Getting to Zero for Women: Violence is the Fatal Flaw in the National HIV/AIDS Strategy FOR IMMEDIATE RELEASE: CONTACT: Sonia Rastogi, [email protected], (408) 306-6805 November 28, 2012, Oakland, CA – Data released in 2012 shows a shocking correlation between violence, trauma, and poor health outcomes of women living with HIV in the U.S. HIV-positive women face disproportionate rates of violence and abuse, which too frequently leads to medication failure and death. Yet the National HIV/AIDS Strategy and its accompanying implementation plan failed to articulate goals and objectives to address this fatal health disparity for women. This World AIDS Day, Positive Women’s Network-United States of America, a national membership body of women living with HIV, calls on the implementers of the National HIV/AIDS Strategy to get to zero HIV-related deaths for women by committing to ending violence and discrimination. Two months ago, Cicely Bolden was brutally murdered in Dallas, TX, allegedly for disclosing her HIV status to a partner. Earlier this year Brandy Martell was shot to death in downtown Oakland, CA, targeted because of her gender identity. Data from the Women’s Interagency HIV Study shows that over 80% of women living with HIV in care have experienced trauma in their lifetimes, and a shocking one-fifth have experienced trauma in the past 30 days. “We see violence against HIV-positive women every day,” says Gina Brown, an HIV-positive woman living in New Orleans, LA. “Some women are literally beaten to death. Others are emotionally or physically abused and, over time, lose the will or ability to take care of themselves, to keep medical appointments, let alone adhere to life-saving medications or eat well.” “Laws that criminalize people living with HIV may play a role in perpetuating violence against women,” says Vanessa Johnson, JD, founding member of PWN-USA. “These laws, combined with the extreme economic injustice faced by women of color in this country, create an environment where HIV-positive women are not safe even in our own homes. Unfortunately, a woman’s HIV status can thus be used as a tool to manipulate, coerce, or control her.” Research reveals that HIV-positive women with experiences of violence and trauma show disproportionately high rates of treatment failure, poor health outcomes, and high death rates than women living without HIV. For instance, women living with HIV experience between two and six times higher rates of various types of child and adult sexual and physical abuse than the general population of women. Recent trauma is associated with over four times the likelihood of failing HIV treatment and almost four times the likelihood of being unable to negotiate or engage in safer sex. Ultimately, violence and trauma lead to higher death rates. Positive Women’s Network-United States of America, a a national membership body of women living with HIV, demands bold action to end the various forms of violence faced by all women, including physical, emotional, psychological, sexual, institutional, and economic violence, and the trauma that violence leaves in its wake. The National HIV/AIDS Strategy did not address the devastating impact of violence against women on the health outcomes of women living with HIV. But the Federal Interagency Working Group on HIV, Violence against Women and Girls, and Gender-Related Health Disparities, created by President Obama in a March 2012 memorandum, provides an historic opportunity to rectify this oversight, and President Obama’s Advisory Council on HIV/AIDS (PACHA) also called for action towards this end in May 2012. The leadership of women living with HIV must be prioritized and centered in every aspect of the work ahead of us. As women living with HIV, the following are our recommendations: Amend the National HIV/AIDS Strategy: The Office of National AIDS and Infectious Diseases Policy must amend the National HIV/AIDS Strategy to include objectives that integrate and prioritize trauma recovery, violence prevention, and sexual and reproductive health services with HIV care for women. Service Integration: Trauma recovery services are a gap in current HIV care for women. Trauma, its impact on health outcomes, and existing interventions must be better researched and understood to meaningfully “get to zero” for women. National Institutes of Health (NIH) must invest in scientific and community-engaged health disparities research that identifies the biological, psychological, and social causal pathways between violence, trauma, and poor health outcomes. Federal agencies, starting with Health and Human Services (HHS), must fund demonstration projects to identify, inventory, and evaluate best practices for trauma-informed care in clinical settings serving HIV-positive women and homegrown interventions that address violence against women and trauma. National Anti-HIV Stigma Initiative: The Office of National AIDS and Infectious Diseases Policy must commit to a robust national anti-HIV stigma initiative. Organized national networks of people living with HIV should be involved in designing such an initiative.