Through face-to-face meetings, and long-distance networking, MENA-Rosa offers women living with HIV an opportunity to talk about their many trials, and occasional triumphs, in dealing with HIV, from medical matters to family affairs. But for change to take root in their personal lives, the members of MENA-Rosa are looking to fix the big picture, raising awareness among key decision makers of their many needs, and mobilizing money to reach their goals.

“There is a lot to do for women living with HIV in MENA. They face particular circumstances and have particular needs,” said Hind Khatib-Othman, Director of UNAIDS Regional Support Team for Middle East and North Africa. “The solutions are available, but we have to confront the stigma and create awareness. All efforts protecting women’s rights should include the rights of those living with HIV.”

Of the estimated 470 000 people living with HIV in MENA, approximately 40% are women. In a region that remains one of the only two where HIV infections and AIDS-related deaths continue to rise, the new report sheds light on a complex set of social, cultural and economic factors that leave women most vulnerable to infection.

One testimonial after another reveal in the report that information about living with HIV is weak at best, if not altogether missing, deeply affecting the lives of women who often face stigma and discrimination as a result of their HIV status. “At first, when they knew that I was infected, my family told me not to sleep or sit by the side of my daughter. They took her away from me. Afterwards, they started to understand that it was ok,” reveals one woman living with HIV from Yemen.

The new report stresses that women engaging in risk-related behaviour, including sex work and injecting drug use, without adequate protection are wide open to HIV infection. Some women are infected through their husbands and others through harmful traditional practices such as early marriage. Economic dependency, which reduces women’s power to negotiate safe sex or to leave violent relationships, is also associated with heightened risk of HIV infection. Gender related violence runs deep in MENA as indicated by a number of national surveys.

Sexual and reproductive health is a pressing concern in the region, the report notes. Around 20 000 pregnant women across the region are estimated to be in need of services to prevent new HIV infection among children, while only an estimated 5% are receiving the care they need.

“Women have been at the heart of change in a region where people have taken to the streets demanding a life of dignity, equality, justice and human rights,” said Amr Waked, actor, activist and UNAIDS regional goodwill ambassador. “These are the same demands of women living with HIV and they deserve no less.”

Education, HIV prevention and access to quality HIV treatment are core to the solution according to the report. Efforts to engage governments, religious and community leaders to change policies, promote gender equality and confront stigma should not be spared.

The new report compiles the changes and recommendations put forward by women living with HIV in the MENA region. Some of these changes include improved access to quality education and employment for girls and women; guaranteed access to the best available care for HIV, including sustained anti-retroviral therapy; special training of doctors, nurses to reduce stigma and discrimination towards people living with HIV; and better access to sexual and reproductive health information and services, including HIV prevention and testing, for both married and single women.

“I hope, in future, people become more open so that the person living with HIV does not become isolated from society. We did not run towards this disease, nor choose to have it,” said a woman living with HIV from Algeria.

While the task is vast, the MENA region is still at an early stage of a major epidemic and has an opportunity of stopping HIV in its tracks. Groups like MENA-Rosa are raising their voices and advocating for a reform. The shifting political order in the Middle East and North Africa presents new challenges to, and new opportunities for, a better life for all citizens. For women living with HIV, the changes they want to see cannot come soon enough.