What A Girl Wants: A Comprehensive US Policy on HIV and AIDS

The US HIV epidemic is taking the greatest toll among low-income women and women of color. US policy must address the complex medical, social, and economic realities of today's epidemic.

The following are co-authors of this article and the work referenced therein: Aziza Ahmed (ICW), Serra Sippel (CHANGE), Hadiyah Charles (HIV Law Project), Kathie Hiers (AIDS Alabama), Naina Khanna (WORLD), Brook Kelley (The Women’s Collective).

The HIV epidemic in the United States has become increasingly feminized, racialized, and impoverished over the past two and half decades. This trend was predictable – after all, it is women, people of color, and poor individuals who have the hardest time accessing health care information and services. President Bush’s response to the domestic HIV crisis was one that did little to change this fate; the former administration underfunded much-needed HIV care, prevention, and treatment services while simultaneously encouraging policies that lacked substantive basis in evidence.

But with the Obama administration things are finally looking up, and in the face of new and exciting health care reforms, women’s rights groups have drawn together a list of recommendations and submitted them directly to Jeff Crowley at the Office of National AIDS Policy in hopes that the White House will integrate these recommendations into the new National AIDS Strategy.  President Obama committed to a three-pronged National AIDS Strategy that would seek to: reduce HIV incidence, increase access to and utilization of care, and reduce health disparities. (Yes, you read that correctly, the United States still lacks a comprehensive national plan to address HIV!).

Our recommendations highlight the need for integrated health care delivery; elimination of government-sanctioned stigma, including the criminalization of HIV; involving HIV-positive women in forming policy; addressing geographic and economic health disparities; increasing access to health care services; integrating sexual and reproductive health services with HIV testing, treatment, and care; and preventing HIV transmission.

We also call for a realization of the rights of HIV-positive women whose complex medical, social, and economic realities require a nuanced and specific response.

Positive women who led and drafted the writing of the recommendations acknowledged this:

The reality for me is that as a woman living with HIV in the US, I am underinsured and cannot afford to get sick. I pay high monthly insurance premiums for poor health insurance benefit coverage. Even if I can get access to HIV care, if I have any other non-HIV related health issue, I have to spend large sums of money out-of-pocket before my insurance coverage can be used. Treating a systemic disease like HIV in isolation of all of the other health issues of a person belies the fact that health is best cared for holistically.

Important to note: we feel the best way to begin to address these challenges is to involve HIV-positive women directly in designing programs and policies that will affect their lives.

By making this submission to the Office of National AIDS Policy, we have not only made our demands to the Obama administration loud and clear, we have provided realistic steps for implementing these recommendations. After years of misplaced priorities, it is finally time to provide access to appropriate and integrated care, treatment, and support for the many women living with HIV and to begin to make real progress in curbing the HIV epidemic amongst women in the United States.