Over three billion women worldwide are HIV-negative.
They have the right to stay negative.

Globally half of the people living with HIV and AIDS are female. Biologically, women are more likely than men to acquire HIV. Gender inequalities and human rights violations heighten girls' and women's vulnerability. Investing in comprehensive HIV prevention for women and girls is also an investment in the health and well-being of boys and men and of communities.

For everyone, safer sex requires:

• Respect for the mutual consent of partners and their right to say no;
• Zero coercion and violence;
• Access to female and male condoms and information on using them; and
• Knowledge of one's own and one's partner's sexual health, including HIV status.

PROVIDE SEXUALITY EDUCATION TO ALL YOUNG PEOPLE

Comprehensive sexuality education in schools, beginning in the primary grades, provides young people with HIV prevention information and skills and
supports them to:

• Build equality in relationships and in society;
• Respect individuals' rights to consent to or refuse sex and marriage;
• Practice safer sex and end sexual coercion and violence; and
• Accept diversity of sexual orientation and HIV status.

ENCOURAGE HIV COUNSELING, TESTING, AND TREATMENT

Knowing one's own and one's partner(s)' HIV status is an essential step towards preventing HIV infections. All individuals and, when desired, couples should have access to confidential HIV counseling and testing as well as treatment. Testing should be based on informed consent. Individuals should be supported in disclosing their HIV status, and all segments of society and institutions should eliminate stigma and discrimination based on HIV status.

PUT THE POWER OF PREVENTION IN WOMEN'S HANDS

Only one female condom is distributed for every 700 male condoms. Additional programmatic and budgetary investments are needed to distribute female condoms much more widely and to teach women how to use both male and female condoms. Research on new methods of woman-initiated prevention, such as microbicides, and monitoring the impact of prevention approaches, such as adult male circumcision, must continue. Further research is needed on how to support couples' rights to have children when one partner is HIV-positive. 

INVEST IN SEXUAL AND REPRODUCTIVE HEALTH SERVICES

New infections in women and young people are growing rapidly, primarily through heterosexual sex. These two groups can be most effectively reached through comprehensive reproductive health services (contraception, abortion, pregnancy and delivery care, and screening and treatment of sexually transmitted infections). HIV-earmarked funds should be invested to expand access to these services and enhance the provision of HIV counseling and testing; treatment, care, and support; and referral. In addition, services should build capacity to:

• Teach women and couples how to minimize the risk of HIV infection when trying to get pregnant;
• Screen for violence against women and provide care, including post-exposure prophylaxis; and
• Provide reproductive health services to women living with HIV.

HIV PREVENTION REQUIRES PROTECTION OF WOMEN'S HUMAN RIGHTS

• End violence against women and girls.
• End stigma and discrimination against people living with HIV and AIDS.
• Promote women's equality. Women should have rights to own and inherit property; equal opportunity in employment, education, and politics; and full equality under the law. 

Acknowledgements

We are grateful to reviewers Jane Galvão and Prudence Mabele.

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