What Works in HIV Prevention for Women of Color

Chapter 2: HIV/AIDS Among Women of Color

Addressing the HIV prevention needs of women of color in a sustained, targeted fashion is long overdue, given HIV infection data and trends that highlight the disproportionate burden of infection found among women of color. Women of all races and ethnicities share certain vulnerabilities to HIV infection relative to men, as transmission of the virus is biologically more efficient from men to women. Even so, women of color are disproportionately at risk. In 1999, an estimated 23 percent of new AIDS cases were identified in women, and women now account for 18 percent of total AIDS cases, almost three times the prevalence rate identified by the Centers for Disease Control and Prevention (CDC) fifteen years ago (Hader et al., 2001). In addition, disproportionate rates of HIV infection are found among those with common cultural backgrounds, socioeconomic status, age, or geographic locale. All of these factors must be accounted for in the development and delivery of HIV prevention messages that resonate with women of color.

The Relative Impact of HIV

AIDS was the fifth leading cause of death for all women age 25 to 44 in 1998 (Hader et al., 2001). Among African-American women in the same age group, however, AIDS was the third leading cause of death. The disproportionate number of AIDS cases among women of color as compared to their representation in the female population of the United States is compelling evidence of the scope of the problem.

While African-American women represent 14 percent of the U.S. female population, they account for 58 percent of cumulative AIDS cases. Between 1998 and 1999, 63 percent of new AIDS cases among women were identified in African-American women. A similar imbalance holds true for Latina women who represent 20 percent of cumulative AIDS cases, yet comprise only 12 percent of the female population. These racial and ethnic disparities parallel broader disparities in health status by race and ethnicity in the U.S. that have been widely documented.

Risk Factors for Women Living with HIV and AIDS

By and large, it is heterosexual contact and injection drug use that put women of any race or ethnicity at risk of HIV infection. Since 1995, heterosexual encounters have led to more infections among women than injection drug use. The CDC estimates that 54 percent of newly reported AIDS cases among women in 1998 were related to sex with an infected partner. At least half of women with unknown risk factors are believed to have been infected through heterosexual contact (Hader et al., 2001).

Young Women of Color

Among young women age 13 to 24, African-American and Latina women represent three-fourths of new HIV infections reported through June 2000 (CDC, 2000). As with older women, unprotected heterosexual contact accounts for the highest number of these new HIV infections. Researchers believe that many of the younger women among the 25 to 44 year old demographic diagnosed with AIDS acquired the virus as teenagers or in their early 20s (Neal, 1997).

Geography

While anyone may engage in risky behavior, geographic location and corresponding HIV prevalence rates may minimize or increase the risk of HIV infection. New AIDS cases among women are increasingly concentrated in the South (41 percent) where sexually transmitted diseases are also more common (Hader et al., 2001). This trend among women is a notable shift from the AIDS epidemic's beginnings in the urban Northeast.

Why Men Matter

Men continue to outnumber women in HIV and AIDS statistics. The CDC (2001) reports that men account for nearly five times as many cumulative AIDS cases as women through June 2000. A smaller distinction between genders is found in HIV infection data where men account for two and a half times more HIV infections than women. This data indicates that the AIDS epidemic now affects women at disproportionately greater rates.

Trends in HIV transmission among men suggest risk factors for women as well. Men who have sex with men continue to dominate U.S. reported AIDS cases overall, but the risk factors for African-American and Latino men tend to be more evenly distributed between injection drug users and men who have sex with men. As a result of the racial and ethnic differences in sexual behavior among men living with HIV/AIDS, African-American and Latina women may be more likely than white, non-Latina women to have a sexual partner who is living with HIV.

---

This article was provided by AIDS Action Council.