Intersectionality: Gender, Structural Factors, Abuse, Trauma and HIV/AIDS for Latinas Claudia L. Moreno, Ph.D., MSW Columbia University School of Social Work

Magnitude of HIV infection Of the 33 million people currently living with HIV/AIDS around the world 50% are estimated to be women. In 1985, only 35% of the infected were women. More women being infected via heterosexual intercourse have changed the face of the epidemic resulting in a ‘feminization of HIV/AIDS’.

Magnitude of HIV Epidemic in the U.S. 1.2 million people living with HIV Each year about 56,000 new infections Stable incidence over past 15 years, despite effective prevention methods 17,000 deaths among people living with AIDS Net increase of 39,000 people living with HIV Hall et al, JAMA, 2008. Prejean, PLoS, 2011 Module 1 (Slide 3)

The Numbers… In the US 0.45% of the population is HIV-positive The HIV prevalence rate is : 2.1% among blacks 2.1% among Latinos 1.7% among whites

Latinas One in every five infections with the HIV virus is among Latinas1 Overall, Latinos comprise 16% of the total US population2 The Latino population is projected to triple between the years 2000 and 2050.

Latina Women: HIV/AIDS Latina women represent 9% of the general population In 1985, Latina women represented 7% of the HIV/AIDS cases In 2012, the incidence has increased 4 times, representing 18% of the cumulative HIV/AIDS cases Heterosexual contact is the major source of infection for adult and adolescents Latinas (39%)* compared to 4% for men US-born Hispanics represent for the largest number of HIV/AIDS cases Puerto Ricans account for 58% of the cases of HIV/AIDS 6

Intimate Partner Violence (IPV) Latinas account for 34% of the incidence The National Family Violence Survey found the rate for IPV was 54% (1990) A recent longitudinal study reported that Hispanics are 9 times more likely to report male-to-female abuse than any other type 7

What HIV has to do with it? Intersectionality examines the way gender, race, class, and sexuality (HIV) concert to create inequality “The interlocking systems of oppression

The Intersectionality of HIV Structural factors: Poverty, Race, gender, class, policies Violence

Changing the Paradigm Traditionally, HIV prevention programs have looked at individual’s Behaviors as targets for prevention and intervention. Intersecting risk factors related to HIV are not targeted,

How HIV relates to Poverty Heterosexuals living below the poverty line in U.S. cities are five times as likely as the nation's general population to be HIV-positive (CDC, 2012). African Americans are 4.5 times as likely as whites to live in poverty Latinos are 4 times as likely to live in poverty Finally CDC has admitted that there is a powerful link between poverty, low socioeconomic status and HIV Because African Americans are 4.5 times as likely as whites to live in poverty and Latinos are four times as likely to do so, the findings could account for many of the ethnic and racial disparities in human immunodeficiency virus infections in this country

Intersecting Factors: HIV & IPV Childhood trauma Being poor Traumatic, forced sexual activities Violence Psychological and physical abuse Asking to use condoms When HIV+ women disclose status Living IPV and HIV status interferes with health care and revictimization 12

Power Differentials Most Latina women are culturally forbidden to discuss about sex with men It is not culturally appropriate to buy condoms Some Women are not fully aware of their partners sexual histories Infidelity is accepted Some women have to endure abuse because of cultural norms 13

Focusing just on behavioral change is ignoring the rest of the picture If we make changes and improve the lives of people in the 99% by eradicating poverty, opportunities for the underprivileged and deal with violence against women, then we can eradicate HIV/AIDS 14

Conclusion Women who have histories of childhood abuse are more likely to be get HIV later on, Poverty puts women at risk for HIV, STI ‘s and IPV- Women who do not have access to resources forced them to remain in abusive relationships, remain isolated, have little or no access to resources and live in fear HIV, IPV and poverty go hand on hand The same risk factor that put women at risk for IPV are related to HIV and STIs 15

Implications for Future Interventions Prevention and research efforts should address structural factors, poverty, discrimination, racism, and colonization HIV and IPV programs should be trauma informed Preventions efforts for Latina should derive from the socio-cultural definitions of risk, cultural scripts regarding gender and power differentials and within the relationship context of sexual risk behaviors The recognition of HIV risk between the context of socio-economic, relational, political and cultural conditions 16

References http://articles.latimes.com/2010/jul/20/science/la-sci-aids-poverty-20100720