Let's not stigmatize HIV+ women with HIV- husbands

[Guest guest]

Dear Forum,

A November 2 article in the Times of India that was recently posted on

AIDS-India

(/message/8064)

cites AIDS experts to say that " Promiscuity among women is on the rise, " and the

evidence presented for this is the " increasing number of women reporting to be

HIV positive while the status of their spouses is negative.”

Yes, there are a lot of HIV-positive married women with HIV-negative husbands.

But how were they infected? We ask people to think about whether it is ethically

defensible for AIDS experts to accuse all

such women of being promiscuous.

Here’s what we find in the Family Health Survey III (see table 12.10 in NFHS-3

at nfhsindia.org): Across India, 39% of married women who are HIV-positive have

HIV-negative husbands. For married women who are

HIV-positive, the proportion of their husbands who are HIV-negative exceeds 50%

in the following groups of women: (a) women with 10 or more years of education

(72% of their husbands are HIV-negative); ( women whose husbands have 10 or

more years of education (63% of their husbands are HIV-negative); urban women

(62% of their husbands are HIV-negative); and (d) women aged over 30 years (53%

of their husbands are HIV-negative).

Imagine a pregnant woman going for an HIV test during antenatal care. Imagine

one of these women, who has many things to hope for and to worry about,

receiving shattering news – that she is HIV-positive. Then, imagine that she

brings her husband in for a test, and

he is HIV-negative. We can expect that this will be happening thousands of times

across India over the next several years.

Who's going to throw the first stone at this woman?

With the assumptions reported in the Times article, AIDS experts get in ahead of

the woman’s husbands and in-laws, accusing: " Your wife is HIV-positive, which

proves she’s promiscuous. She's had sexual partners she's never told you about.

She lied. " These charges

have real and destructive consequences for women and for their families.

How can AIDS experts be so sure? HIV-positive women may have done nothing more

disreputable than going to the dentist. Many dentists routinely do not sterilize

reused instruments between clients. In India, 23% of medical injections are

given with needles and/or

syringes reused without sterilization. People stand in line for tattoos. Many

beauty saloons do not sterilize instruments that might pierce the skin.

In short: When an adult has an HIV-infection, that does not tell us anything

about their sexual behavior. That is what AIDS experts should be telling

husbands, wives, and the general public. It is true, caring, and responsible.

Rather than making charges against these women, AIDS experts should be listening

to those who deny risky sexual exposures, to try to find out where they were

infected – maybe during a hospital stay, maybe during antenatal care. These

women could help to find careless clinics that infected them, and that may be

infecting others in the community. But that will not happen if everyone’s mind

is poisoned to stigmatize them, to say that they are lying. AIDS experts have

similarly not traced unexplained HIV infections in children with HIV-negative

mothers.

There is work to be done to understand what is happening.

Stigmatizing women who are HIV-positive with HIV-negative husbands is NOT the

sort of work that needs to be done to deal with this epidemic.

Gisselquist

Mariette Correa

E-MAIL: <david_gisselquist@...>