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The United Nations has designated this year, for the first time since 1990, the International Year of Women with HIV and Aids. A staggering 19 million women are now affected not just by the illness combined with acute poverty but also by a lack of access to treatment as a result of their second-class citizenship.

Many in Africa, for example, learn about their HIV status when they attend an antenatal clinic. Often, their husband or mother-in-law is informed first. The woman may be sterilised or undergo an abortion without consultation. Men are rarely tested, so they side-step being identified and blamed, unlike a mother-to-be.


Campaigning group The International Community of Women with HIV and Aids (ICW) is determined this year to tackle the lack of sexual, reproductive, legal and financial female rights. For instance, the World Health Organisation has set a target of 3 million receiving treatment by 2005. The ICW is campaigning to ensure that 50 per cent are HIV-positive women and girls.

At present, 49 per cent of those with HIV are female; a rise to 70 per cent is predicted in 10 years. ICW was founded in 1992 by 56 women who no longer wished to be marginalised. Forty-three have since died. But the ICW fights on.

The ICW says gender bias is not only a problem in the developing world, it manifests itself here too in policy-making and the attitudes of some professional providers. "Jane" was diagnosed 14 years ago. A campaigner, she is open about her status overseas, but has chosen to remain unidentified in this country until her children have left home.


"We're weary, for instance, of being asked to attend meetings as an after-thought, to stand up and provide a personal testimony but little else," she says. "The issue of 'how I got infected' matters far less than 'what I did next'. We want to be included from the outset in deciding agendas, taking decisions and ensuring their implementation."

Another challenge to professionals is that many HIV-positive women remain underground, terrified of becoming a family and community leper. "I've met middle-class British grandmothers in their fifties whose husbands travelled for business or with the army," Jane says. "They are now widows with HIV and daren't tell their children about their status for fear, for instance, that they'll be forbidden to cuddle their grandchildren. That has to change. Some of us have been positive women for years. It's time we were involved."

- Go to www.icw.org