In 1989, international public health professional Kathryn Carovano took a trip to Lima, Peru to spread awareness of AIDS and HIV prevention.* She worked with a group that explained the ways in which women can prevent disease through contraception and nonpenetrative sex. During her stay, she was told the following story by a local health educator:

We had just finished a health promotion program with a group of women and we asked them to fill out an evaluation form. One of the women who was very good during the training was taking a long time to finish the questionnaire, so I asked her if she was having trouble with it. She told me that she was having a hard time reading it, so I asked her if maybe she needed to use glasses. She said yes, that she had had her eyes tested 10 years ago, and the doctor prescribed glasses for her. She had bought a pair but lost them a few months later. To explain why she had never gotten a new pair she said, “My husband told me that I was so stupid that he would never buy me another pair of glasses.” So just imagine this woman asking her husband to use a condom or consider having nonpenetrative sex.

This story serves to highlight the role that women’s agency has in HIV/AIDS prevention. According to the Center for Disease Control, the number of AIDS cases in America totaled 1,009,220 in 2007. Approximately 810,676 of these cases were male and 198,544 cases were female. This means that the vast majority of AIDS sufferers are male.

There is not high risk of contracting HIV through woman-to-woman sex. According to AVERT.com, "very few women have been known to pass HIV on to other women sexually, though it is theoretically possible if infected vaginal fluids or blood from an HIV positive partner enter the other woman's vagina (perhaps on fingers or sex toys)."

It can, therefore, be concluded that women are much more likely to be infected with AIDS by a man, rather than a woman. This means that a woman’s likelihood of being transmitted with HIV is directly affected by two factors:

1) Her basic knowledge of the measures and practices necessary to prevent HIV
2) Her ability to refuse behaviors which she knows are risky (this ability will always be influenced by her partner's attitudes and beliefs about a woman's right to dictate what happens in the bedroom)

To what extent does an American woman have control over her body, especially during sexual acts? Does she engage in sexual behaviors because she receives pleasure from them, or because she wants to appease her partner? What role does our social construct of women's sexuality play in a woman’s willingness to engage in behaviors that may leave her vulnerable to HIV?

In this country, AIDS prevention is not so much about accessibility (anyone can go to the drug store and buy a condom) as it is about the ability to choose what happens in the bedroom. The real question is, how free do women feel to protect themselves and stand up for what they know to be healthy and true?

*Narratives and statistics for this article were taken from “More Than Mothers and Whores: Redefining the AIDS Prevention Needs of Women” by Karyn Carovano and materials published by AVERT.com.

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Shaina Gaul is a feminist and freelance writer living in Iowa. View more of her writing at http://www.couchSpud.net.