Feeling overwhelmed? Having HIV is overwhelming. It is particularly overwhelming for women because so many of us have dedicated our lives to helping and taking care of other people. We may feel like escaping, but there are loved ones counting on us. We may need to take care of ourselves, but may feel selfish if doing that means the needs of people we care for won't get met.

HIV is a huge problem for women, but it is so much more. HIV is the magnifying glass that exposes the injustices, oppression and powerlessness that women the world over have struggled against for years. In a study (WIHS) that looked at causes of death (other than AIDS) in 308 HIV-infected women, there were 9 due to liver failure, 10 due to drug overdose, 7 due to pneumonia, 9 due to lung disease, 7 due to non-AIDS malignancies, and 7 due to murder, suicide or accident. Hepatitis C was present in 45% of those who died of AIDS, and 72% of non-AIDS deaths (Cohen, et al.).

Poverty

Women are more likely to be poor than men. With HIV, poverty makes it difficult for women to protect themselves from HIV because the struggle to survive today may seem larger than the struggle to avoid getting HIV. Poverty makes it harder to get health care, to get medications, to eat well, to have a healthy place to live, to have transportation to places that can help, to know your family's OK so you can focus on yourself, to feel that you have choices, and to minimize stress. The threat of poverty, and all the problems it causes, can make it difficult to get out of dangerous relationships.

Violence Against Women

Many women and children have been infected with HIV directly through rape. Violence can also put women at risk indirectly. Of 1103 women enrolled in the WIHS study, 67% reported sexual or physical violence by a current or past partner, and 33% had been victims of childhood sexual abuse. Being raped or abused as children can also make women feel powerless in sexual relationships later in life. If they use drugs or alcohol to drown the pain, they can be at risk of getting HIV from sharing needles, from having sex with partners who have shared needles, or from making unsafe personal choices while under the influence of drugs and alcohol. Those who become addicted may also later trade sex for drugs or money to buy drugs. One study found that 75% of prostitutes, 70% of drug abusers and 40% of runaways were sexually assaulted as children, all of which can make women vulnerable to HIV and AIDS.

Even when women are not being abused, many women give up their power in relationships in order to smooth things over or keep them in the relationship. Even if a woman is not afraid of being beaten, she may be afraid her partner will be irritated, mistrustful, or hurt if she doesn't want to have sex, or wants him to use a condom.

Homophobia Hurts Everybody

Homophobia (fear or prejudice against homosexuals) makes it difficult for men who like to have sex with men to be honest about it, with themselves or others (including girlfriends and wives). If they can't be honest about it, they're less likely to use condoms (to protect themselves or others). Homophobia pressures gay men to date women, so they will be accepted by society and their family and friends. Some get married or have children with a woman to prove they're straight (heterosexual).

Likewise homophobia pressures women who like to have sex with women to deny it or hide it. Many lesbians have felt they had to chose the lesbian world or straight world. When they get HIV, they often feel ostracized by both worlds, the straight world for being gay, the lesbian world for "breaking the rules" (having sex with men or using drugs) or for making other lesbians feel unsafe by suggesting that women can get HIV through sex with other women. (Yes, it has happened.)

Homophobia can make women who got HIV from men who had sex with other men feel embarrassed or ashamed, when what they need is support and understanding. Homophobia can make it difficult for heterosexual men to be open about having HIV, for fear people will say they are gay and discriminate against them.

Homophobia hurts everybody.

Anyone Can Get HIV

Anyone can get HIV. It doesn't matter whether rich or poor, white or black, young or old, married or single... If you give HIV a chance to travel from one person to another (through blood, semen, vaginal fluids or breast milk) it can happen to anyone. If you have sex, condoms can protect you if you use them correctly. If you don't use condoms (and since men wear them, few women have control over this), you are putting yourself at risk. You may trust your partner. (Of course, we want to.) But you can't be with them 24 hours a day. Anyone can get HIV. It's a human disease. That's what the "H" stands for.

HIV is an unforgiving magnifying glass, glaringly revealing the problems women have struggled to survive for eons. There are AIDS activists, researchers, case managers, doctors and others fighting AIDS. Addressing the injustices and barriers that make women vulnerable is also part of that fight.