HIV: Women and Girls

Angela Crawley Excerpts

Tuesday 12th April 2016 Westminster Hall

[Angela Crawley (Lanark and Hamilton East) (SNP)]

It is a pleasure to speak in the debate and to serve under your chairmanship, Ms Buck.

We are discussing HIV, which curses the lives of people in all walks of life across the globe. Yet many of the women who are infected are unaware of the status of their condition and are unable to access the treatment that they rightly need to go on to live a long and sustained life. I thank the hon. Member for Finchley and Golders Green (Mike Freer) for securing this debate on tackling HIV and AIDS specifically in women and girls.

Perhaps due to the lingering stigma attached to HIV since the time of the virus’s discovery more than 30 years ago, its impact on women is often disregarded in policy. Recognising that the barriers, stigmas and issues of access to services and treatment all require further consideration, let us use today’s debate to turn the trend on its head—we must recognise that, globally, HIV is the No. 1 killer of women of reproductive age.

We must also recognise the UNAIDS 90-90-90 target, which we heard about from the hon. Gentleman: the ambition by 2020 to have 90% of all people living with HIV knowing their HIV status; 90% of all people with diagnosed HIV infection receiving sustained antiretroviral therapy; and 90% of all people receiving antiretroviral therapy having viral suppression. That should be not only an ambition but a reality, and we must ensure that we do all that we can to make that the case.

There are, without doubt, issues of HIV infection among women in the UK, but the heaviest concentrations of HIV infection are in the developing world. In such places, women are most affected. In sub-Saharan Africa, the region with the highest burden of HIV, 57% of people living with HIV are women, and figures from 2014 show that, among women of all ages, there were 12,500 new HIV infections every week. Those figures are huge. The effect of infection on each life is devastating; the lives of young girls, future women, will be devastated unless we do more to act. We must ensure that the UK plays a prominent role in securing a future for them. It is vital to consider how aid programmes funded by the UK and the devolved Governments can help to change that deadly trend.

There is a correlation between disproportionate rates of HIV infection among women and gender inequality. Gender inequalities have far-reaching consequences for women living with, and at risk of, HIV. To name but a few, issues include domestic violence, the role of sexual violence and the lack of access to income and property. Only last month, with the Women and Equalities Committee, I visited the UN Commission on the Status of Women, which focuses primarily on women’s economic empowerment. We must ensure that we unpick such gender issues and learn how best to tackle them. I ask the Minister how DFID intends to monitor and track the progress of sexually transmitted disease and to set targets for achieving those goals. The disease will not disappear by itself, and ultimately we must do all that we can to end the epidemic.

Advances have been made to improve access to antiretroviral treatment, but socioeconomic barriers for women to overcome remain. In particular, UNAIDS research identifies food insecurity as a barrier to adherence to antiretroviral therapy. Without adequate dietary intake, people undergoing antiretroviral therapy cannot experience the full benefits of treatment. That can create a vicious cycle. Women are usually those involved in producing, purchasing and preparing food. When a woman is HIV-positive, household food security is impacted as responsibilities shift to the younger women in that household, often raising additional issues of food insecurity for their families.

It is believed that 90% of HIV-positive children contract the virus from their mother during pregnancy, delivery or breastfeeding. Inadequate nutritional status may increase the risk of HIV transmission, and women therefore need access to information and replacement feeding options to minimise the risk of transmission during breastfeeding. It is unacceptable that the number of women and girls contracting HIV infections continues to be a growing trend, especially in developing countries. Young women aged between 15 and 24 are five times more likely to be affected than young men of the same age. The problem of HIV in Africa is complicated and there is no magic bullet. However, we must do more to educate men and boys about how they can prevent this disease, so that we prevent such harrowing statistics. Adolescents between 15 and 19 make up 74% of the new HIV infections that affect young girls and women.

The Scottish National party believes firmly that the empowerment of women is key to tackling and battling global poverty, and we are not alone. The First Minister is quoted as saying that the SNP sees the empowerment of women as the key in battling global poverty. Scotland’s First Minister has said:

“For virtually every nation, fully empowering women is probably the single simplest way, in which they can sustainably increase their productive potential. Gender equality can help to transform the global economy.”

The World Bank has said:

“Putting resources into poor women’s hands while promoting gender inequality in the household and in society results in large development payoffs.”

The UN General Secretary has said that

“removing the barriers that keep women and girls on the margins of economic, social, cultural and political life must be a top priority for us all—businesses, governments, the United Nations and civil society.”

The Scottish Government have taken action where possible to help the world’s most vulnerable people through their small grants programme. This programme supports NGOs to make a big impact and reduce poverty worldwide. The grant also includes using community sport to educate young people about HIV and using technology for a mobile phone app to improve emergency care in Zambia.

The HIV crisis is impacting developing nations, but it can be stopped. In order to best contribute, UK aid must focus on education about HIV transmission and on empowering women who are at most risk of infection. I urge the Minister to consider the effects of HIV on women and girls. How does the Department intend to monitor and track its progress in achieving the sustainable development goals? It is the responsibility of all Governments wherever possible to provide leadership in this debate. I hope the Minister will be able to respond to my questions.

--- Later in debate ---

[Patrick Grady]

I am sure we can all give examples from our constituencies or broader areas of interest of specific projects or programmes that have made a difference. An issue relating to some of the broader questions that have been asked about DFID is to do with its different priorities: the way in which it is leveraging the 0.7%, which we all welcome, and how that can be done as effectively and as holistically as possible. Having some flexibility to try to innovate in new areas and support small, dynamic projects is definitely one area for consideration.

There is the important question of education specifically about HIV/AIDS, which we have heard about, but there is a broader question of education as well. Although it is true that, as I have said a number of times—my hon. Friend the Member for Lanark and Hamilton East said it too—there is no silver bullet to global development, educating women and girls is about as close as we can get. Broader access to education—not just education on HIV/AIDS but, more broadly, education that trains and empowers women with the skills they need to take into society—can reverse the negative spiral that I spoke about at the beginning of my remarks. That economic empowerment is crucial.

[Angela Crawley]

I want to highlight again the need to educate men and boys on their role as community leaders, partners, fathers and brothers, because they also have a role to play in education.

[Patrick Grady]

Indeed. Speaking from my 36 years’ experience as a man, I entirely agree about the need to tackle all these issues. Education, in a range of different forums and of both men and women, is important.

Access to treatment is also crucial. It has been interesting to read in some of the documents supplied in preparation for the debate about the progress made in terms of prophylactic and preventive treatment such as the dipivirine ring trials and various other medical advances, which are incredibly encouraging. It is important that they are invested in and supported. That is why the points made, especially by the hon. Member for Finchley and Golders Green, about intellectual property in the development of pharmaceuticals is key. That has come up in numerous Westminster Hall debates on international development, in particular on tackling preventable disease. It would be interesting to hear from the Minister how the Government intend to take forward those proposals—I was interested to hear that movement in that direction appeared in the Conservative manifesto.

Just as with education, where specific education and improvements in education across society as a whole is needed, the same is true in treatment. We need to be able to treat the specific symptoms, effects and infections and boost the overall level of wellbeing of society as a whole. That is where questions of food security and so on come in.