By Sylvia Cowman and Lymaris Albors
The U.S. faces an ongoing HIV epidemic, with women, particularly women of color, bearing a heavy burden. While there have been substantial advances in the prevention and treatment of HIV, the unique needs of women have often been overlooked. In observance of National Women’s and Girls HIV/AIDS Awareness Day, it is important to recognize that to make real strides in reducing new infections, it’s critical that we prioritize women in HIV prevention strategies.
In 2022, women in the U.S. accounted for one in four people living with HIV and 18% of new diagnoses. The rates were even higher among women of color. Black/African American females aged 13 and older accounted for 50% of new HIV diagnoses, while Latinas accounted for 20%. According to 2023 data, women represented 21% of new HIV infections in New York State, while in New York City, women represented 18% of new infections. Transgender women represented an additional 3% of new HIV diagnoses, among which 42% were Black, and 48% were Latinas.
Women living with HIV, especially women of color, continue to be affected disproportionately by stigma surrounding the virus, which may discourage them from seeking care or even getting tested. The fear of being judged or rejected within their communities is a barrier to accessing treatment or necessary support. Combating this stigma and improving education about HIV is crucial to ensuring that women feel empowered to seek care.
Despite these disparities, women remain underrepresented in HIV prevention programs, and many lack access to the necessary tools to protect themselves. PrEP (pre-exposure prophylaxis) is a highly effective intervention that reduces the risk of HIV transmission from sex by 99%, yet women are often not receiving it. According to data from AIDSVu, among all PrEP users in the U.S., only 8% are female. Further studies tracking PrEP prescriptions indicate that fewer than 10% of all prescriptions go to women.
The advent of new, longer-acting HIV treatment and prevention options that are easier to administer — microarray patches or under-the-skin implants, for example — offers a new ray of hope. Many of these products, including pills and injections, can be administered every 6 months. For women, access to these longer-acting options could be a game-changer. They not only provide convenience but also greater flexibility, discretion, and an empowering method of protection without the burden of daily pill taking. A recent study on PrEP use found that women make up only 7% of oral PrEP users. However, among those using injectable PrEP, women represent a higher proportion—12.5%. This suggests that, relative to oral PrEP, more women are opting for the injectable option.
However, even as these advancements offer hope, systemic challenges continue to hinder equitable access to HIV prevention and treatment for many women. The underfunding of public health programs; particularly Medicaid, the largest insurer of low-income people living with HIV in the U.S.; and other programs that serve low-income and less-resourced communities, will further limit access to HIV prevention and treatment. Federal and state healthcare policies often fail to prioritize innovative interventions, which could leave many unable to afford or access longer-acting HIV medications. Women, particularly those who are uninsured or underinsured, find themselves caught in a web of exclusion from the latest, most effective HIV care.
The time has come for the U.S. to prioritize women in the fight against HIV. In the spirit of National Women and Girls HIV/AIDS Awareness Day, we must call for equitable access to HIV care. Culturally relevant, community-centered education campaigns are also needed to raise awareness about PrEP and longer-acting HIV medications. Engaging trusted community leaders and healthcare providers in this effort is key to combating misinformation and stigma. It is imperative that we ensure equitable access to HIV prevention tools, remove stigma, and create an environment where women feel supported in making informed decisions about their health. Investing in the health of women is not just a matter of individual well-being—it is a step toward ending the HIV epidemic for everyone.
Sylvia Cowan is the Vice President of Customer Experience, Growth and Retention, Amida Care and Lymaris Albors is the CEO, Acacia Network; Board of Directors Representative, Amida Care
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