August 14, 2012
The 19th International AIDS Conference is officially over, and our work back in our communities must ramp up if we are to end HIV/AIDS, including among Black women.
In the U.S., women account for about 1 in 4 people living with HIV, and the majority of the new infections -- roughly 60 percent -- occur among Black women. The AIDS rate among Black women is 15 times higher than that of their White peers. In 2008, AIDS was the fourth leading cause of death among African American women ages 25 to 44.
Tragically, many of the young women who die became infected as teenagers.
Why are Black women disproportionately impacted by HIV/AIDS? We know that the world over HIV/AIDS affects society's most vulnerable populations: poor people, women, children, members of sexual and other minority groups. Black American women reside at the nexus of several of these risk factors. Around the world women experience gender power disparities that cause them to earn lower wages, increase their risk of domestic violence and can cause them to engage in survival behaviors that elevate their risk for HIV infection. Black women in America are no exception.
Culturally, we know that African American women often play caretaker for their entire family (and even extended family), too often without the support of another parent or partner. Many of them -- particularly low-income women -- struggle daily to keep their children fed, safe and looked after. Black women also live in a culture that expects them to place their children's needs above their own. Even when they want to take better care of themselves, they often face decisions during the course of their day that require them to choose between their children's wellbeing and their own.
These and other factors help to contribute to the increase in new HIV infections among Black women. But just because these structural and cultural issues exist, doesn't mean that we should accept that high HIV/AIDS rates are inevitable. They are unacceptable and we must continue to ramp up our response.
Thankfully, there are beacons of hope.
For decades we have fought against vertical transmission of the HIV from a mother to her newborn child. Fortunately, in most parts of the U.S., we have virtually eliminated mother-to-child transmission. Even in Washington, D.C. -- the American city with the worst HIV epidemic, whose HIV rates in some communities exceed those in sub-Saharan Africa -- no baby has been born with HIV since 2009. This represents tremendous progress.
Another bright spot can be found in the galvanizing activism of women responding to HIV/AIDS. Vanguard groups like the U.S. Positive Women's Network (USPWN) and the "30 for 30" campaign fight every day to make sure women are present in all AIDS policy discussions and that dollars, programs and messages target women in ways that they truly understand. Fierce advocates like Dazon Dixon Diallo of SisterLove in Atlanta and Naina Khanna of USPWN, based in Oakland, have refused to back down. And Black women living with and at risk for HIV are better off for their efforts.
Another reason that new HIV infections persist among Black women is that, as with many women worldwide, some lack control over sexual encounters, even with their spouses. This means that they may not be able to use condoms or other protective methods consistently and correctly. The two-year-old CAPRISA 004 study, represents an exciting scientific advance, demonstrating that the concept of a woman-controlled topical gel containing an HIV-killing solution can work. More research needs to be done on microbicides, but it appears that such a product could reach the market in the not-too-distant future.
Although these advances offer hope for an end to AIDS among women, we're very far from that reality today. The single most important step we can take for women (and for all Americans) is to ensure the full implementation of the Affordable Care Act (ACA). Already the ACA is giving millions of women and their loved-ones, including young adults, who are coming of age in an epidemic, access to health care and preventive services they don't have today. And this is the most important intervention we have.
Black women must be part of the AIDS conversation. And thanks to the hard work of women all over the world, in many places they are. Because the fact of the matter is, when a Black woman becomes ill or her wellbeing otherwise suffers, the community of people depending on her struggles as well. For women who are already HIV positive, self-care includes seeking medical treatment and adhering to the drug and self-care regimen that the doctor prescribes.
Black women can save themselves because Black women are greater than AIDS. And Women and men must not relent in this effort until AIDS is a memory.
Yours in the struggle,