People around me are endlessly trying to “raise awareness” whenever they get engaged in a social justice concern. They want ribbons: pink ribbons around Breast Cancer Awareness, yellow ribbons for deployed troops, and red ribbons for AIDS/HIV awareness. They want them on their lapels at award ceremonies and on their cars as they move through their day. They buy them, they make them, they imagine them. They want people to “get educated” and attribute many of the world’s problems to ignorance. Of course, they are right. Education/knowledge is critically important.
And yet, I find myself asking: what are you going to do with that awareness? Is awareness enough? Is there more to all this than awareness? I am one of “them” and I want to know.
What leads me to ask these questions today is that National Women and Girls HIV/AIDS Awareness Day is March 10. Announced by the US Department of Health and Human Services and, in particular, its Office on Women’s Health this is both to acknowledge that March is Women’s History Month and, less positively, to acknowledge “the facts.” And yes, these are facts we should all know. To quote the Department of Health and Human Services Web site:
In 2005, women represented 26 percent of new AIDS diagnoses, compared to only 11 percent of new AIDS cases reported in 1990. Most women are infected with HIV through heterosexual contact and injection drug use.
Women of color are disproportionately affected by HIV/AIDS. AIDS is now the leading cause of death for black women ages 25 to 34.
As a Center for Disease Control Fact Sheet puts it:
Early in the epidemic, HIV infection and AIDS were diagnosed for relatively few women and female adolescents (although we know now that many women were infected with HIV through injection drug use but that their infections were not diagnosed).
Today, women account for more than one quarter of all new HIV/AIDS diagnoses. Women of color are especially affected by HIV infection and AIDS. In 2004 (the most recent year for which data are available), HIV infection was the leading cause of death for black women (including African American women) aged 25–34 years; the third leading cause of death for black women aged 35–44 years; the fourth leading cause of death for black women aged 45–54 years; the fourth leading cause of death for Hispanic women aged 35–44. In the same year, HIV infection was the fifth leading cause of death among all women aged 35–44 years and the sixth leading cause of death among all women aged 25–34 years. The only diseases causing more deaths of women were cancer and heart disease.
(To download the full fact sheet, click here.)
Women and girls in the United States (and globally) need to know about HIV/AIDS. We need to know, as well, that not all women are alike, and that women and girls of color are disproportionately at risk. And, we all need to know that women—and girls—continue to be caught in double (triple? quadruple?) binds that subject us to risk. Women are both expected to be responsible for contraception and HIV/AIDS prevention and positioned in ways that ensure that many are unable to ensure safer sex practices. The CDC labels this “sexual inequality.”
Widely shared cultural norms and institutional practices (including relationship violence and socioeconomic dependency) continue to disempower women and girls in the United States, and not just “over there” (wherever that is). Nearly 25 percent of African Americans live in poverty, while the figure for Hispanics is nearly 20 percent. Women are slightly less likely than men to be prescribed the “most effective treatments for HIV infection.” (Source: CDC Fact Sheet). And the current state of the US health care system means that many have little or no access to what they need. Yes, American women remain relatively disempowered. Awareness is important. We need to know “the facts.” (And, to be clear, it is not just women and girls that need to know this. We all do.) But awareness is not enough. (I am not alone in this; in wandering the Web, after writing this rant, I discovered the following on “Awareness” on the blog “Stuff White People Like.”)
If awareness is not enough, what else do we need? Of course, we need prevention programs and care for those already infected. The CDC, and many others, sponsor prevention programs that focus on women, in all our variety. Googling “AIDS/HIV prevention programs women” brings up 8,110,000 hits. Googling is certainly not enough and, while critically important, nor are these many programs enough. Yes, we need behavioral change. And this is both difficult to accomplish and hard to sustain. There are a range of models for effective behavior change, and critiques thereof. (See, for example the August 2008 report entitled “Behavior Change and HIV Prevention:(Re)Considerations for the 21st Century” or the much older, but still relevant, 1995 Fact Sheet from the Rural Center for AIDS/STD Prevention entitled “Behavior Change Models for HIV/STD Prevention.”) And yet, we cannot merely focus on individual change and elimination of risk behavior, one by one by one by one. We must also seek institutional, governmental, and cultural change (in this regard, see for example, “Government Structures and Behavior Change in the Politics of HIV/AIDS” ). We must let go of American individualism and neo-liberal social change through our purchasing power (see Samantha King, Pink Ribbons, Inc.). We must change more than our behavior around sex or needles. We need more. We need fundamental, radical social change. Only that will be enough.
Hence, for example, the UN Commission on the Status of Women meetings, which opened March 2 in New York focused on gender equality. At the opening, UNAIDS Executive Director Michel Sidibé said:
Gender equality must become part of our DNA—at the core of all of our actions. Together with governments and civil society, we must energize the global response to AIDS, while vigorously advancing gender equality… These causes are undeniably linked.
Mr Sidibé highlighted three priority actions needed to make this a reality: integrated delivery of antenatal, sexual, and reproductive health and HIV services; respect and protection of human rights; and new models of development in which women and men have greater control over their lives.
We need more than awareness. We need radical social change and the simple, but radical, and increasingly old-fashioned notion that women are human beings.
But what, you say, does all this have to do with religion?
Of course, religions are key to disseminating “awareness.” And many are engaged in either support for those who are infected or prevention programs of various sorts.
But that is not enough. Religion’s role? One answer is that religion should get out
of the way of that radical, inclusive change. We can let the others move on beyond awareness into change. Or, we can follow the advice of civil rights leader (now congressional voice) John Lewis and we can, religious and secular alike, get in the way—in the way of injustice, and in the faces of those who prevent change.
