We Know HIV Doesn't Discriminate — So Why Are Women Still Being Left Out of the Conversation Around HIV?
Having recently become single again after being in a monogamous relationship for over a decade, and finding myself thrust into a whole new world of dating apps and identities (polyamorous, pansexual, etc.), I also realized it was time to start getting regular STI screenings again – including for HIV.
This was about eight months into my singledom, by which time I'd had three new partners (yes, I was enjoying my own exploration of polyamory). Though I had been using condoms, of course an STI screening was still the responsible thing to do, so I scheduled a full panel, including an HIV test, with my ob-gyn.
When I came in I was surprised to be greeted with a flurry of concerned questions from my doc: "Why do you want an HIV test? Do you think you have been exposed? Are you having any symptoms?"
"No," I explained, a little shaken. "I am just single again after many years and have been sexually active with more than one partner. I felt it was the proper thing to do at this point."
"Have you been using condoms?" she asked.
"Yes," I replied.
"Well, then we shouldn't have much too worry about," she said, and then suddenly asked, "Do you know if any of your partners are bisexual or have sex with men?"
"Not that I know of – though my ex had been with men before."
"Oh," she said, feigning an uncomfortable smile. "Well, let's just do the panel."
Fortunately, all was well, but several things left me uneasy about the visit. First of all, why did I have to specifically ask for an HIV test as part of my STI screening panel? Shouldn't this be an automatic inclusion? This day and age, should anyone have to justify the need for an HIV test?
Second, my doctor's bedside manner on the topic left much to be desired. Not only did her alarm _alarm me_, but her questioning seemed a bit invasive and irrelevant. She seemed to think it was strange of me to want an HIV test until she heard my ex had had sex with men – which really wasn't why I was getting the test done at all.
I had known for years my ex had a sexual history with men, though like many MSM, he identified as straight and I was the _only_ person who knew this about him. Unfortunately, because of sexist and homophobic attitudes that still exist in our society, this is the case for many MSM – and it's rare that they would disclose this to their female partners, as in my case. So with many women not knowing whether their male partners are MSM, why should that make a distinction of my perceived HIV risk? (Also, I had been tested with my ex and we were monogamous for the last 10 years, which she didn't ask about.)
Though it's true that bi and gay men, and trans women, are the most at-risk groups in terms of acquiring HIV, we know it certainly doesn't discriminate. Women and girls today not only need to know the facts about HIV and how to protect themselves or get care – but more so, providers need to step it up in terms of incorporating routine testing for, and conversations around, HIV as a normal part of women's healthcare.
I had the pleasure of speaking with HIV activist and policy badass Regan Hofmann last year on this topic for Plus magazine, who reiterated this: "We need to help more health care providers become aware of the fact that women are at risk for HIV. But until that changes," she adds, "women need to be agents of their own health. When you go to your doctor for your annual exam, ask for an HIV test. If your doctor (says) you don't need one, ask to get one anyway."
This is why, every March, Hofmann helps promote National Women and Girls HIV/AIDS Awareness Day (NWGHAAD). According to the U.S. Office of Women's Health, which sponsors the annual event on March 10 (and throughout the month of March), "about one in four people living with HIV in the United States is female. Only about half of women living with HIV are getting care, and only four in 10 of them have the virus under control."
According to the CDC, women made up nearly 20 percent of new HIV diagnoses in the United States in 2015 – and 86 percent of those were attributed to heterosexual sex (only 13 percent were attributed to injection drug use). This is a fact that most women who have sex with men do not realize.
Hofmann, an amfAR board member and former policy officer for UNAIDS's U.S. Liaison Office in Washington, D.C., knows this reality firsthand. She has been living with HIV for over 20 years. Hofmann says conversation about HIV is not only essential for women's health, but also necessary in order to eradicate stigma around the condition, which is counter-productive to ending the virus.
"If HIV carried no stigma, more of us living with HIV would know our status and access the treatment that not only keeps us healthy but that also suppresses our viral loads so we are virtually non-infectious," Hofmann told Plus. "Those who contribute to HIV-related stigma undermine our ability to resolve the pandemic. As stigma is largely fueled by fear, we must continue to educate people about the latest scientific facts to help them move from fear to compassion."
This year, NWGHAAD would be a good time for us as women, and as a society, to reflect and remember that HIV and AIDS affects us all. Together, we can solve this issue – but we must remember that women and girls are a huge part of the puzzle. We simply can no longer afford to be left out of the conversation.
"Women face unique HIV risks and challenges that can prevent them from getting needed care and treatment," reads the mission statement on the NWGHAAD webpage. "Addressing these issues remains critical to achieving an HIV- and AIDS-free generation."
For more information, visit the NWGHAAD page at WomensHealth.gov.
Desirée Guerrero is the associate editor of Plus magazine. This column is a project of Plus, Positively Aware, POZ, TheBody.com and Q Syndicate, the LGBT wire service. Visit their websites – http://hivplusmag.com, http://positivelyaware.com, http://poz.com and http://thebody.com – for the latest updates on HIV/AIDS.
