We applaud the Government of Canada's continued efforts to push women's and children's health to the forefront of the global agenda, as the high-level Summit on Maternal, Newborn and Child Health opens in Toronto this week. In far too many many parts of the world, women still struggle to access the health services they need, at an often deadly price.
Both the adults and the kids cry often but data collectors must not confuse their role with the families' service providers. It must be noted that the study has gone through several layers of ethical review and nevertheless, the stories trouble those who hear them. In some cases, children feel safe enough to make horrific disclosures for the first time.
Adhering to medications has the potential to bring about very positive results in the overall population. The thinking is that if you increase the number of HIV-positive people on treatment, you lower the total amount of virus circulating in a community and, ultimately, reduce the number of new HIV infections.
Racialized women and children, especially from the Global South often become the face of health issues as their faces (literally) are plastered on the websites and brochures of global health organizations. Their images usually accompanied by indicators of poverty and rural geographies and are offered to an audience as the justification for much needed programs.
As advocates, we often like to use analogies to explain the scourge of pandemics like HIV: It's a runaway train with no conductor, a loaded gun in the hands of a madman, a tide that needs to be turned. The problem with analogies though is that they have a way of detracting from the overarching, inevitable truth: People are dying. Real people. By the end of 2012, there were 35.3 million people across the world living with HIV. Even more jarring is the fact that one third of those people also have tuberculosis, and many of them will die before they even know that they have it.
HIV is a development issue not simply because of its detrimental impact on economic productivity and the health status of a community, but because low levels of socioeconomic development are actually creating a context in which HIV continues to be spread. When youth perceive their future prospects as exceedingly bleak, they are more inclined to partake in high-risk behaviour.
Many of the social and economic barriers that stand in the way of effective HIV prevention, treatment, support and care for people living with HIV are the same barriers that impede access to comprehensive sexual and reproductive health programs and services. In societies where cultural and gender norms tightly restrict the sexual and reproductive lives and choices of women and men, the risk for both unintended pregnancy and HIV infection is greatest.
I am part of the HIV support community at Positive Women's Network (PWN) in Vancouver, BC. Many of our members are of Aboriginal descent -- not a surprise, given that Aboriginal people are disproportionately affected by HIV. Stigma shadows discussions about sexual health, mental health and wellness, drug use, and definitely sex itself.
It is no coincidence that in countries and regions with high HIV/AIDS prevalence, women tend to have a lower position in society. But exactly what are the linkages between how women and girls are valued and their risk for HIV/AIDS? A significant factor is the ability to make choices. Women's lack of power relative to men gives them less bargaining power in negotiating the use of condoms to protect themselves. Poverty and lack of alternative options lead women to use survival strategies, including prostitution and exchange of sex for resources. To improve women's position in society and give them more control over their life choices, the perceived value of women and girls must change.
Recent advances in our understanding of HIV transmission, treatment, prevention and testing are changing the landscape of our response to HIV and generating a significant amount of optimism. The buzz at the International AIDS Conference this past July in Washington D.C. was that we may now be able to achieve an "AIDS-free generation."
Since 1996 we have developed better HIV medications and we live longer, fuller and healthier lives. People who are newly diagnosed and the young might not remember the endless funerals and whisperings about who was sick, who had committed suicide, or who had partied to death to escape the inevitable wasting and loss of personal strength and dignity. It's certainly a good thing that we have better medications, but the AIDS industry has become so dichotomized and disjointed that it is not recognizable from those early "grass roots" days, where everyday people did what they could with little resources and a whole lot of heart. The grass roots of HIV have withered and died.
Canada used to be a leader in supporting research to monitor HIV in key populations -- terrifically difficult because the activities that put them at risk are covert and illegal in many countries; surveillance can expose vulnerable populations to authorities and create risks for them. But Canada bowed out of supporting the HIV/AIDS Surveillance Project this year, just one more brick in a wall that is contributing to exclusion and marginalization of those most vulnerable to HIV infection. It's such a shame that our government has lost its vision of never leaving anyone behind.