A few weeks ago, the UN High Level Meeting on AIDS took place in New York City. It coincided with the 30 year anniversary of HIV/AIDS’ burst onto the scene. First diagnosed as a rare cancer in gay men, the disease has morphed in more ways than one over the past decades. What was once a gay man’s disease now has “the face of a woman,” as UN Women head Michelle Bachelet recently put it.
A meeting co-hosted by Women Deliver during the meetings, “Protection and Prevention Saves Lives: Girls, Women, and HIV,” brought Bachelet together with other women’s rights heavyweights to highlight the needs of girls and women within HIV/AIDS, and consider that holy grail: HIV/AIDS and sexual and reproductive health, and whether the twain shall ever meet?
“Integration” has been a tired buzzword for too long. We have finite financial resources, limited media attention span, and growing epidemics in dwindling time. It’s time it grows legs and moves into action. But what could or should it look like? Here’s an idea for starters: how about HIV/AIDS and reproductive health advocates put their heads and expertise together to address cultural and social stigma surrounding reproductive health?
One aspect of the global HIV/AIDS movement that’s always impressed me is the success advocates have had in reducing stigma around infection. In the thirty years that this disease has taken root, stigma has shrunk dramatically. Famous people from all professions and walks of life have come forward to divulge their status (some voluntarily, others involuntarily). Heads of state take HIV tests in public to show people it’s nothing to be ashamed of. Annie Lennox can wear a black “HIV positive” tee-shirt to the UN. Stigma remains a component of dealing with HIV/AIDS, but perhaps not the biggest challenge.
In contrast, stigma remains arguably the biggest obstacle to advancing reproductive health and rights worldwide. Earlier this year I was in Ghana, where reproductive health laws are some of the most progressive in the continent, and yet social and religious stigma is so stifling that unsafe abortion remains a leading cause of death for women there. Contraceptive use, too, is highly stigmatized. If you use it and you’re unmarried, you’re promiscuous. If you’re married, you’re being unfaithful.
Stigma looks different everywhere, but the overall outcome is the same: women are judged, pressured, and oppressed. Access to services is chronically limited. This is true in Ghana, as it is in the US and around the world.
And yet, the sexual and reproductive health movement has never had a public, high-level anti-stigma brigade like the HIV/AIDS movement has had. In fact, speaking openly about abortion even in the US is taboo.
Earlier this year, Gwyneth Paltrow and Scarlett Johansen got a ton of publicity for voicing their support of Planned Parenthood, but their words were carefully chosen. Neither mentioned the importance of abortion access, and while it does only comprise 3% of PP’s services, it’s still a really important part! Even birth control was only fleetingly mentioned. These issues are still off limits in a public context.
Where is the Magic Johnson, the Arthur Ashe, the Elton John, the Annie Lennox of safe abortion access, or contraceptive use? We need to find them and embolden them, and the HIV/AIDS movement can help. There are lots of ways that HIV/AIDS programming can better integrate with current reproductive health programs. But I think where the extra muscle of the movement is most needed – where we really need new support, innovation, and voice – is around tackling the stigma of abortion and contraceptive access.
Reducing stigma around HIV means talking openly about sexual risks and practices and making sure people are informed. It means starting and sustaining difficult conversations. We need our friends in the HIV/AIDS movement to help us bring abortion and contraception into those conversations, and in turn, we need to work harder at understanding why HIV/AIDS anti-stigma efforts have succeeded.
I imagine a world without AIDS, but I also imagine a world where women’s access to critical services like safe abortion and contraception is not obscured by stigma. I imagine a world where Annie Lennox wears an “abortion rights positive” shirt to the next UN high-level meeting.