Aids catches up with women

Clare Garner meets the author who wants to turn the debate upside down

STANDING in a sex shop signing copies of her new book, Robin Gorna, a Catholic theology graduate, is mounting a personal crusade to turn the Aids debate upside down.

In Vamps, Virgins and Victims she argues that women are in the HIV frontline but nobody seems to know it. You might think that most of the ways in which women down the years have been taken for granted have been spotlighted - even if they haven't been corrected - but Ms Gorna, head of health promotion at the Terrence Higgins Trust, has hit upon another.

In the 10 years she has been working for the Aids charity, she has seen knowledge and awareness of Aids increase year by year. But the focus has always been men - first homosexuals, and later heterosexuals.

Now women are contracting Aids at a faster rate than men. Cases of Aids in females in the UK rose by 10 per cent between 1994 and 1995, from 211 to 232, while cases in males fell by 14 per cent, from 1,570 to 1,352.

The reason, says Ms Gorna, is that women are not being treated as a separate risk group by health promoters. Unless a "long overdue" feminist approach to Aids is adopted, she says, the trend could continue.

"This does not mean, in some political sense, that HIV is becoming a women's disease," she says. "It does mean that women are being infected at rapidly increasing levels, so much so that they are catching up with men."

Ms Gorna sees women's vulnerability to Aids as threefold: biological, social and economic. The vast majority of HIV-positive women in the UK (and worldwide) have acquired the infection through sex with a man. These women are mostly heterosexual in their orientation or identity. Biologically, she says, women are at least twice as likely to contract HIV as men. "Semen has more HIV in it than vaginal fluids do, and the route of transmission is more effective from men to women than vice versa."

Women also suffer an increased risk for social reasons, she argues. "Often women have less control over sex than men. The reality is that many, many women are coerced into sex. That might be at the level of rape or abuse, or simply within marriage. One of the great tragedies of the understanding of Aids is that it has always been based on promoting condoms and lubricants which are worn by men. There is no way women can insist on condom use."

Economics is the third factor. "Where a woman is poor she feels she must fulfil her marital or cohabiting obligations. A lot of young women are in a situation where they are not fully consenting to sex. Economic inequality translates into sexual inequality."

Current campaigns focus on the promotion of monogamy as an effective way of preventing HIV - a strategy doomed to failure, Ms Gorna thinks. "It is a simplistic and dangerous strategy which ignores the fact that women cannot control the most crucial component: the monogamous behaviour of their male partners." A UK survey which revealed that 76 per cent of women with Aids believed they were in a monogamous relationship supports her theory.

"We need to be addressing those men and saying: "Look, guys, you know if you are screwing around, you know what you're up to: use a condom. Protect the woman you're having sex with. That's where it comes back down always to the gender power relationship."

Explaining the title of her book, she said: "It's a triangle. The vamps and virgins refers to the way women's sexuality is polarised between total innocence or total excess. Within the context of HIV you have another axis, which is the victim. My contention is that women are in the middle of the triangle. We're not vamps, we're not virgins, we're not victims, we're just human beings getting on with our lives in lots of different ways."

Ms Gorna herself defies neat definition. She is a single bisexual who enjoys and advocates a full and varied sex life, as was apparent in her choice of venue for her book launch last week. In an effort to drive home the diversity of women's desire and sexual experience, she headed for a women's sex shop.

Yet she is also a practising Catholic. "I confess I was in church last weekend, and they did their Spuc [Society for the Protection of the Unborn Child] talk. What was interesting is this person was talking about abortion and they were praying for people who protect human life and I sat there and I thought: "You know, that's my job."