Crucial Facts About How HIV/AIDS Affects Women

The concept of HIV/AIDS as a "man's disease" — specifically gay men — dates back to the 1980s, and is not in any way a reflection of the actual reality of the illness. It doesn't discriminate, and that's reflected in the statistics. Globally, it's the leading cause of death for all women between the ages of 18-45, in front of childbirth, cancer, road accidents, and everything else. The American Foundation for AIDS Research also notes that global new infections in 2015 were basically gender-equal, with women making up 47 percent of them.

This, by the way, is one of the many reasons why President Trump's "global gag order" is a heinous idea. In case you weren't paying attention, one of Trump's first orders in office was to reinstate and expand a policy that bans the distribution of governmental aid to foreign NGOs who provide either abortions or just information about them. The problem isn't just limited to abortion availability; foreign NGO health clinics provide all kinds of services, including HIV/AIDS treatment.

"HIV/AIDS programs that treat entire communities could face defunding," Michelle Goldberg noted in Slate, adding that the director of National AIDS Policy under George W. Bush has said that "it would have been impossible to treat HIV/AIDS in the developing world" if the global gag rule at the time had extended to HIV/AIDS organizations. (Bush deliberately exempted them from his version of the order. Trump doesn't.) It's the "foot soldiers in America's global campaign against HIV/AIDS," The Economist says, that may be the biggest "casualties" of the order; and, by extension, that means millions more ill and dead women.

Upsettingly, a disproportionate amount of the HIV/AIDS diagnoses among women in America are in African-American women. While women represent about a quarter of all HIV diagnoses in the U.S., and are still behind gay men as a group, African-American heterosexual women made up 61 percent of the new diagnoses in 2015, according to the Center for Disease and Prevention.

There have been various analyses of why African-American straight women experience more HIV diagnoses in America. A review of studies in the New York Times in 2015 found that one potential cause is the disproportionately high levels of incarceration of African-American men across America. According to the NAACP, African-Americans are incarcerated at six times the rate of white Americans, and as of 2001, 1 in 6 African-American men had been in jail. Researchers believe this may have contributed to the levels of HIV/AIDS among African-American women because of various factors that may increase HIV contraction for incarcerated men: forced sex, unclean needle use for tattoos or drugs, and a lack of healthcare services once they get out.

Sex is the major way in which women worldwide contract HIV — 86 percent of their diagnoses, according to the CDC, come from heterosexual sex. Slate, in 2004, published a thorough debunking of the idea that African-American women's higher rates of HIV/AIDS came from men on the "down-low" (having sex with men and not revealing that to female partners). The reality, experts agree, is that a combination of higher poverty levels among African-Americans and incarceration patterns are what creates the risk. It's not just gender inequality; it's race, too.

Here's a factoid you may not know: certain sexually transmitted diseases raise your risk of contracting HIV — and that has a definite impact on the spread of HIV/AIDS among both gay and straight women. The CDC explains it as a combination of behaviors and illness-related risk factors: having an STD may mean that you're more likely to have experienced or done some sexually risky behavior, like unprotected sex, and any partner who gave you an STD may also give you HIV for the same reason.

The other element, though, is that STDs create an issue to do with the sores and inflammation of skin that sufferers often experience. CATIE, the Canadian health organization, explains:

"Inflammation increases the concentration of “activated” immune cells in the area infected with the STI. Although the inflammatory response is meant to help fight the sexually transmitted infection, HIV likes to infect some of these recruited immune cells, also known as CD4 cells. Also, HIV finds it easier to infect, and replicate in, CD4 cells that are “activated”. Therefore, if someone has an STI in the mouth, genitals or rectum, and that area is exposed to HIV, the higher concentration of “activated” CD4 cells facilitates HIV infection, replication and spread throughout the body."

Incidentally, this may also be part of the reason why African-American women experience more HIV diagnoses; they're five times more likely than white American women to have chlamydia and 10.7 times more likely to have gonorrhea. The reason seems to be the high incarceration rate of black men, again. With fewer men to choose from, and considering the fact that many Americans choose to date and have sex within their own racial background, young African-American women may feel less empowered to negotiate safe sex with their partners. And that's before we count the fact that they have less access to healthcare services and aren't targeted by campaigns about safe sex in general. It's stats like that which really emphasize the need for movements like Black Lives Matter.

HIV/AIDS is affected by societal prejudices and patterns, and activists have repeatedly raised the role that entrenched gender inequality plays in how it spreads among women. The HIV/AIDS organization AVERT has a pretty comprehensive rundown of how the interaction works; if women have poor health education and a lack of access to healthcare, their chances of HIV/AIDS rise. But it's also less direct than that. Lower levels of education overall, lower protection by the law, and higher levels of intimate partner violence also contribute to higher HIV/AIDS levels among women.

The Center for Disease Control and Prevention lays out the reasons behind the disturbing intimate partner violence statistic: if you're in an abusive relationship you're less likely to be able to make sexual choices for yourself, are more likely to have forced sex, may not be able to negotiate for safe sex, and are likely to do more risk-taking in sexual behavior. Women in violent relationships are four times more likely to have HIV than women who aren't.

That's not all. Being a child bride raises your likelihood of contracting HIV, according to the UN, because of a lack of sexual education or power to make healthcare decisions. The HIV/AIDS problem for women isn't just a health issue — it's a women's rights issue.