A topic that is often neglected - or avoided - has been enabling HIV-positive women to deal with unwanted pregnancies through emergency contraception and voluntary safe legal abortion. So how was the topic covered at the Mexico AIDS conference? A quick scan of the conference program (which may admittedly have omitted some references) shows that of the 7309 abstracts on the conference CD-ROM, about 50 addressed pregnancy termination in some way.
About 21 abstracts reported on abortion rates in relation to pregnancy outcomes - a large proportion of these studies referred to sex workers, with only a few focused on women living with HIV. One abstract mentioned stigmatization of HIV being increased due to its association with pollution and abortion in South Africa; a few also mentioned forced abortion as a human rights violation.
A handful of research reports incorporated abortion as a study topic. Barbosa et al. compared access of HIV-positive and HIV-negative women to abortion services in Brazil. They found that women living with HIV more often had abortions (and tubal ligations) but they did not present information on why this might be the case. The Women's Health Research Unit from the University of Cape Town, South Africa, reported on interview studies with people living with HIV and health-care providers, concluding that "tailored contraception, preconception, and termination of pregnancy counselling may be critical to helping HIV+ women and men...make informed decisions that optimize the reproductive health outcomes for them as well as their future children." Nevertheless, Ruth Borms reported that even in Europe, where abortion is permitted by law, health-care providers seldom discuss pregnancy termination with HIV-positive clients.
While voluntary pregnancy termination was scarcely addressed at previous AIDS conferences as a policy issue, several speakers addressed the need to include abortion care within the scope of reproductive rights. Notable examples: Morolake Odetoyinbo (GNP+, Nigeria) stated that prevention of unsafe abortion, treatment of miscarriages and postabortion care are special needs of HIV-positive women. Shaun Mellors (International HIV/AIDS Alliance), Marion Stevens (Health Systems Trust, South Africa), Kalindy Bolivar (Coordinadora Juvenil por la Equidad de Género, Ecuador), and Elizabeth Maguire (Ipas) reflected on the need to include both safe motherhood and safe pregnancy termination as services for women living with HIV. Zonny Woods, who spoke in the closing plenary on the needs of women and girls, also mentioned the need to include safe abortion as a reproductive right for HIV-positive women.
These presentations were encouraging steps forward, but much remains to be done to overcome the stigma and taboos attached to the issue. I was able to attend a couple panels on integration of HIV/AIDS and reproductive health services; what was striking about some of those presentations was that abortion was presented as an obstacle and a problem to be overcome in promoting linkages and integration, not as a right that women living with HIV should have so that they can deal with unwanted pregnancies.
Ipas and the Health Systems Trust offered a Global Village session on "Linking HIV and reproductive choice - reflecting on strategies for advocacy," the first time that pregnancy termination was a workshop topic. We started off with 24 participants but when it became clear that we would talk specifically about abortion care, many people left. Debbie Billings remarked: "Unwanted pregnancy among positive women is a reality that hardly is discussed. The workshop that I attended was one of the few spaces in the conference where abortion as an option was addressed. It was disappointing to see so many participants leave the workshop just as we broke into small groups to strategize how to disseminate messages about positive women's reproductive rights. The topic of abortion seemed to make many people uncomfortable, so much so that they had to leave the session."
Our advocacy for the rights of women living with HIV to become mothers has definitely advanced in recent years - we are talking about their right to bear children, to use assisted conception and to adopt children. Hopefully, the right of HIV-positive women to avoid unwanted pregnancies will become as accepted an issue at the next AIDS conference in 2010, not only in presentations on policy needs but also sessions discussing interventions and linkages between HIV/AIDS and reproductive health services.
]]>Grover, co-founder of the Lawyers Collective in India, has made it a point to work closely with civil society in the legal and rights-based work he pursues. His career began with a case focused on the rights of homeless people and since then he has worked with community members in drafting Indian laws related to HIV and sexual violence. He is currently arguing a court case against the sodomy law in India.
Grover stressed that any work on human rights and health must be based on a combination of the "academic" and "real-life experience." Scientific evidence is needed to show which public-health interventions will have a real impact on the risks and vulnerabilities of various groups. At the same time, people from these communities must have a platform to share their own views and experiences regarding the factors that they feel place their health in jeopardy. We already have interventions developed in such a manner and these need to be promoted; examples include empowerment strategies among sex workers and needle-exchange programs for injecting drug users.
As the Special Rapporteur on Health, one of Grover's tasks will be to work on further refining the definition of the right to health as used in human rights law. In this regard, he will focus on a limited number of key issues that can be delineated more clearly. Although he was clear about already having some ideas about which issues he believes will be worth pursuing, he also wants input from civil society.
In order to gather as much input as possible in a short period of time, Grover will work with NGOs to hold a series of regional consultations for civil society organizations, including groups working on HIV/AIDS, women's issues, sexual orientation, human rights and health issues affecting marginalized groups. He hopes that these dialogues will lead to a growing consensus on issues requiring urgent attention.
The civil society representatives at the informal Mexico meeting took the opportunity to put forward their views on some of the issues that are of vital importance in their region. These include: addressing the issue of unsafe abortion and negation of safe legal abortion care by governments such as Nicaragua; homophobia by conservative and religious groups, which is obstructing health-related work for non-heterosexual people; and access of indigenous groups and young people to adequate health services.
These topics fit in well with Grover's expressed desire to address marginalization and empowerment as perspectives for the work of the Special Rapporteur. He will be setting up a webpage through which civil society groups can send him information and feedback in the very near future.
]]>When asked if the PEPFAR-related anti-prostitution pledge had negatively affected her organization's funding, Silva Leite remarked that all donors have their own specific policies and interests. Moreover, these can change over time so it is better for organizations not to depend on them but to seek more sustainable funding sources. Davida did this by creating a fashion label called Daspu; the sex workers collaborate with designers who translate their ideas into concrete fashions. Daspu now is featured in fashion magazines and forms part of the mainstream Brazilian fashion scene - this has also led to increased recognition and respect for the sex workers' organization.
At the same panel about making, tracking and spending money, Julia Kim described the IMAGE Project in South Africa, which has combined a micro-credit financing scheme for the poorest women in rural communities with an educational component focused on issues of HIV, violence, and gender bias. Comparative research between communities that only offered micro-credit and communities that included the gender empowerment component showed that both interventions tackled poverty but the latter also contributed to reducing HIV risks and gender equity.
A shared approach in the Brazilian and South African interventions was the linking of researchers and community-based organizations. Davida has worked with staff of a business school to develop Daspu as a business, rather than just a project. IMAGE has involved researchers in documenting and evaluating the cross-sectoral project in anticipation of scaling up the intervention.
A third panelist, Martha Kwataine, described how the Malawi Health Equity Network has worked with grassroots groups to help monitor national and district health budgets. She and others acknowledged that the type of evidence produced by groups such as IMAGE and Davida can help support advocacy on the importance of including gender empowerment and financing for women as essential components of strategies to address HIV/AIDS. We are seeing that women with economic resources are in a better position to confront situations that put them at risk - now we must ensure that macroeconomic policies incorporate investment for women as well.
]]>Maria de Bruyn is the Senior Policy Advisor for Ipas.
On 9-10 October 2006, Addis Ababa University and the Gates Institute for Population and Reproductive Health organized an interesting conference for over 480 participants in Addis Ababa, Ethiopia: "Linking Reproductive Health and Family Planning with HIV/AIDS Programs in Africa." As is often the case at such meetings, useful information was shared that led to more questions needing answers.
A number of presentations investigated the fertility intentions of people living with HIV/AIDS. Researchers reporting on studies from Botswana, Ethiopia, Malawi, Namibia, Nigeria, South Africa, Tanzania and Uganda indicated that HIV-positive women (and men) often want to continue having children. Not surprisingly, however, considerable numbers of women living with HIV also do not want (more) children - especially if they are already mothers, are somewhat older and not in a relationship with a new partner. Sadly, numerous studies also reported an unmet need for family planning among HIV-positive individuals, which is resulting in unwanted pregnancies. One study among people receiving antiretroviral therapy at a large clinic in Ethiopia, for example, found that unsafe abortion was a problem for their female clients.
]]>Maria de Bruyn is the Senior Policy Advisor for Ipas.
On 9-10 October 2006, Addis Ababa University and the Gates Institute for Population and Reproductive Health organized an interesting conference for over 480 participants in Addis Ababa, Ethiopia: "Linking Reproductive Health and Family Planning with HIV/AIDS Programs in Africa." As is often the case at such meetings, useful information was shared that led to more questions needing answers.
A number of presentations investigated the fertility intentions of people living with HIV/AIDS. Researchers reporting on studies from Botswana, Ethiopia, Malawi, Namibia, Nigeria, South Africa, Tanzania and Uganda indicated that HIV-positive women (and men) often want to continue having children. Not surprisingly, however, considerable numbers of women living with HIV also do not want (more) children - especially if they are already mothers, are somewhat older and not in a relationship with a new partner. Sadly, numerous studies also reported an unmet need for family planning among HIV-positive individuals, which is resulting in unwanted pregnancies. One study among people receiving antiretroviral therapy at a large clinic in Ethiopia, for example, found that unsafe abortion was a problem for their female clients.
Several research groups gave presentations on the feasibility of integrating reproductive-health/family-planning counseling into HIV/AIDS services and vice versa. While HIV-positive clients (and researchers) consistently endorsed such integration, they often encountered problems such as a lack of appropriate knowledge on the part of providers and insufficient staff numbers to promote integration. A particularly interesting paper from the Constella Futures Group highlighted the need to address policy issues before integration of such services is begun (e.g., are health systems structured in a way that supports integration or linkages?).
What was striking about the discussions was that little mention was made of creating linkages between HIV/AIDS and postabortion care/legal abortion services, despite the reports on unintended pregnancies. Employing (paying!) trained HIV-positive persons as reproductive-health/family-planning counselors, to help alleviate staff shortages and contribute to services more oriented to client needs, was also scarcely raised as a strategy during a working group on needed policy change. Ipas advocated for more meaningful involvement of people living with HIV in the design, implementation and reporting of studies dealing with the reproductive health of HIV-positive persons. During the meeting we shared a presentation of our own work with Jennifer Gatsi, a member of the International Community of Women Living with HIV/AIDS (ICW), who collaborated on a study with us in Namibia. Startlingly, Jennifer was the only HIV-positive person to present research findings at the conference.
The presentations and working group outcomes from the conference will be made available soon through this website.
]]>Advocates for women’s and rights issues can rightly take pride in having focused at least some attention on topics that were relatively neglected, such as female-controlled (at least to some extent!) barrier methods (female condoms, microbicides, diaphragms and cervical caps) and violence against women.
]]>Advocates for women’s and rights issues can rightly take pride in having focused at least some attention on topics that were relatively neglected, such as female-controlled (at least to some extent!) barrier methods (female condoms, microbicides, diaphragms and cervical caps) and violence against women.
One hot topic that was debated in formal and informal sessions was the current push by national and international agencies to have as many people tested for HIV as possible. Most people agree that knowing one’s HIV status can have many benefits, not the least of which is enabling a person to seek appropriate treatment in a timely manner (assuming that affordable treatment is available within a reasonable distance from their place of residence, of course). What concerns those who question the speed with which testing initiatives are being expanded is whether this public-health measure will be based on respect for individual human rights.
Some worry that routine offers of HIV tests by health-care providers may easily turn into routine imposition of HIV tests for patients who are not knowledgeable or confident enough to ask about the benefits and risks associated with tests. (And just think about it – how often have you asked your physician all the questions you had about a medical exam, procedure or prescription? Have you never felt just a little intimidated or reluctant to challenge or question what your doctor says? I know that it’s happened to me and my well-to-do, highly educated, empowered female friends; women raised to be subordinate will have even more problems with this.)
The growing shortage of health-care workers in many areas means that health systems don’t have adequate staffing levels to ensure that patients can give informed consent or receive counseling. Inadequate infrastructure can mean that confidentiality is not ensured as no separate spaces are available where people can receive test results in privacy. Or people’s confidentiality is breached later when they can only access antiretroviral therapy (ART) at offices labeled “AIDS Services,” “ART for adults” and “ART for children.” When women are asked to take HIV tests during labor and delivery, they will often be in a ward with others – how can protocols ensure that their consent is informed and private? And how well can they consider benefits and risks at such a time?
At two different sessions on testing and counseling, speakers highlighted the increased numbers of people tested through Botswana’s provider-initiated testing system. However, it was only in response to an audience member’s question that one scientist admitted they were only now starting to consider evaluations that might also assess client satisfaction, access to ART and possible negative impacts subsequent to testing.
The ATHENA Network and International Community of Women Living with HIV/AIDS (ICW), with assistance from the Center for Health and Gender Equity (CHANGE), organized a press conference to highlight the need to examine testing from a gender perspective. For example, the experiences of ICW members point to the fact that “Testing services often do not address the stigma, discrimination and related violence, and loss of livelihood that many women face if their status becomes known. This makes seeking treatment and care a devastating prospect for many.”
The questions raised about the push for testing were good and necessary. What we need to hear about as soon as possible, however, is how the challenges to human rights-based testing and counseling are being tackled. Just a few examples (there are more!). Many physicians are coming to Africa from other countries to help deal with the health-care worker shortage (e.g., from Cuba). How well can doctors who don’t speak local languages ensure that people are able to give informed consent for a test? A study coordinated by Ipas on meeting HIV-positive women’s health needs recommends that women living with HIV be paid as counselors, instead of having them supplement health services as volunteers. Health-care workers in Argentina confirmed that HIV-positive counselors can offer superior services – how many testing programs are taking this approach? How do testing protocols take into account follow-up of people who tested positive (e.g., in accessing ART if needed or in providing treatment and support for mothers and children)?
Regarding reproductive choice: in 1992, when ICW was founded, the network published 12 statements on what was needed to improve the situation of women living with HIV/AIDS; one of those statements was: “The right to be respected and supported in our choices about reproduction, including the right to have, or not to have, children.” In the 2002 Barcelona Bill of Rights, ICW and other organizations stated that a fundamental right for women and girls around the world is “to sexual and reproductive health services, including access to safe abortion without coercion.” So is reproductive choice receiving attention at the AIDS conference?
Some state that it was scarcely addressed; that is certainly true, for example, in comparison to prevention of perinatal transmission. But a few small steps forward have been made if we consider that the topic was virtually ignored in the past. About 20 poster and CD-ROM abstracts included the topic of pregnancy termination or integration/linking of HIV/STI and abortion services; several called for access to safe abortion services or noted how current laws create obstacles for women.
Of course, many people will not read the abstracts and did not see the posters. So was the topic visible otherwise? The T-shirts given away to participants in the Women’s March and Rally (the first to be officially endorsed by an AIDS conference) featured the Barcelona Bill of Rights, including access to safe abortion. Buttons distributed by the ATHENA Network and Blueprint Coalition asked for “sexual rights, reproductive choice and healthy motherhood.” And in an opening plenary speech on the first day of the conference, Louise Binder highlighted the need for women to have access to safe abortion for all indications permitted by law. Now we need to ensure that the 2008 International AIDS Conference includes at least one oral abstract, round-table or panel discussion session on reproductive choice with discussion of issues such as antenatal care for women who choose to become pregnant after knowing their status, access to safe abortion and integration/linkage of postabortion care services into HIV/AIDS information and services, coercive abortion/sterilization as human rights violations, and the possibility of adoption for HIV-positive parents.
One final observation: Louise’s plenary was the final one on 14 August and previous speakers had exceeded their allotted time. This resulted in many delegates leaving the session to go to the next one; considerable numbers of women also left the room before hearing the presentation on women and HIV/AIDS. When her presentation went a bit long, the chair of the session (a woman!) cut off her microphone. To her credit, however, Louise stood her ground, refused to budge and was supported by remaining delegates so that eventually her microphone was turned back on and she could finish. The most insulting thing about this was the chair’s admonition that Louise had to conclude because the next session was about to start and included “important people – Bill Clinton and Bill Gates.” Now what does that say to us about women having a fully recognized and meaningful place at the table??
Some references:
ATHENA Network: http://www.athenanetwork.org
ICW press release on testing: http://www.icw.org/node/211Ipas study: http://www.ipas.org/publications/en/MDGMON_E06_en.pdf
]]>Maria de Bruyn is the Senior Policy Advisor for Ipas.
"Gender-based violence and HIV: making the connection" was the theme for an evening satellite meeting convened by the International Community of Women Living with HIV/AIDS (ICW) and the ATHENA Network. Chairs Sofia Gruskin of Harvard University and Mary Robinson, former president of Ireland now with the Ethical Globalization Initiative, invited panelists from Africa, North America and Latin America to speak about intersections between gender-based violence (GBV) and HIV. Other delegates then offered information on approaches they used, challenges they faced and ideas about how to move forward.
Awino Okech (Mother Tongue, South Africa) called on those present not only to address HIV infection resulting from domestic and sexual violence, but also violence in response to women's voluntary or involuntary disclosure of their positive HIV status. She also asked for honesty in addressing the fact that some women become positive because they, like men, choose to have extramarital relations; a focus on sexuality needs to be added to our analyses.
]]>Maria de Bruyn is the Senior Policy Advisor for Ipas.
"Gender-based violence and HIV: making the connection" was the theme for an evening satellite meeting convened by the International Community of Women Living with HIV/AIDS (ICW) and the ATHENA Network. Chairs Sofia Gruskin of Harvard University and Mary Robinson, former president of Ireland now with the Ethical Globalization Initiative, invited panelists from Africa, North America and Latin America to speak about intersections between gender-based violence (GBV) and HIV. Other delegates then offered information on approaches they used, challenges they faced and ideas about how to move forward.
Awino Okech (Mother Tongue, South Africa) called on those present not only to address HIV infection resulting from domestic and sexual violence, but also violence in response to women's voluntary or involuntary disclosure of their positive HIV status. She also asked for honesty in addressing the fact that some women become positive because they, like men, choose to have extramarital relations; a focus on sexuality needs to be added to our analyses.
Claire Thiboutot (Stella, Canada) and Lydia Mungherere (ICW, Uganda), were joined by audience members in highlighting the double problems faced by sex workers in countries as diverse as Canada, Laos and Uganda. They not only suffer domestic and sexual violence from clients, law enforcement personnel, bosses and intimate partners, but also find it difficult or impossible to report such crimes because gender-based stereotypes and discrimination imply that they "cannot" really suffer violence since they are "only whores."
Arely Cano (ICW Nicaragua) added that women need to stop accepting - and transmitting to their children - gender norms that reinforce male dominance and women's subordination; Lynde Francis (ICW, Zimbabwe) added that monogamous women who are infected by their spouses need to recognize such HIV transmission as a form of violence and a breach of their marriage contracts, which were supposed to offer them additional protection. Charlotte Bunch (Center for Women's Global Leadership, United States) commented that these experiences indicate that we must develop solutions by combining knowledge and wisdom gained in the fields of sexual rights, human rights, violence against women and HIV; this will require willingness to acknowledge and work on various stigmatized issues. An audience member pointed out that this is also pertinent with regard to services for survivors of violence. For example, Ipas-Brazil has worked with hospitals so that women are not required to press charges to "prove" they have been raped in order to be offered post-exposure prophylaxis for HIV (if they are not already HIV-positive), emergency contraception or safe legal abortion if they are pregnant as a result of the assault.
Mary Oduka of Irish Aid pointed to the need to also work with men to change the gender-based discriminatory norms that innately condone violence against women. In Uganda, men have worked with drinking groups that now exert peer pressure on their members to prevent them from beating their wives and going out unless they have ensured that their family has had sufficient food that day. Audience members also suggested that a new network of female Health Ministers be expanded to include female ministers from other sectors (Education, Justice, etc.) to develop prevention and service approaches from a multi-sectoral perspective.
]]>Editor's note: For more on how gender and HIV relate to reproductive health, read Time to Deliver for Women and Girls, HIV Prevention Integral to Reproductive Health, and Gateses Speak out for Women.
Maria de Bruyn is the Senior Policy Advisor for Ipas.
Prior to and throughout the International AIDS Conference, activists and experts are meeting in a series of satellite sessions that address issues that may not get the full attention of the conference. This satellite session focused on linking HIV/AIDS with sexual and reproductive health and rights (SRHR), especially with regard to men who have sex with men, sex workers and injecting drug users. There were a number of noteworthy statements and reflections:
]]>Maria de Bruyn is the Senior Policy Advisor for Ipas.
Prior to and throughout the International AIDS Conference, activists and experts are meeting in a series of satellite sessions that address issues that may not get the full attention of the conference. This satellite session focused on linking HIV/AIDS with sexual and reproductive health and rights (SRHR), especially with regard to men who have sex with men, sex workers and injecting drug users. There were a number of noteworthy statements and reflections:
Finally, participants acknowledged that we must do much more to address the particular needs of youth, women and disabled people - in addition to the vulnerable groups mentioned above. It is important to note that there was no mention of older people - either HIV-positive or HIV-negative. The fact that post-menopausal women are no longer of childbearing age leads many SRH and HIV/AIDS workers to overlook their sexuality as well as their sexual and gynecological health. Linking SRHR and HIV/AIDS is of vital importance for all people affected by and living with HIV/AIDS: youth entering puberty, people of reproductive age and older adults.
It was further noted that gathering evidence of the benefits to society of observing individuals' human rights (e.g., reduction of certain health costs) may be important for donors and governments; these agencies must accordingly make resources available for such data collection. However, meeting participants pointed out that political ideologies may lead those in power to ignore certain evidence or emphasize only certain rights. Respect for, and promotion of, sexual and reproductive rights therefore cannot be made contingent on "evidence" as the dignity of all human beings requires that their rights be observed.
The organizers of the satellite meeting - Action Canada for Population and Development, the International Community for Women Living with HIV/AIDS, IPPF, CARE Canada, the government of Canada, the United Nations Population Fund and WHO - promised to produce a summary document from the meeting so that interested groups can move forward with the suggestions for action.
]]>
Maria de Bruyn is a Senior Advisor for Ipas and a medical anthropologist by training. At Ipas, she has identified, researched, and publicized linkages between abortion and other sexual and reproductive health issues, including HIV/AIDS.
One issue that is receiving a great deal of attention at the International AIDS Conference is the effect the AIDS epidemic is having on women and girls around the world.
In 1992, the International Community of Women Living with HIV/AIDS (ICW) was formed at the Amsterdam AIDS Conference. There, HIV-positive women spoke out about the need to address gender biases that increase their vulnerability to HIV infection, worsen the stigma and discrimination attached to AIDS, and place most of the burden of care for AIDS patients and orphans on their shoulders.
Today, 14 years later, some progress has been made.
]]>Maria de Bruyn is a Senior Advisor for Ipas and a medical anthropologist by training. At Ipas, she has identified, researched, and publicized linkages between abortion and other sexual and reproductive health issues, including HIV/AIDS.
One issue that is receiving a great deal of attention at the International AIDS Conference is the effect the AIDS epidemic is having on women and girls around the world.
In 1992, the International Community of Women Living with HIV/AIDS (ICW) was formed at the Amsterdam AIDS Conference. There, HIV-positive women spoke out about the need to address gender biases that increase their vulnerability to HIV infection, worsen the stigma and discrimination attached to AIDS, and place most of the burden of care for AIDS patients and orphans on their shoulders.
Today, 14 years later, some progress has been made. Antiretroviral treatment (ART) is available to greatly reduce the chances of HIV transmission during pregnancy and childbirth. International and national agencies are beginning to recognize the need to link HIV/AIDS programs with sexual and reproductive health services so that women's health needs are met more comprehensively. ICW has become a co-sponsor of the international AIDS conferences and associations of HIV-positive women who offer affected women counseling, care and support have arisen in countries of all regions of the world.
Too much remains undone, however. While far fewer children are born HIV-positive, only a minority of mothers receive needed ART to ensure their own survival. Although the risks of cervical cancer are increased in HIV-positive women, most of them don't even know about cancer screening and even fewer have access to Pap smears. Discrimination within the health sector still occurs in various countries. Women who choose to become pregnant after knowing their positive HIV status are socially ostracized; some HIV-positive women are still turned away from hospitals when they are about to give birth. Women living with HIV who have unwanted pregnancies have no access to safe legal abortions; others are only granted legal abortions if they "agree" to be sterilized. And while women may be invited to international and national meetings to "tell their stories," their insights and contributions to policymaking are often marginalized or not even sought.
At the Toronto AIDS Conference, my organization, Ipas and our partners will present findings from a pilot project carried out with eight partner organizations in 11 countries that investigated the extent to which affected women are affected by discrimination, receive needed reproductive health services and are involved in local policy formulation. Together with ICW, we will offer a skills-building workshop for HIV-positive women and non-governmental organization on understanding and addressing these shortfalls as human rights violations.
Ipas is also pleased to be a part of the ATHENA Network, a new coalition uniting individuals and organizations in the need to establish respect for human rights and gender equity as the framework for all policies and programs addressing women and HIV/AIDS. ATHENA was a co-sponsor of a march and rally for women's rights at the start of the conference, as well as other events addressing gender discrimination in relation to HIV testing, violence against women and increased community dialogue on these issues.
It is no longer enough to recognize that women are greatly affected by the epidemic and to plead for some attention. It's time - or rather past time! - to demand that interventions be stepped up to alleviate the impact of HIV/AIDS on women and girls worldwide.
]]>Editor's note: For more on the connection between HIV/AIDS and reproductive health, read Gateses Speak Out for Women and HIV Prevention Integral to Reproductive Health.