The United States and other countries represented at the United Nations High Level Meeting on HIV/AIDS, which starts today, can change that. Unfortunately, there are already signs that we are going to stay the same failed course. Some country delegations, led by the Holy See (note: a non-member state with no epidemic that is neither a donor or aid recipient country), are working to block all references in the final outcome document to women's rights and access to sexual and reproductive health services. Despite the fact that sexual transmission is the number one way HIV is spread, despite the fact that women account for half of all people globally living with HIV, some countries would rather pursue a moralistic agenda around sex and women than put an end to AIDS.
Have no doubt that we will lose this fight if we do not address women's rights directly. World leaders must support increased access to sexual and reproductive health services and women- and girl-centered approaches to HIV/AIDS, such as combination prevention interventions that include female condoms. They must confront the larger issues that fuel the epidemic, including gender inequality, human rights violations, violence against women, and poverty. To end AIDS we have to fight the things that are bigger than AIDS.
At the same time, we must increase investments and set bold targets for treatment and prevention, especially now that we know treatment can be an effective tool for prevention. However, ignoring the sexual and reproductive health and rights of women assumes that HIV is paying attention to an idyllic fantasy about how the world works. It assumes that women and girls have control over if, when, with whom, and with how many people they have sex; whether or not their partner wears a condom or adheres to a treatment regimen; whether or not they have access to female and male condoms; and the fidelity of their partners. It assumes that married women are magically safe from HIV infection. It assumes that some women don't have to depend on income from unprotected sex to survive and to support their children, and that there is no stigma or discrimination associated with seeking HIV prevention, treatment, or counseling services, or being pregnant while HIV positive. Women live at the intersection of disease and injustice, and as long as we're unwilling to address that, HIV is winning.
The High Level Meeting is a starting point to refocus the discussion and make women a priority. This is where the United States has the opportunity to take its world leadership to the next level in stopping HIV and AIDS. The United States' delegation to the meeting must push back against any attempt to delete references to sexual and reproductive health from the final outcome document, and it must insist that women's rights and sexual and reproductive health and rights be recognized as the crux of successful interventions.
The United States, and the world, must decide how sincere they are when they say they want to put an end to HIV/AIDS. Right now the disease has the upper hand, and our blind spots are still the only thing in the way of changing that. It's time to put aside our agendas and pride and fight HIV on its own terms. It has already demonstrated that it doesn't have much regard for ours.