HIV increases among women many powerless over sex

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Everyone engaging in the near-universal activity of sex is at risk of becoming infected with HIV, but women and girls often do not have any control over whether they have intercourse and are catching up to men in new HIV infections, experts say.

Women and their infants are rapidly becoming the exception in the success of many HIV/AIDS-prevention programs to be discussed at a major U.N. conference among government ministers from Wednesday to Friday.

“The problem is that when you take abstinence or use a condom in heterosexual relations, it is always male- controlled—always,” said Dr. Peter Piot, executive director of UNAIDS, the leading coordinating group combating the pandemic.

"In every single region in the world, the proportion of women among those being infected with HIV is increasing,” Piot said, whether in Southeast Asia, Eastern Europe, Central America and even the United States.

Particularly disadvantaged are women who have been raped, including child brides by their husbands, women who are never treated and prostitutes, Piot said in an interview on Monday.

“We know that in many societies now the biggest risk factor is to be married at an early age, always with an older man,” Piot said. “The irony is that marriage is becoming a risk factor for HIV, and the majority of women, in Thailand, in East Africa, are now only infected by their only sex partner, their husbands.”

Of the more than 38 million people with HIV, the virus that causes AIDS, 17 million are women and 13.5 million of them live in Africa. Some 2.8 million people died of AIDS in 2005.

“I believe that we are having such a big epidemic, among other reasons, because of the lack of control of women over sexuality. And also the absence of female-controlled methods,” Piot said.

Research on microbicides—gels or creams for women designed to protect them against AIDS—offer the best promise of prevention. The gels could be available by 2010, U.N. reports say.

SQUEAMISH ABOUT SEX

Among the many recommendations for prevention are secondary-school education for girls, wider testing, sex education, general and reproductive health care and fewer children among teenagers. Also included in U.N. reports are peer education among prostitutes and drug users.

While UNAIDS, in a new 630-page report, is frank about how one gets and prevents HIV/AIDS, a final statement from government delegates is expected to be as squeamish as it was at the last major U.N. conference on AIDS in 2001.

“The same issues that were most contentious in 2001 are still contentious,” Piot said.

Even mentioning homosexuals, sex workers and drug users is taboo among Islamic nations, many Catholic countries—and the Bush administration.

“The argument is that they are illegal in many countries and that mentioning even those groups will be an endorsement,” Piot said. Instead, the phrase “vulnerable groups” is used.

In most of the world, AIDS began with prostitutes, homosexuals and drug addicts. When AIDS is not contained among those groups, it spreads to the general population, including babies born to infected mothers.

The United States has pledged more money to fight AIDS than any other country—$15 billion.

Of the 20 percent earmarked for prevention, about half the funds are designated for “abstinence and be faithful” programs. Groups receiving money have to demonstrate they are opposed to prostitution, needle-exchange programs are frowned on and sex education for young people is lacking.

“We’re not against abstinence programs as long as it’s part of the overall picture,” Piot said. “For a 14-year-old girl, it is a human right to be abstinent and not to be married, not to be raped.”

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