamydia and Gonorrhea are the most common STDs reported • Young females aged 15 to 19 had the highest Chlamydia rate • Young women of color are disproportionately affected by STDs • Viral STDs are the most prevalent and problematic STDs today, such as HIV, HPV, Herpes and Hepatitis B

16. Child Abuse Variables • Types of child abuse • Physical abuse, sexual abuse, neglect and emotional maltreatment • Signs of child abuse • Physical • Burns, bites, bruises (faded/old or new), broken bones, or black eyes • Frightened of parents and shrinks when approached by adults • Reports of injury by parent or adult caregiver Information retrieved from US National Library and the National Institutes of Health http://www.nlm.nih.gov/medlineplus/childabuse.html & Child Welfare Information Gateway at http://www.childwelfare.gov/pubs/factsheets/signs.cfm

17. …child abuse cont. • Neglect • Frequent absent from school • Begs or steals food or money • Lack of medical care • Lack proper clothing for the weather • Sexual Abuse • Difficulty walking or sitting • Nightmares or bed wetting • Changes in appetite • Sophisticated sexual knowledge • Emotional Maltreatment • Extreme behavior; i.e. demanding, extremely passive, or aggressive Information retrieved from US National Library and the National Institutes of Health http://www.nlm.nih.gov/medlineplus/childabuse.html & Child Welfare Information Gateway at http://www.childwelfare.gov/pubs/factsheets/signs.cfm

18. Domestic Violence Variables 2007 National Census of Domestic Violence Services On September 25, 2007--1,346 programs indicated that they…. • Served 53,203 victims • There were 7,707 unmet requests for services, due to shortage of funds or staff • 20,582 hot line calls • 29,902 people trained

19. Socio-Cultural Issues for Women • Gender Role…in the World of Sex • Male/Female socialization • Hygiene…douching, over the counter yeast creams • Distrust…Disbelief

20. socio-cultural...cont. • Myths Around Sexuality • Social and Information Network (HIV/AIDS whispered, closeted) • Stigma (discrimination, isolation) • Little, poor or no communication with Healthcare Providers (influenced by ethnicity, race, gender, class, language, etc)

21. Socio-Economic Factors • Poverty…low income…part-time employment • Limited education…functional illiteracy • Outside mainstream (weak messages back in the neighborhood) • No relationship to Public Models of PWAs (the FACE of AIDS) • Little or No Influence on Decision Makers and/or Program Designers and/or Service Providers

22. Socio-economic..cont. • Limited Time..No Time • Limited Access to Primary Care/ Prevention Screening • Violence in communities and Families • The “NEED” to Reproduce • Societal Norms (young women/older men; concurrent partners of males • Histories of Trauma (childhood sexual abuse, incest, domestic violence)

23. OWH Women and HIV/AIDS Programs • Model Mentorship Program • Women and HIV Prevention Strategies Workgroup • Women in the Rural South • Incarcerated and Newly Released Women • HIV Prevention in Minority Institutions • Native Women and HIV Prevention • HIV Prevention for Women in Puerto Rico and US Virgin Islands

24. OWH programs..cont. • Intergenerational HIV Prevention program • Intersection of HIV and Domestic Violence • HIV Prevention for Girls at Risk for Gang Activity • National Women and Girls HIV/AIDS Awareness Day, March 10, 2008, “Honoring Our Sisters: Women Living with HIV/AIDS”

25. OWH HIV Program Evaluation-2007 • A diverse set of programs were funded, all of which successfully recruited women of color. • Knowledge-based prevention programs for women of color are effective. • The Mentoring Partnership Model is effective in increasing organizational capacity of protégé programs.

26. Evaluation Conclusions • Program capacity is an important consideration in funding small, community based organizations. It is recommended that adequate funding be allocated to support the services provided and data collection activities. • There is a need to re-think what HIV/AIDS risk behavior information is important to ascertain from women of color and how to ask it. • Women of color may know their HIV status but may not be in care.

27. Thought For Today "We are each gifted in a unique and important way. It is our privilege and our adventure to discover our own special light.“ Mary Dunbar

28. Contact information Frances E. Ashe-Goins RN, MPH Deputy Director - DHHS-OWH 200 Independence Avenue, SW Washington, DC 20021 202-690-6373; fax 202-401-4005 Frances.Ashe-Goins@hhs.gov www.womenshealth.gov 1-800-994-9662