International Women’s Day is an opportunity to review how much society has advanced when it comes to gender equality and to examine with a critical eye the worrisome trends that remind us of the many issues still pending.
This year is especially meaningful, since we are marking the 100th international observance of this day commemorating women’s valiant struggle for the recognition of their rights.
That is why this year, 2011, our Gender, Diversity, and Human Rights Office and UNAIDS have chosen to jointly highlight the gender equality perspective in health, with emphasis on the human immunodeficiency virus (HIV).
A growing number of women in the Region of the Americas are contracting HIV.
In Latin America, the percentage of women out of the total number of persons with HIV has risen from 6% in 1994 to over 30% today. In the Caribbean countries, which have the second highest prevalence rate in the world after Sub-Saharan Africa, women account for 50% of the cases, with a particularly high prevalence in young women.
We recognize that this is influenced by greater biological susceptibility, since epidemiologic studies have shown that women are twice as likely as men to contract the infection when exposed. However, the main reason for the rapid growth of HIV prevalence among women in Latin America and the Caribbean is related to gender inequalities. Social norms as well as few educational and economic opportunities limit the possibility of negotiating safe sex for many women in the Region.
Women who ask their partners to use condoms are often at risk of physical or emotional abuse or accusations of infidelity or are even forced from their homes. Historical barriers, such as less control over resources, child-care responsibilities, or limited power in family decision-making, also impede women’s access to HIV testing and treatment services.
This underscores the importance, for example, of ensuring routine HIV screening tests for pregnant women. The aim is timely detection of HIV infection and the provision of care, as well as the prevention of mother-to-child transmission. The test should be done at the same time as the syphilis screening test. Nevertheless, the data show that in 2009, only 57% of pregnant women received these tests, and in 2008, only five countries had managed to cover 80% of pregnant women with these simple tests.
Consequently, Latin America and the Caribbean have the world’s highest prevalence of syphilis in pregnant women: approximately 460,000 cases of gestational syphilis each year, with 50- 80% developing serious adverse effects.
With regard to mother-to-child transmission of HIV, some 5,700 to 10,400 cases are recorded each year. Given the severity of these problems, the most recent PAHO Directing Council, held last September, adopted the Strategy and Plan of Action for the Elimination of Mother-to-Child Transmission of HIV and Congenital Syphilis in order to achieve this objective by 2015.
Public health is a network of networks.
As I have noted on other occasions, public health is a network of networks that pools the efforts of many social actors. It is therefore very important to increase awareness of these problems and promote the development of good practices in the area of gender equality in health, particularly in response to HIV.
For this reason, in observance of International Women’s Day, we have awarded prizes to the winners of the competition held by the PAHO Gender, Diversity, and Human Rights Office and UNAIDS.
Forty-two activities from 16 countries were submitted to the competition for only two prizes. The jury selected:
. “Promoting sexual and reproductive health (SRH) and HIV prevention in adolescents and youth living in marginal areas of Buenos Aires” – Argentina -. This project gives priority to key groups of juveniles, including youth living in poverty, HIV-positive youth, migrants, and indigenous people. The project has stressed consideration of the influence of gender roles on health care, attempting to build equitable relationships, promoting equal opportunities, and transforming the unequal relationship between the sexes.
. “Prevention in HIV-discordant couples” – Trinidad and Tobago – initiative that includes couples in which only one member has HIV. This initiative was highly successful despite its small budget and staffing limitations, managing to reach all HIV-discordant couples in its area of influence. Moreover, it had a multiplier effect, spreading throughout the island and getting all HIV-positive mothers, private physicians, communities, and religious leaders involved.
To the prize-winners, as well as those who carried out the other 40 initiatives that participated in the competition, our recognition and encouragement. They are working every day to promote the changes necessary to achieve true gender equality in public health and all areas of society. Each of us, to the best of our ability, can join in these efforts to create a more just, prosperous, and egalitarian society.
I invite you to join this noble crusade for gender equality and to work tirelessly to improve women’s health. No doubt about it, that is the best way to commemorate International Women’s Day.
. PAHO Press Release
* Mirta Roses Periago Director, Pan American Health Organization (PAHO/WHO)