HIV/AIDS: Impact for Women and Girls

1
HIV/AIDS Impact for Women and Girls

• Frances E. Ashe-Goins, R.N. M.P.H
• Deputy Director
• U.S. DHHS-Office on Womens Health

2
Office on Womens Health

• Vision Statement
• All Women and Girls are Healthier and Have a
  Better Sense of Well-Being
• Mission statement
• Provide leadership to promote health equity for
  women and girls through sex/gender-specific
  approaches

3
AIDS Incidence Cases
4
(No Transcript)
5
(No Transcript)
6
No. of Persons (in thousands)
7
(No Transcript)
8
AIDS Rates
9
(No Transcript)
10
(No Transcript)
11
(No Transcript)
12
(No Transcript)
13
HIV/AIDS and a Womans Biological Makeup

• Women are more likely to contract HIV from an
  infected male partner than vice versa the odds
  range from twice as likely to 20 times more
  likely.
• The mucous membrane in the vagina is exposed to
  semen for a longer duration in comparison to
  vaginal fluid that may enter the penis.

14
Biological Makeup cont.

• The immature cervix of young women have an added
  degree of vulnerability from the susceptible
  cells.
• STDs create a 3 fold risk in acquiring HIV
• Open ulcers or sores around the genital or anal
  area create portals for viral entry

15
STD Variables

• April is National Sexually Transmitted Diseases
  (STDs) Awareness Month.
• 19 million new STD infections occur each year
• Chlamydia and Gonorrhea are the most common STDs
  reported
• Young females aged 15 to 19 had the highest
  Chlamydia rate
• Young women of color are disproportionately
  affected by STDs
• Viral STDs are the most prevalent and problematic
  STDs today, such as HIV, HPV, Herpes and
  Hepatitis B

16
Child Abuse Variables

• Types of child abuse
• Physical abuse, sexual abuse, neglect and
  emotional maltreatment
• Signs of child abuse
• Physical
• Burns, bites, bruises (faded/old or new), broken
  bones, or black eyes
• Frightened of parents and shrinks when approached
  by adults
• Reports of injury by parent or adult caregiver

Information retrieved from US National Library
and the National Institutes of Health
http//www.nlm.nih.gov/medlineplus/childabuse.html
Child Welfare Information Gateway at
http//www.childwelfare.gov/pubs/factsheets/signs.
cfm
17

• child abuse cont.
• Neglect
• Frequent absent from school
• Begs or steals food or money
• Lack of medical care
• Lack proper clothing for the weather
• Sexual Abuse
• Difficulty walking or sitting
• Nightmares or bed wetting
• Changes in appetite
• Sophisticated sexual knowledge
• Emotional Maltreatment
• Extreme behavior i.e. demanding, extremely
  passive, or aggressive

Information retrieved from US National Library
and the National Institutes of Health
http//www.nlm.nih.gov/medlineplus/childabuse.html
Child Welfare Information Gateway at
http//www.childwelfare.gov/pubs/factsheets/signs.
cfm
18
Domestic Violence Variables

• 2007 National Census of Domestic Violence
  Services
• On September 25, 2007--1,346 programs indicated
  that they.
• Served 53,203 victims
• There were 7,707 unmet requests for services, due
  to shortage of funds or staff
• 20,582 hot line calls
• 29,902 people trained

19
Socio-Cultural Issues for Women

• Gender Rolein the World of Sex
• Male/Female socialization
• Hygienedouching, over the counter yeast creams
• DistrustDisbelief

20
socio-cultural...cont.

• Myths Around Sexuality
• Social and Information Network (HIV/AIDS
  whispered, closeted)
• Stigma (discrimination, isolation)
• Little, poor or no communication with Healthcare
  Providers (influenced by ethnicity, race, gender,
  class, language, etc)

21
Socio-Economic Factors

• Povertylow incomepart-time employment
• Limited educationfunctional illiteracy
• Outside mainstream (weak messages back in the
  neighborhood)
• No relationship to Public Models of PWAs (the
  FACE of AIDS)
• Little or No Influence on Decision Makers and/or
  Program Designers and/or Service Providers

22
Socio-economic..cont.

• Limited Time..No Time
• Limited Access to Primary Care/ Prevention
  Screening
• Violence in communities and Families
• The NEED to Reproduce
• Societal Norms (young women/older men concurrent
  partners of males
• Histories of Trauma (childhood sexual abuse,
  incest, domestic violence)

23
OWH Women and HIV/AIDS Programs

• Model Mentorship Program
• Women and HIV Prevention Strategies Workgroup
• Women in the Rural South
• Incarcerated and Newly Released Women
• HIV Prevention in Minority Institutions
• Native Women and HIV Prevention
• HIV Prevention for Women in Puerto Rico and US
  Virgin Islands

24
OWH programs..cont.

• Intergenerational HIV Prevention program
• Intersection of HIV and Domestic Violence
• HIV Prevention for Girls at Risk for Gang
  Activity
• National Women and Girls HIV/AIDS Awareness Day,
  March 10, 2008, Honoring Our Sisters Women
  Living with HIV/AIDS

25
OWH HIV Program Evaluation-2007

• A diverse set of programs were funded, all of
  which successfully recruited women of color.
• Knowledge-based prevention programs for women of
  color are effective.
• The Mentoring Partnership Model is effective in
  increasing organizational capacity of protégé
  programs.

26
Evaluation Conclusions

• Program capacity is an important consideration in
  funding small, community based organizations. It
  is recommended that adequate funding be allocated
  to support the services provided and data
  collection activities.
• There is a need to re-think what HIV/AIDS risk
  behavior information is important to ascertain
  from women of color and how to ask it.
• Women of color may know their HIV status but may
  not be in care.

27
Thought For Today

• "We are each gifted in a unique and important
  way. It is our privilege and our adventure to
  discover our own special light. Mary Dunbar

28
Contact information

• Frances E. Ashe-Goins RN, MPH
• Deputy Director - DHHS-OWH
• 200 Independence Avenue, SW
• Washington, DC 20021
• 202-690-6373 fax [phone]
• Frances.Ashe-Goins_at_hhs.gov
• www.womenshealth.gov
• 1-800-994-9662