Part I: Needs of Women in the AIDS Crisis
S.P. is a 23-year-old Hispanic woman who tested positive for HIV, the virus associated with AIDS. She applied for Social Security disability benefits when she was unable to work because of weight loss and increasingly painful episodes of pelvic inflammatory disease and nausea.
Despite two hospitalizations for pelvic inflammation, continued symptoms and evidence of a severely weakened immune system, S.P. was denied benefits. According to the standards of the Social Security Administration, she does not have AIDS.[1]
INTRODUCTION
"Women Don't Get AIDS: They Just Die From It" announces a flyer produced by the AIDS Coalition to Unleash Power (ACT UP). It calls attention to the fact that thousands of women with HIV have died without an AIDS diagnosis. The U. S. Federal Centers for Disease Control's (CDC) definition of AIDS is primarily based on symptoms of AIDS in white gay men; therefore the number of women who have died from AIDS is not accurately represented.
Though the CDC's original surveillance definition has been expanded, it still does not include even one HIV-opportunistic infection related specifically to women. Pelvic inflammatory disease (PID), chronic vaginal candidiasis, rapidly progressing cervical cancer, and human papillomavirus (HPV) are a few of the possible manifestations specific to women with HIV.
The persistent inadequacy of the definition of AIDS illustrates one reason why AIDS is a women's issue. AIDS affects women in many ways: as direct service providers, as wives, mothers, grandmothers, sisters, children, lovers, friends and those who have been infected with HIV. In the midst of this pandemic, women remain under-served, discounted, and discriminated against.
Since women as a group are oppressed across the world and have less power than men, the presence of such a wide-reaching disease increases their already adverse situations. Black and Hispanic women, weighted down with the double burden of racism and sexism, have suffered the most. The men, women, and children in their communities, both in the United States and abroad, have been disproportionately infected by HIV. In addition, the needs of Native American and Asian-Pacific Islander women, including prevention education, have been virtually ignored, supposedly because they are considered to be at "low risk" for the disease. Finally, another group of women has been treated as if they were invisible in this epidemic, except when homophobic violence has been perpetrated against them--those who identify as lesbian and/or have sex with women. They have been subtlety but insidiously discriminated against through the lack of acknowledgement by the CDC and others that women who have sex with women are at risk for AIDS.
This focus paper is concerned with the needs of women in the AIDS crisis. First, Part I will cite some international statistics related to women and AIDS. Then, it will describe some of the problems ordinarily encountered by women and how HIV exacerbates the difficulties already in their lives. Finally, it will suggest actions which churches can take to address the needs of women. Part II (which will appear as Focus Paper #18) will be concerned with prevention education and will include a list of resources.
Speaking to religious leaders in Harlem, NY, on October 1, 1991, Dr. Antonia Novello, the Surgeon General of the United States, stressed the importance of churches becoming involved with the AIDS crisis. She said, "Places of worship must be places of refuge, education, and support." Addressing the black and Hispanic leaders in particular, she noted that the churches in these communities have always been concerned with outreach such as feeding the hungry, clothing the naked, and housing the homeless. She pointed out, "What is new [about AIDS] is the urgency of what we have to do for our community."[2] Following is an examination of some of the urgent issues.
Global Overview: Critical Issues
On December 1, 1990, the United Nations focused on women and AIDS on World AIDS Day. (See page 10 for a responsive reading titled WHEN AIDS WEARS A WOMEN'S FACE which was used by churches across the world in recognition of World AIDS Day in 1990.) At a special gathering at the United Nations to mark this observance, these sobering statistics were shared:
In July 1990 the World Health Organization (WHO) estimated that there were between 8 million and 10 million people infected with the human immuno-deficiency virus (HIV); of these, some 3 million, a third, were women;
Since the proportion of women with AIDS is rising faster than that of men, WHO predicts that, by the year 2000, the number of new AIDS cases reported annually will be divided evenly between women and men;
The 200,000 women who would actually become ill during the 1990--1991 period alone would exceed the total of all AIDS cases reported to WHO over the first decade of the epidemic;
In certain localities as diverse as sub-Saharan Africa and urban America, between 10% and 25% of all women of child-bearing age are HIV-infected;
Moreover, WHO estimates that, by the year 2000, 10 million infants will have been born HIV-positive, having contracted the disease in utero from their AIDS-affected mothers;
Another 10 million uninfected children will be orphaned through AIDS-induced maternal deaths.[3]
The implications of these statistics alone are staggering in relation to the needs of women.
As indicated earlier, current statistics are misleading. If the CDC's definition of AIDS were inclusive of opportunistic infections associated with HIV in women and children, the number of women and children with AIDS would skyrocket. On October 1, 1991, Surgeon General Novello said there had been about 3,000 reported cases of children with AIDS but many more have been unreported or undetected. She estimated that there have been 20,000 cases of AIDS in children. Though this writer is aware of no estimates for the true impact of AIDS on women, she has heard professionals working with HIV-infected women in New York City area report that they have known more women who have died of HIV than of CDC-defined AIDS.
A related problem which has global implications is that many foreign countries use the Atlanta-based U.S. Federal Centers for Disease Control's definition. An example was given by Joyce M. Alkober, a board member of the Asian-Pacific Islander Coalition for HIV, during a phone interview on October 6, 1991. Her homeland of the Philippines uses the CDC's definition of AIDS; therefore many HIV-infected people die in the Philippines and are not counted as AIDS-related deaths because they don't fit a definition of AIDS based on white gay men from another country.
Across the world, women not only get HIV but bear much of the weight of caretaking in the AIDS crisis. The story of Elizabeth Nakabago and her family in Uganda is illustrative:
Elizabeth Nakabago, a 49-year old widow, was walking home from the burial rites of a girl of 17 who had died in childbirth, probably of complications arising from AIDS. Mrs. Nakabago's 52-year old husband, part-owner of a bus in Kampala, came home to die last year, leaving her seven children ages 5 to 17. She also cares for two grandchildren left her by three of four grown sons and daughters who died of AIDS.[4]
On the whole, the needs of women like Mrs. Nakabago have received little attention, even though the numbers of women with HIV and women who are caretakers of HIV-infected children and adults at home and in hospitals are escalating.
HIV does not exist in isolation from other global concerns related to women and their status. Indeed, AIDS magnifies some of the most critical problems which affect women across the world. As early as May 1987, an International Working Group on Women and AIDS identified seven women's problems that AIDS exacerbates: (1) racism and sexism,, (2) inadequate quality and inaccessibility of health care, (3) the absence of decent affordable housing, (4) insufficient support services for raising children, (5) unequal educational opportunities, (6) unequal job opportunities, and (7) distortion and suppression of female sexuality.[5] Later that year, the women and AIDS Resource Network (WARN) of New York City also raised concern about: (8) issues of reproductive freedom and (9) discrimination and violence against lesbians.[6] Almost five years later, women's situations in the midst of the AIDS pandemic have not improved.
Racism, Sexism, and Heterosexism
Deeply ingrained societal racism, sexism, and heterosexism worsen the effect of AIDS on women. Racist approaches to this crisis ignore the fact that people of color have been disproportionately infected with HIV and affected by the impact of HIV. Often, minority women are already struggling with other aspects of racism in their lives: poverty, prejudice, discrimination, and lack of power. AIDS prevention education has been done for women; but, too often, it has been insensitive to the culture of the poor, African American and Hispanic American women most affected by HIV in the United States and abroad.
Sexist approaches to AIDS view women as "vectors" of disease to men and babies, as persons whose behavior must be controlled rather than as persons with the disease who need support and treatment. An illustration is the focus on prostitutes, who (supposedly) are spreading AIDS. "Several nations . . . have moved to jail HIV-infected prostitutes, although no such punishment was even proposed for any groups of HIV-infected men, not even rapists or men who knowingly donated HIV-positive blood."[7] Writing for the National Lawyer's Guild, Arlene Zarembka and Katherine M. Franke observed, "inordinate attention has been paid to the role of female sex workers in the AIDS Epidemic"[8] and the danger they pose to men.
Rather than focus on women as AIDS-carriers, people could more helpfully concentrate on prevention education for women because women are more at risk of being infected by men than men are of being infected by women. For instance, in New York City, which uses a very careful interviewing process, only 18 documented cases of woman-to-man sexual transmission, or less than one tenth of a percent, exist in a total of 35,649 men diagnosed with AIDS (as of October, 1992). On the other hand, about 25 percent of the cases of women with AIDS in New York City are heterosexually transmitted (1,728 of 6,805 women as of October, 1992).[9]
Discrimination and violence against lesbians has increased since the beginning of the AIDS crisis. Many people inappropriately blame gay men and lesbians for the spread of AIDS. Though lesbians presumably are one of the groups least infected with HIV, it has become apparent that lesbians are discriminated against because inadequate information is available concerning woman-to-woman sexual transmission of HIV. The CDC does not track women-to-woman sexual transmission and does not report it. No one really knows the extent of HIV infection resulting from woman-to-woman sexual activity.
Health Care
The problem of inadequate quality and inaccessibility of health care, already affecting women unequally, is brought into sharper focus when women are infected with HIV. Most of the medical research for new drugs for AIDS is done on men, which means women are excluded from the opportunity to choose to receive a new drug at the earliest time. Also, since drug-testing is done on men, it is not always clear if drugs that work well for men will work well for women. Physicians cannot know the best drugs for women if women have not been included in protocols.
Women are less healthy than men and have fewer financial resources to pay for adequate health care. Women in the United States, particularly black and Hispanic women, are more likely than men not to have health insurance. Women are less healthy because they often, especially those with children, pay less attention to their health and focus on their children's health.
Many women are diagnosed with AIDS just before they die or even after death. One reason for this is women wait longer to go for treatment. Another reason women are diagnosed late is because doctors have not been educated about women and HIV. If women with HIV received treatment earlier, they would live longer.
Reproductive Freedom
Issues of reproductive freedom for women infected with HIV are special concerns of women. Both women who do not want abortions and women who want them have been discriminated against.
Dr. Janet Mitchell of Harlem Hospital in New York City has written about those who pressure women to abort: "The idea that HIV-infected women should avoid pregnancy or should have abortions, and the more frightening notion that all HIV-infected women should be sterilized, are real, even if they are verbalized by only a few."[11] Counselors too often disregard the reproductive rights and the cultural context of women in relation to childbearing: "Latino and black cultures place great value on a women's fertility. Having a child elevates the status of the women in her family and her community."[12] Women's religious culture may also be ignored:
When Teresa became pregnant for the second time 18 months ago, her husband and baby girl were sick with AIDS. She has tested positive for HIV, but was still healthy. Her physicians recommended abortion.
As a devout Catholic and environmental researcher, Teresa looked to God and science for guidance. The message she heard was to keep her baby.
"It is very difficult when you are faced with [your own] death," says the New York woman, who asked that her real name not be used. "If I terminated the pregnancy, I was afraid I would be condemned, that I would not be with God at the end of the world."[13]
On the other hand, the rights of those who choose an abortion need protection. In October, 1990, the New York City Human Rights Commission did a survey which discovered that 42 percent of the women who identified themselves over the phone as HIV- positive to health care providers were falsely refused abortions or overcharged.[14]
Women must be empowered to make their own decisions about becoming pregnant and/or continuing a pregnancy when they are HIV-infected. They need supportive counseling which provides accurate and appropriate information about HIV and pregnancy. In addition, it must be remembered that "no meaningful reproductive options exist in the absence of adequate nutrition, prenatal and medical care, or without day care, education and schooling for all children...."[15]
Child Care and Other Support Services
Another problem is lack of integrated family services for women with AIDS. Many women must go to one clinic for their health care and to another clinic for the care of their children. Surgeon General Novello (and many other people involved in service organizations for women) emphasized the need for community-based centers where comprehensive services can be provided for families with HIV all under one roof.[16]
Caretaking of healthy children by healthy mothers who also must work to stay ahead of poverty is difficult enough; when both mother and at least one child are HIV-infected, the burden is overwhelming. In addition to integrated family services, women with HIV or with children with HIV need in-home respite care, in- home child care assistance, and affordable and accessible day care for their children.
Lack of education, underemployment and low paying jobs which enforce dependency on social service agencies affect women more than men. Women with HIV, predominately poor black and Hispanic women in the United States must, cope not only with the illness of a spouse, child, or grandchild, but often with their own illness as well. Dealing with medical and social service appointments and all of the paperwork and regulations that entails in addition to worrying about child care, housing, employment, sickness, and bill-paying is a challenge for women who are not dealing with HIV-related illnesses and is even more difficult for those who are infected with HIV.
The absence of decent affordable housing, particularly for female-headed households and the impoverished and the working poor, is another major concern. Thousands of people with HIV are homeless; some were homeless before infection, others made homeless because of the disease. Many facilities for homeless people with AIDS take only men. Of those that house women, even fewer are equipped to take women and their children. They do not have enough room; they are not set up to address the needs of women with children.
Housing Works, Inc., is an organization in New York City which serves primarily people of color who are homeless, substance abusers, and/or mentally ill. All are HIV-infected. Housing Works has 19 scatter site apartments in New York City and offers support services for those they house, including assistance in keeping them "clean and sober" from drugs and alcohol.
In an interview on October 18, 1991, staff member Barbara Hines noted homeless HIV-infected women are often less mobile than men, because of their children. For instance, women want to be near a good public school. Also, women worry about their children's well-being before they worry about their own. One of the women the organization is housing is an ex-substance user who has done time in prison. While she was incarcerated, her children were placed in foster care. After she was released, she lived with her father but she can not have her children back until she has her own place. Housing Works provided her with an apartment and now her children live with her. She is still struggling. Her children are testing the limits as they adjust to living with their mother again. Housing Works gives support to her and is concerned about keeping her family together, including reuniting the women's husband and father of her children when he is released from prison.
Women's Vulnerability and Church Empowerment
Women are more vulnerable than men in the AIDS crisis, concluded an Expert Group Meeting on Women and AIDS, co-sponsored by the World Health Organization and the Government of Sweden, in September, 1990. The group documented that the "lower status of women within the family and society, the lack of independent income and the social and economic dependency on men heightened women's vulnerability to HIV infection since they were less able to control the personal and socio-economic circumstances which put them at risk, creating a feeling of powerlessness, both in personal relationships and society."[18]
Churches can play an important role in empowering women by advocating for and serving the needs of women and children generally and specifically in relation to the AIDS crisis. As the Surgeon General has said, churches can be "places of refuge, education, and support."
WHAT CHURCHES CAN DO
1. Pastors and their congregations can strive to create open, supportive, non-judgmental communities, where people will feel safe to express their needs and ask for help. Identify general areas of concern, such as racism, sexism, and homophobia, and hold educational forums on these issues. Do general education about AIDS and also specific education about issues relating to women and children globally, nationally, and locally. Virtually nothing may be happening locally for women; if so, educate folk about need and advocate for change.
2. Support efforts which will improve the status of women and/or will help HIV-infected women who are ill but do not fit under the Center for Disease Control's present definition to get the medical and other services they need.
3. Sponsor a community health fair in your church, making sure health issues of women and children are addressed. Provide child care and age-level appropriate health education and health services for children. Offer transportation to the site.
4. Know your community and the needs of women and children in it. Do you have doctors, nurses, and nurse's aides who need support (and who also can be resources to you)? What about home health care workers, who are mostly women? Are they receiving adequate AIDS education in relation to universal precautions? They work daily with persons with AIDS; do they need a support group? Are there families which have one or more members sick with HIV? What kind of help do they need? A local AIDS service organization, hospital, or health commission may be able to assist you with information. Be sure to find out if they are sensitive to the needs of women, children, and people of color. If they are not, advocate for those whom they are serving inadequately.
5. Investigate models for assisting homeless HIV-infected people. Different areas have different needs and cultures. An important question church people can ask of those working with homeless persons is: "What are you doing to meet the needs of homeless women and their families, particularly those with HIV infection?" They may not be doing anything or may be discriminatory. A few years ago, while I was pastoring a church, I was visited by a person soliciting help from churches in housing the homeless over night in their buildings. He claimed homeless women were more difficult to deal with than homeless men because the female homeless population was more mentally ill. I wondered then and now, "What is the real story?"
6. AIDS tends to be concentrated in areas where local United Methodist Churches are struggling financially. If yours is a more privileged church, find out about the needs of other United Methodist Churches in your conference which may be trying to cope with the impact of the AIDS crisis. Develop partnerships with them. Nationally you can contribute to the Advance Special "Enabling AIDS Ministries" (#982215-6).
7. As the AIDS pandemic continues, there will be a growing need for foster parents, respite foster parents, and adoptive parents. (See the November/December 1991 issue of New World Outlook for more information.)
8. Make space available in your church for HIV positive support groups and AIDS education events for women. Sponsor such groups. Assist with child care when the women are meeting.
9. Be aware of groups of women who may not be receiving services and education, such as women in prison, women in homeless shelters, and women in battered women's safe houses: what is being done to empower these women?
10. Sex education and prevention education are important for all ages. Support efforts of public schools. Don't forget to educate your own church members. Sponsor events conducted by trained, nonjudgmental leaders in your church. Encourage "peer education" by youth, women, and men. (Focus Paper #18 will address women and prevention education.)
11. Have your congregation develop a Covenant To Care Statement announcing to the community that "if you have AIDS or are the loved one of a person who has AIDS you are welcome here." (See the HIV/AIDS Ministries Network Focus Paper # 6 on AIDS: A Covenant to Care for information and tips.)
NOTES:
[1] David Barr, "What Is AIDS: Think Again," New York Times, December 1, 1990.
[2] A speech given at the "Harlem's Religious Leaders' Conference on AIDS" in the Episcopal Church of the Intercession, New York City, on October 1, 1991 during the third annual Harlem Week of Prayer for the Healing of AIDS.
[3] "World AIDS Day 1990: Focus on Women and AIDS," New York: United Nations Department of Public Information DPI/996 (November 1990), p.1.
[4] Jane Perlez, "In AIDS-Stricken Uganda Area, The Orphans
Struggle to Survive," New York Times, June 10, 1990.
[5] "An Open Letter to the Planning Committee of the
International Conference on AIDS," (May 1987), pp.1-2.
[6] The Women and AIDS Resource Network (WARN), "An AIDS
Information and Referral Clearinghouse for Women," (September
1987), p. 3. (Unpublished paper)
[7] "World AIDS Day 1990: Focus on Women and AIDS," New
York: United Nations Department of Public Information DPI/996
(November 1990), p. 2.
[8] Airline Zarembka and Katherine Franke, "Women and AIDS:
Part Two; Controlling HIV Women or Meeting Their Needs?," The Exchange (July 1991), p. 2. (Published by the National Lawyers
Guild AIDS Network, 558 Capp Street, San Francisco, CA 94110.)
[9] New York City Department of Health AIDS Surveillance Unit, New York City AIDS Surveillance Update, Third Quarter 1992 (October 1992).
[10] Gena Kolata, "AIDS Research on New Drugs Bypasses Addicts and Women," New York Times (January 5, 1988).
[11] "Women, AIDS and Public Policy," AIDS and Public Policy Journal, III, 2 (1988), p. 51.
[12] Mitchell, p. 51.
[13] Laura Abraham, American Medical News (July 22, 1988).
Researchers have disagreed about the rate of perinatal transmission. A recent study by John F. Modlin of Johns Hopkins Hospital in Baltimore reports that transmission rates in theUnited States and western Europe range from seven to 35 percent (CDC WEEKLY, 11/5/90).
[14] From AIDS POLICY AND LAW (10/31/90). Quoted in "New York Study Faults Services for Women with HIV," Women and AIDS Project (Wntr. 1991) p. 20.
[15] International Working Group on Women and AIDS, "An Open Letter to the Planning Committees of the International Conference on AIDS" (May, 1987).
[16] A speech given at the "Harlem's Religious Leader's Conference on AIDS," New York City, October 1, 1991.
[17] "World AIDS Day 1990: Focus on Women and AIDS," New York: United Nations Department of Public Information DPI/996 (November 1990), p. 2.
WOMEN AND HIV: REFERENCES, SPECIAL PUBLICATIONS, CONTACTS
The following references, etc. are taken from Focus: A Guide to AIDS Research and Counseling, Volume 7, Number 1, December 1991.
REFERENCES
ACT UP/ New York Women and AIDS Book Group. WOMEN, AIDS AND ACTIVISM. Boston: South End Press, 1990.
Bayer, R. AIDS and the Future of Reproductive Freedom. THE MILBANK QUARTERLY. 1990; 68(2): 179-203.
Berrier J, Sperling R, Preisinger J, et al. HIV/AIDS Education in a Prenatal Clinic: An Assessment. AIDS EDUCATION AND PREVENTION. 1991; 3(2): 100-117.
Fletcher SH. "AIDS and Women: An International Perspective." HEALTH CARE FOR WOMEN INT'L. 11(1): 33-42.
Gilliam A, Scott M, Troup J. "AIDS Education and Risk Reduction for Homeless Women and Children: Implications for Health Education." HEALTH EDUCATION. 1989; 20(5): 44-47.
Gravell C. "Progression of HIV Infection in Women: Asymptomatic State to Frank AIDS." NAACOG's CLINICAL ISSUES IN PERINATAL WOMENS HEALTH NURSING. 1990; 1(1): 20-27.
Jessup M. "The Treatment of Perinatal Addiction.: Identification, Intervention and Advocacy." WESTERN JOURNAL OF MEDICINE. 1990; 152(5): 553-558.
Nyamathi A, Shin DM. "Designing a Culturally Sensitive AIDS Education Program for Black and Hispanic Women of Childbearing Age." NAACOG's CLINICAL ISSUES IN PERINATAL WOMENS HEALTH NURSING. 1990 1(1): 86-98.
Viadro CI, Earp JA. "AIDS Education and Incarcerated Women: A Neglected Opportunity." WOMEN AND HEALTH. 1991; 17(2): 105-117.
SPECIAL PUBLICATIONS:
WORLD, WOMEN ORGANIZED TO RESPOND TO LIFE-THREATENING DISEASES, is a monthly newsletter featuring profiles of women with HIV disease and articles on services for women and issues affecting women. For free subscription, write: P.O. Box 11535, Oakland, CA 94611, (510) 658-6930.
THE JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION published a theme issue on pelvic inflammatory disease (PID). The November 13 issue (Vol. 266, No. 18) includes reports on PID prevention, diagnosis, and risk.
AIDSFILE, published by San Francisco General Hospital Medical Center, devoted its Summer 1991 issue to HIV disease in women. The issue included articles on the epidemiology, treatment during pregnancy, and participation in clinical trials. For a free copy write: AIDSFILE, SFGH, Ward 84, 995 Potrero Avenue, San Francisco, CA 94110.
FOCUS: A GUIDE TO AIDS RESEARCH AND COUNSELING devotes its December 1991, Vol. 7, No. 1, issue to women and HIV with articles on: "HIV-Related Gynecologic Conditions: Overlooked Complications" and "Reducing Risk Among Female Partners of Injection Drug Users."
CONTACTS:
J.D. Benson, MFCC, UCSF AIDS Health Project, Box 0884, San Francisco, CA 94143-0884, (415) 476-6444.
Judith Cohen, PhD, MPH, Project Aware, 3180 18th Street, Suite 205, San Francisco, CA 94110, (415) 476-4091.
Catherine Maier, MA, San Francisco AIDS Foundation, P.O. Box 426182, San Francisco, CA 94142-6182, (415) 864-5855.
Carola Marte, MD, Beth Israel Hospital Methadone Program, 245 East 17th Street, New York, NY 10003 (212) 420-2075. Dr. Marte is the Coauthor, with Machelle Allen, MD of "Gynecology Protocol for HIV-infected Women in Medical Clinics," a five-page document available free by writing to the above address.
Laurie Wermuth, PhD, Department of Sociology and Social Work, California State University-Chico, Chico, CA 95929, (916) 898-6397.
WHEN AIDS WEARS A WOMAN'S FACE
BY CATHIE LYONS
In the decade of the '90s, the face that AIDS wears often will be that of a woman and her infant. Whether or not a woman is infected with the virus that causes AIDS or has a related illness, her life will be touched by the global AIDS pandemic in one way or another.
Each year on World AIDS Day -- December 1-- churches in their solidarity with women are called to unite in prayer and action . . .
- WITH ALL WOMEN WHO ARE LIVING WITH HIV INFECTION AND RELATED ILLNESSES, in order that women might receive the treatment and care they need, that their burdens might be eased and their voices hears, that they not be shunned by family, friends and community and that guilt and blame not be heaped on them;
- WITH MOTHERS WHO COMFORT THEIR CHILDREN IN THE MIDST OF ILLNESS, who feed and bathe and care, who wipe the tears and hold the fevered head, who cry out in anguish, who know helplessness and despair, who cradle their weakened infants to their wearied breasts;
- WITH WIVES WHO CARE FOR HUSBANDS, FRIENDS AND LOVED ONES, who hold family and community together in times of crisis and suffering, who bear witness to God's mercy and compassion in the midst of sickness and death;
- WITH GRANDMOTHERS AND GREAT-GRANDMOTHERS, who nurture and rear the sons and daughters of their sons and daughters; grand women who -- in their won time of need -- will mourn the deaths of the women and men they hoped would live to care for them;
- WITH DAUGHTERS who are expected by family, culture and country to put their needs aside to care for others, to sacrifice and deny themselves until they can give no more;
- WITH GIRLS growing up in a world of violence, cultural norms and expectations, poverty, ignorance and global debt crises which will affect their health and development and that of their children and families-to-be;
- WITH WOMEN PROFESSIONALS in health ministry and research who lead their countries in the struggle against the spread of HIV and its related illnesses.
Churches in solidarity with women are called to covenant together to . . .
- TO RECOGNIZE the disproportionate burden of suffering carried by women in the midst of the HIV/AIDS pandemic;
- TO ADVOCATE with women for community-wide HIV/AIDS prevention education and techniques sensitive to women's needs, which empower women and girls to protect their health;
- TO ADDRESS the care-provider expectations placed upon women and seek support for women and families as they care for loved ones with HIV/AIDS;
- TO ENCOURAGE men to protect themselves and their sexual partners from sexually transmitted illnesses;
- TO CALL upon the international community for the development of cost-effective treatments, therapies and forms of care;
- TO WORK to break down the stigma and fear of AIDS and to recognize that the face that AIDS wears is always the face of a person who is created and loved by God and who is the most important person in someone else's life.
- TO CELEBRATE the healing power of God's mercy and love in the lives of individuals and communities which work to stop the spread of HIV/AIDS and to care for those already ill;
- TO PRAY for those who are ill , those who provide care, who apply their gifts and talents to the search for treatments and cures, who seek equal care and recognition of women's needs, who have been a sign of God's presence in the midst of sickness, loneliness and death;
- TO CONFESS that they have been slow to respond and remain filled with fear and judgment;
- TO SEEK God's forgiveness and empowerment to do God's will in the world by being merciful, compassionate, and caring in the midst of a disease that is relentless and brutal, that leaves gaping wounds in the lives of those who have lost the ones they love the most;
- TO WORK to address the economic iniquities and injustices which impede effective responses to the global HIV/AIDS crisis;
- TO RECOGNIZE that when AIDS wears the face of a woman, countries suffer immeasurable and irreplaceable loss -- so central is the health of a woman to the well-being of the family and the human community.
"AVOIDING WOMEN"
BY ROBERT MARKS
Robert Marks, Editor, FOCUS: A Guide to AIDS Research and Counseling, in Vol. 7, No. 1, December 1991.
Why has there been such hesitation to address the needs of HIV- infected women in the United States? The most obvious response is that women comprise only a fraction of the HIV-infected population, currently only 10 percent of reported U.S. AIDS cases. But these numbers are misleading. This little slice of the epidemic, dwarfed by the numbers of gay men who have died, and by the grief of gay men as their communities have been decimated, is the fastest growing AIDS epidemic in the U.S. Ten years ago, had we the foresight to attend to the "insignificant" epidemic among gay men that we should have today regarding the epidemic among women, tens of thousands would be alive.
TIMES OF SCARCITY
Numbers should not matter, but they do in times of scarcity. When resources abound, every individual is valuable; when resources recede, only the biggest, the loudest, the most powerful get saved. AIDS is essentially a disease of communities, and because specific communities have been disproportionately hit by the epidemic, the response to scarcity is to look after one's own.
There is no real solution to such competition: there is simply not enough. But if we, as AIDS providers, acknowledge that attending to the needs of one HIV-infected woman is as valuable as attending to the needs of one gay man, one drug user or, for that matter, one famous sports personality, we do not eliminate the scarcity, but we do temper the competition. And by cooperating we stand a better chance of increasing resources, achieving economies of scale, and maintaining critical exchanges of scientific information.
THE GREAT DISINCENTIVE
The greatest disincentive to responding to AIDS among women, however, is the most fundamental: we shy away from the awesome task of addressing the societal problems women face when they attempt to access health care and protect themselves from HIV infection.
Women are statistically poorer than men, more likely to be single parents, and more likely to be uninsured. Women's health issues continue to be relegated to a dim corner in medical practice.
Last, but not least, as Christine Miller quotes: . . . The result is that men traditionally decide whether women will be protected from transmission, and because of their economic dependence, women may have to choose between possible exposure and support for themselves and their children.
When AIDS providers approach women with HIV disease, we also confront 5,000 years of sexism. Can we influence attitudes and philosophies that have evolved over millennia? The answer must be couched in terms that most of us working with AIDS have learned well: activism and innovation. AIDS has shown itself to be the crucible in which old assumptions about sex, drugs, and medicine can be melted down and recast. To this mix must be added sexism and its health care consequences.
"UNCONDITIONAL LOVE: The AIDS Heartline Story
A Video Available from EcuFilm
UNCONDITIONAL LOVE: The AIDS Heartline Story is a warm and caring story about St. Paul's United Methodist Church and the outreach program that members of the congregation organized to help persons with AIDS in their community.
This 30-minute video tells about two gay men, both infected with HIV, and their struggle to be accepted in a church whose members had reservations about being near persons with AIDS, let alone helping them. As members of the church became better educated about this devastating disease, they began to open their hearts in love and giving to those with AIDS.
The church started a food pantry and medical supply center for persons with AIDS. They arranged low-cost hotel accommodations for families visiting from out-of-state. The congregation gave emotional, spiritual and religious support in keeping with the gospel's mandates.
This video is an excellent resource to show what a congregation
can accomplish when it is willing to take risks to help those in
need. Order from:
EcuFilm
810 12th Avenue, South
Nashville, TN 37203
(800) 251-4091 or call collect in Tennessee (615) 242-6277.
Sale price: $24.95
Rental: $18.00
Video ad provided by EcuFilm, Nashville, TN.
THREADS OF LOVE: A Tapestry of Remembrance
NOW AVAILABLE IN SPANISH
THREADS OF LOVE: A TAPESTRY OF REMEMBRANCE is a 10-minute video recommended for use with congregations and discussion groups. This non-threatening resource about The NAMES Project AIDS Memorial Quilt helps groups and individuals understand the depth of suffering being experienced by persons and families who have lost the ones they have loved the most.
Video calls upon churches to be what the Quilt has been to so many persons. "The Quilt challenges our churches and worshiping communities to be nonjudgmental places of openness where persons whose lives have been touched by AIDS can name their pain, can reach out for compassion and consolation."
"Our churches must be what the Quilt has been: an outstretched hand, a welcoming shoulder, a comforting breast where pain finds Christ's mercy and the love and companionship of those who bear his name."
"To be in the presence of the Quilt, to experience its messages and emotions is to be in the presence of the Holy: to be upheld and sustained by the knowledge that God's mercy has no end, that God's love endures, that God has received those who have died, and that the wounds of the living will be healed."
THREADS OF LOVE in Spanish may be ordered from:
Health and Welfare Ministries ,
General Board of Global Ministries,
The United Methodist Church
Room 330, 475 Riverside Drive
New York, NY 10115
(212) 870-3871
Make checks payable to Health and Welfare Ministries Program
Department. Specify: that the order is for Spanish language
version. Price: $10.00
