Maria de Bruyn is a Senior Advisor for Ipas and a medical anthropologist by training. At Ipas, she has identified, researched, and publicized linkages between abortion and other sexual and reproductive health issues, including HIV/AIDS.

One issue that is receiving a great deal of attention at the International AIDS Conference is the effect the AIDS epidemic is having on women and girls around the world.

In 1992, the International Community of Women Living with HIV/AIDS (ICW) was formed at the Amsterdam AIDS Conference. There, HIV-positive women spoke out about the need to address gender biases that increase their vulnerability to HIV infection, worsen the stigma and discrimination attached to AIDS, and place most of the burden of care for AIDS patients and orphans on their shoulders.

Today, 14 years later, some progress has been made. Antiretroviral treatment (ART) is available to greatly reduce the chances of HIV transmission during pregnancy and childbirth. International and national agencies are beginning to recognize the need to link HIV/AIDS programs with sexual and reproductive health services so that women's health needs are met more comprehensively. ICW has become a co-sponsor of the international AIDS conferences and associations of HIV-positive women who offer affected women counseling, care and support have arisen in countries of all regions of the world.

Too much remains undone, however. While far fewer children are born HIV-positive, only a minority of mothers receive needed ART to ensure their own survival. Although the risks of cervical cancer are increased in HIV-positive women, most of them don't even know about cancer screening and even fewer have access to Pap smears. Discrimination within the health sector still occurs in various countries. Women who choose to become pregnant after knowing their positive HIV status are socially ostracized; some HIV-positive women are still turned away from hospitals when they are about to give birth. Women living with HIV who have unwanted pregnancies have no access to safe legal abortions; others are only granted legal abortions if they "agree" to be sterilized. And while women may be invited to international and national meetings to "tell their stories," their insights and contributions to policymaking are often marginalized or not even sought.

At the Toronto AIDS Conference, my organization, Ipas and our partners will present findings from a pilot project carried out with eight partner organizations in 11 countries that investigated the extent to which affected women are affected by discrimination, receive needed reproductive health services and are involved in local policy formulation. Together with ICW, we will offer a skills-building workshop for HIV-positive women and non-governmental organization on understanding and addressing these shortfalls as human rights violations.

Ipas is also pleased to be a part of the ATHENA Network, a new coalition uniting individuals and organizations in the need to establish respect for human rights and gender equity as the framework for all policies and programs addressing women and HIV/AIDS. ATHENA was a co-sponsor of a march and rally for women's rights at the start of the conference, as well as other events addressing gender discrimination in relation to HIV testing, violence against women and increased community dialogue on these issues.

It is no longer enough to recognize that women are greatly affected by the epidemic and to plead for some attention. It's time – or rather past time! – to demand that interventions be stepped up to alleviate the impact of HIV/AIDS on women and girls worldwide.

Editor's note: For more on the connection between HIV/AIDS and reproductive health, read Gateses Speak Out for Women and HIV Prevention Integral to Reproductive Health.