This is because these 17 states also all have dangerous HIV laws on their books that criminalize or regulate acts that can expose someone to HIV. These laws are rooted in unscientific and outdated understandings of HIV and disproportionately target communities of color. Often they are dishonestly adopted as measures that protect women, while specifically targeting sex workers.
Although these two policy areas are often different, they both have a common effect: they make it difficult for poor and marginalized women to access basic health care. Tracing their overlapping histories can therefore help move the abortion rights movement forward.
Abortion rights activists seeking to legally challenge trigger bans in these states can learn from the recent successes of HIV groups like the Positive Women’s Network of Colorado and its allies. In 2018, they successfully overhauled punitive laws targeting HIV-positive sex workers. The success of the Positive Women’s Network builds on a long history of activism by HIV-positive women, such as Carla Abbotts, whose story lies at the intersection of HIV and reproductive rights. Abbotts recognized that activism in both areas was crucial to ensuring basic health care for women. His activism can help guide today’s efforts to dismantle draconian laws and inform future coalitions.
Originally from New Jersey, Abbotts worked as an accountant in San Francisco in the 1980s. She socialized with the sex-positive artistic alternative underground subculture that flourished in the city, which included comic artists and DJs. A former intravenous drug user, Abbotts’ recovery journey has led her to be active in the Narcotics Anonymous support group. Her first brush with activism was to sue the Free Pregnancy Center, a crisis center in San Francisco, in 1986. Her lawsuit became part of a larger challenge to pregnancy crisis centers by feminist activists, and her story has been covered in newspapers and magazines across the United States. . Abbotts launched his lawsuit shortly before his own HIV diagnosis.
Abbotts later told parts of his story in his own voice in San Francisco’s underground alternative art scene and nightlife. She collaborated with artist Dori Seda for a 1987 comedy anthology issue titled “Door of Deception…or Right to Lie.” In the autobiographical comic, Abbotts, suspecting she is pregnant, finds the Free Pregnancy Center in the San Francisco Yellow Pages, where it is advertised as a walk-in clinic offering free pregnancy tests and birth control. . She makes an appointment and, upon arriving in her best clothes with a container of urine ready for her test, the thought bubble above her head reads: “For the worst I have decided to do my best.”
The comic reflected the encounter with the real world that she had had in this center. Unbeknownst to Abbotts, the center had a reputation for misleading young women about their health care options. Abbotts recalled the first sign of trouble when the clinic nurse asked her about her religious background. After the pregnancy test, the nurse insisted that she watch a slide show while waiting for her results. The slides featured images of a trash can filled with dead fetuses, women fatally injured by their abortions and subsequently committing suicide. Furious, Abbotts turned off the projector and said to the bewildered nurse, “You’re lucky I didn’t throw it out the window!”
After Abbotts learned she was pregnant, the nurse pressured her to adopt. Abbotts stormed out of the clinic and went to the Better Business Bureau to find a way to end how the clinic was misleading women seeking abortion services. She was connected with a feminist lawyer who helped file a lawsuit, and Abbotts eventually got access to the abortion and the care she needed.
His lawsuit targeted the center and its funder, the Pearson Foundation. Through the Committee for the Defense of Reproductive Rights, the lawsuit succeeded in preventing the pregnancy center from false advertising and limiting the ability of the Pearson Foundation to fund such clinics. Abbotts confessed, “I never thought I would end up doing something like this!”
By then, however, she was struggling with AIDS and declining health. In the late 1980s, AZT was the only treatment available for HIV. His doctor suggested that he participate in phase I trials on dextran sulphate. A few years later, she also enrolled in the CD-4 Phase 1 clinical trials. Abbotts felt lucky to have participated in both trials, even though the results were disheartening.
Abbotts was the only HIV-positive woman enrolled in both clinical trials. The gay men she encountered in the trials were well connected to services and care. At that time, HIV/AIDS care in San Francisco catered almost exclusively to gay men. It was often justified by the observation that there were so few HIV-positive women in the city. However, many doctors did not understand that AIDS manifests differently in women. Additionally, women with HIV had only one support group specifically for them in the late 1980s.
Abbotts grew increasingly frustrated with power struggles with her doctors over her treatments. The dextran made her even sicker and the doctors initially ignored her complaints. CD-4 initially increased its energy but soon proved ineffective. She also had to find a new primary care provider each time a trial ended.
But Abbotts’ ties to gay men and her observations of disparities in care motivated her to create health care support for HIV-positive women. She joined the Women’s AIDS Network and became one of the first HIV-positive women to serve on its board. She began speaking publicly and sharing her experiences as an HIV-positive woman more frequently.
Activists, namely those involved with the direct action group Act Up, helped fight for HIV-positive women to be recognized by the Centers for Disease Control and Prevention and included in trials beginning in the late 1980s. But Abbotts used his own experience to raise even more questions about inequities in access and treatment, and helped push AIDS activists to think broadly about health care. She forced them to ask themselves: what good could clinical trials even do if women’s basic health care needs were not met from the outset?
“Before you can even think of a clinical trial,” Abbotts wrote to fellow HIV-positive women, “the basics must be met. They should not replace a woman’s primary care.
His health stabilized after completing his trials – both the trial and the clinical trials. But it wasn’t due to the treatments. Abbotts understood the importance of educating women about their health, whether it was abortion or HIV. She has worked hard to provide women with the necessary information about their bodies to help them make the best life decisions for themselves. Abbotts continued to advocate for herself and other HIV-positive women until her death in 1999 at the age of 40.
Abbotts’ story highlights how HIV-positive women stood up for themselves when they were often ignored. Even today, HIV-positive women, especially women of color, continue to be underrepresented in clinical trials. Along with proposed HIV criminalization laws, these women risk being further marginalized and having less access to health care due to anti-abortion laws.
Activists like Abbotts, who have connected their reproductive health experiences to conversations about HIV care, show us how these ideas touch on some of the same areas and affect overlapping populations. Thus, efforts to expand access to abortion will be most effective if they address the broader realm of health care for women and others with uteruses, whether HIV-positive or HIV-negative.