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HIV/AIDS Resource Center for Women
Michelle Lopez Alora Gale Precious Jackson Nina Martinez Gracia Violeta Ross Quiroga Loreen Willenberg  
Michelle Alora Precious Nina Gracia Loreen  

Why Race Matters: Women and HIV

April 18, 2016

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What Is Privilege?

"I am a white woman, I have privilege. I recognise that we don't have to have a hashtag for white lives. ... Racism towards white people is up for discussion and it pains me!

"The statistics of HIV speak volumes don't they? Maybe I need to shout it louder, as my white voice is more listened to!" -- MelPainter2014, "#BlackLivesMatter," on A Girl Like Me

Privilege is a set of unearned, and often invisible, benefits experienced by people who, based on aspects of their identity, fit into social groups that have power: white race, middle or upper class, male, heterosexual, documented citizen, native English speaker (in the U.S.), to name a few.

Some examples of privilege include, but are not limited to, being able to:

  • assume that most of the people you or your children study in history classes and textbooks will be of the same race, gender, or sexual orientation as you
  • assume that your failures will not be thought of as being due to your race or gender
  • disregard thinking about your race, class, gender, sexual orientation, disabilities, etc., on a daily basis.

A few things to remember about privilege (adapted from Everyday Feminism's "What Is Privilege?"):

  1. It's often easier to notice oppression than privilege.
    It's definitely easier to notice the oppression (system of unjust treatment) you personally experience than the privileges you experience, since being mistreated tends to leave a deeper impression than being treated fairly.
  2. Privilege doesn't mean you didn't work hard.
    Many people feel personally attacked when someone points out their privilege, as if that person is saying they haven't worked hard or experienced challenges or trauma. Having privilege doesn't mean a person's life is easy, but rather that it's easier than others' in certain ways.
  3. Privilege describes the kind of treatment everyone ought to experience.
    Often, when someone points out some way another person has privilege, that person protests that they haven't gotten any "special advantages" -- that what they are getting is basic fair treatment. The problem is that others who don't have privilege are getting less than that, not that that person is getting more than they deserve.
  4. We need to understand privilege in the context of power systems, not individual experiences.
    People tend to look at privilege individually instead of as a system. President Obama's election as the first president of African descent was an inspiring, historic event. It did not signal an end to racism. Black people are still impacted unfairly by poverty, police violence, and poor health outcomes, even though Obama is president. Privilege is part of systems and social patterns. The few notable exceptions to the rule of privilege do not make privilege go away.
  5. Privileges and oppressions affect each other, but they don't cancel each other out.
    Often, people believe that they can't experience privilege because they also experience oppression. A common example is the idea that poor white people don't experience white privilege because they are poor. Poverty is a system of oppression, but this doesn't cancel out the fact that they can still benefit from being white.

"I can completely understand why broke white folks get pissed when the word 'privilege' is thrown around," writes author and advocate Gina Crosley-Corcoran in a great article called "Explaining White Privilege to a Broke White Person." "I was constantly discriminated against because of my poverty and those wounds still run very deep ... [But] the concept of intersectionality recognizes that people can be privileged in some ways and definitely not in others."

What Is Intersectionality?

Intersectionality is the idea that many parts of a person's identity impact their life at the same time. Some of those aspects give them privilege, and some lead them to experience oppression. The parts of a person's identity cannot be separated. For example: All women experience sexism. But the sexism that Black women and white women experience will be different, because Black women experience sexism that is also affected by racism.

If we think about a woman living with HIV as "just" a woman and not as a Black woman, or a mother, or a woman with past experience of trauma, or a woman living in a rural area, or any other aspect of her identity that impacts the way she lives in society, then many key ways to connect with that woman and advocate for her needs and rights will get missed.

In order to provide each woman with the best possible care, services, and support, it is important for our care providers, government, and other connected systems not to treat HIV disease just by itself. They must recognize and address the intersectional issues that impact women's ability to access great HIV care, heal from past traumas, and have the best possible quality of life with HIV.

On World AIDS Day 2014, our partners at Positive Women's Network-USA (PWN-USA) teamed with a diverse group of advocates to write a statement calling for more intersectional approaches in HIV work. "The differences in our experiences -- the learning edges of power and oppression, privilege and vulnerability," said the report, "can, for our extraordinarily diverse HIV community, be sources of strength themselves."

HIV Among U.S. Women of Different Races/Ethnicities

Race and gender intersect with many other factors in the lives of women living with HIV. Below are a few examples of factors that affect women living with HIV in different racial groups, or make them more vulnerable to HIV.

Factors Impacting HIV Among U.S. Women of Different Races/Ethnicities*
According to the U.S. Census Bureau, 26% of African Americans and 24% of Latinos are living in poverty, compared with 10% of whites
American Indians/Alaskan Natives have the highest rate of poverty of any racial/ethnic group in the U.S. -- roughly 29%
Due in part to histories of racist housing policies, African Americans and Latin@s are far more likely than whites to live in concentrated poverty (entire neighborhoods/areas cut off from easy access to resources like health care or high-quality schools)
American Indian reservations are also sites of high concentrations of poverty
Poor whites are much more likely to be spread out to more economically diverse neighborhoods, which increases their access to opportunity
A 2010 study by the U.S. Centers for Disease Control and Prevention (CDC) of people living in poverty in 25 U.S. cities found that HIV rates in these areas were very high -- over 2%. Higher than one is a generalized HIV epidemic (spread over many groups, not just concentrated to a few). HIV rates in these high-poverty areas did not differ a lot by race, showing the extent that poverty as well as race matters when it comes to HIV
Immigration Experience
The experiences of undocumented people, including Latin@s and Asian immigrants, may lead them to fear being tested for HIV or disclosing HIV status
Immigration status and migration patterns also affect access to health care
Lack of available HIV education materials in a language a person speaks or reads is a barrier to HIV awareness
Cultural Factors
Among American Indians/Alaskan Natives, there are over 560 federally recognized tribes whose members speak over 170 languages and have their own beliefs and practices, which makes it harder to develop culturally appropriate prevention
In more traditional Asian and Latin@ communities, gender roles and cultural norms (ie., "machismo," which stresses that Latino men be very masculine, and "marianismo," which demands Latinas be "pure") may add to prevention challenges
Some Asians/Pacific Islanders may avoid HIV care or prevention services to "save face" (avoid potential humiliation -- a core value in many Asian cultures) or for fear of bringing shame to their families
Data Limitations and Racial/Ethnic Misidentification
Incorrectly identifying a person's race/ethnicity can lead to underestimation of HIV cases. This may happen more frequently with Asians and Pacific Islanders, so the true rate of HIV in this group may be unknown
Racial misidentification of American Indians/Alaskan Natives may also lead to undercounting of this population in HIV surveillance
All these issues can lead to underfunding of targeted services
Transgender individuals in all racial groups face the challenge of data limitations and misidentification on the basis of gender identity
Rates of Violence and Trauma
The body of research continues to grow that shows that women living with HIV face a greater impact of trauma and violence, both before and after their diagnosis, than the general population of women

American Indian/Alaskan Native women experience sexual and intimate partner violence (IPV) at a higher rate than any other racial group of women in the U.S.

  • 39% of Native women have reported experiencing intimate partner violence (CDC reports that about 31.5% of women overall have experienced IPV), and 34% will be raped in their lifetime (compared to less than one in five women in the general population)
  • The rate of posttraumatic stress disorder (PTSD) among Native women is also very high
  • These harms against Native women are underreported, and not well documented
Stigma is named as a factor increasing vulnerability of all racial groups
Stigmas are intersectional as well; types of stigma (based on gender identity, sexual expression, class, race), when they occur together, can make one another worse, and fuel HIV-related stigma
"Girl Next Door" Stereotypes
There is very little written specifically about the cultural factors that can leave white women vulnerable to HIV
Many white women have reported that not "looking like" they were at risk for HIV ("I'm the girl next door," says one educator who is a white woman living with HIV), may have led to them not being offered HIV testing for years, even if they were connected to sexual health care
This is another reason why it is in white women's interest to oppose racism: It is bad for their health, too. Racial privilege may lead white women to get messages from society that they are "normal," "good," and "clean" compared to women of color. These beliefs are a barrier to white women being tested for a health condition that is associated with women of color -- even though white women acquire HIV in the same ways that women of color do.
When women with privilege challenge the racism that portrays having HIV as different from what "regular women" experience, in part because rates are so much higher among Black and Brown women, then we fight stigma at its roots
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