She was America’s first deputy assistant secretary for women’s health, and has held crucial federal health policy positions as U.S. assistant surgeon general and rear admiral in the Department of Health and Human Services. For more than 20 years, Susan Blumenthal, MD, MPA, has fought to improve the health of women and erase the inequality that makes them more vulnerable to many diseases, including HIV.

POZ: In 1985, you helped arrange the first federal government conference on women and AIDS. What has changed since then regarding women and the disease?

Blumenthal: At the beginning of the AIDS epidemic, women were not included in clinical trials. The [early] omission of women as research subjects and as the focus of [HIV] prevention campaigns put women’s health at risk because women did not know that they were vulnerable to infection. Since then, women’s health [has become] a top priority; funding has increased, and many prevention efforts are targeting women’s unique needs. But [there is still] much more to be done.

Why do you choose to focus so much of your effort on prevention versus treatment?

Currently, we have a sick-care system, not a health care system. We spend $2 trillion on health care—more than twice that of any other nation—and yet we have the highest infant and maternal mortality rate in the industrialized world. As much as 70 percent of those health care costs could be prevented with behavioral interventions, such as not smoking, having a healthy diet, getting physical activity and safe sexual behavior.

What factors continue to make women around the world especially vulnerable to HIV infection?

Despite the differences in women’s lives across the globe, there are risk factors that remain similar for women [everywhere]. For example, there’s the decreased economic power of women; reduced social and legal rights in some parts of the world; and the fact that women may be unable to insist that their partners remain monogamous, or [wear] condoms. Also, gender-based violence is another issue that is both the cause and consequence of HIV infection.

How can we tackle these factors?

We must continue to research [gender] differences with HIV/AIDS and empower women themselves. We need to intensify our efforts to ensure education and economic opportunities for women. And as women go to the polls this election season, they need to be informed about the candidates’ health care plans. Knowledge is power when it comes to your health.     

POZ wants to hear your ideas about the best ways to address the specific challenges for women with HIV. Share your personal experiences, and talk to other women about their obstacles and triumphs. Log on to the “Positive Women” forum at forums.poz.com and click on the “Women and Power” thread.