HIV and AIDS

Patterns of hazardous alcohol consumption exist in countries with the worst HIV epidemics, most notably Southern and Eastern Africa, according to ICRW expert Katherine Fritz and colleagues in, “Alcohol: The Forgotten Drug in HIV/AIDS,” a comment for a special series of The Lancet.

The authors also highlight the risk to women who sell and serve alcohol in bars, hotels and other venues “who are at increased risk of drinking alcohol themselves, engaging in unprotected sex with their clients and HIV infection.” They conclude that gender and alcohol researchers should work jointly to determine ways of integrating gender into programs designed to reduce alcohol-related sexual-risk behavior, which might offer valuable lessons to the field of HIV and substance-use research.

The Lancet special series focuses on the growing HIV epidemic among people who use drugs and was launched July 20 in Vienna at the XVIII International AIDS Conference.

Download full text of "Alcohol: The Forgotten Drug in HIV/AIDS" at The Lancet »
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HIV and AIDS have been part of the global landscape for nearly 30 years, and will continue to impact the lives of millions of people, particularly women and girls, far into the future. Policymakers, program managers and service providers have long been aware that women and girls are uniquely vulnerable to HIV infection. Social science research conducted across the globe describes how the underlying causes of poverty and gender inequality heighten the vulnerability of women and girls to HIV. Faced with high rates of violence, poor access to school, health information, or legal services, women and girls are often at a disadvantage when managing their risk to HIV.

Global funders recently called for a more efficient use of resources to better serve the health care needs of women. They advocate integrating HIV prevention and treatment services with other reproductive health and family planning services. This is a highly desirable goal. Yet even if countries improve their health systems, this alone will affect only certain aspects of women’s vulnerability to an epidemic fueled by underlying legal, social and economic inequality.  

More must be done. We believe that a meaningful, effective AIDS response, at its core, demands an understanding of how women live.  Here are our recommendations:

• Understand who women are and what they need. Services often focus on women’s singular needs, such as food or livelihoods, or their singular identities as mothers or sex workers. They are women and mothers. They are sex workers and loving partners. They are at risk of hunger and HIV.
   
• Craft a response that recognizes that women live every day in relationships with families, communities and institutions – connections that influence their HIV risk.
   
• Let women speak for themselves and articulate their needs. This means intentionally placing women – especially those living with HIV – in leadership positions on national and international decision-making bodies as well as ministries and committees that address issues affecting women.
   
• Make policies work. National HIV responses must have a multi-faceted vision that truly addresses women’s needs. Government leaders must mandate, coordinate, fund and be accountable for strategic plans that ensure women’s right to full, healthy lives.

It’s time we did better by women.  Let’s get it right – right now.

Learn more about our work in HIV and AIDS, and stigma and discrimination.