Even though African-American women and Latinas ages 13-24 account for only 32 percent of the U.S. female youth population, they account for roughly 83 percent of new HIV infections among young females in the U.S. In addition, black women account for 62 percent and Latinas for 19 percent of cumulative AIDS cases among women 13 to 24. Numerous studies have found that the major mode of transmission in this population is heterosexual contact.
What exactly is contributing to these numbers?
In this exclusive, two-part roundtable discussion, we attempt to explore the pressing issues that are increasing HIV risk among young girls and women of color. We look at what is working, what is going terribly wrong and what is being overlooked in terms of HIV/AIDS prevention, education, testing and outreach.
Participating in this discussion are Tracie Gardner, Founder and Coordinator of the Women's Initiative to Stop HIV/AIDS NY (WISH) at the Legal Action Center; Jennifer Irwin, Deputy Executive Director at Health and Education Alternatives for Teens (HEAT), and Co-Founder of the Young Women of Color HIV/AIDS Coalition (YWCHAC); and Claire Simon, Co-Director and Co-Founder of the Young Women of Color HIV/AIDS Coalition.
Kellee Terrell: The CDC [U.S. Centers for Disease Control and Prevention] released some surveillance data showing that among teens and young women 13 to 24, rates of HIV infections are going up. We also know that those numbers are being largely driven by young women of color, especially among African Americans.
The first question I want to throw out is to Jennifer. What is not working, in terms of prevention toward this demographic, looking at the work you've been doing at HEAT?
Jennifer Irwin, Deputy Executive Director at Health and Education Alternatives for Teens
Jennifer Irwin: What we're seeing in terms of young girls that come through our doors is a couple of things. One, in terms of prevention -- and I guess this determines whether or not you view testing as prevention -- but a lot of the young women that we deal with are hesitant to get an HIV test. One reason for that is a lot of these young women don't view themselves at risk, in terms of their behaviors. A lot of them still tell themselves "I'm not a young, gay male. I'm having heterosexual sex, therefore I really don't need to get tested."
Another issue that comes up with a lot of young women is condom use. First, there's sort of an assumption amongst these young girls that if the male doesn't want them to use a condom, they don't need to use a condom. And then for those girls who want to use condoms [even when their partners don't want to], they are having serious difficulty negotiating condom use. With our clients, a lot of them have partners that are considerably older than them, and that creates this whole power dynamic that spawns fear, on their part that they'll be rejected, or they will be perceived to have something and not be quote-unquote clean if they use a condom.
Kellee Terrell: Tracie, just coming from WISH, what are you seeing that is going wrong on a policy level?
Tracie Gardner, Founder and Coordinator of the Women's Initiative to Stop HIV/AIDS NY at the Legal Action Center
Tracie Gardner: Well, at WISH we help policymakers who are responsible for funding and programming that would address the epidemic among young women understand the challenges and the dimensions of the problem. They include the issues that Jennifer spoke of, but at the policy level, it comes down to the politics of who makes the most noise; who has the ear of the decision makers; who's perceived to be at risk versus who actually is; and their ability to articulate in the policy arena. [Some of the issues we see] are policies that are in place that don't really work. For example, the siloing of HIV from other health and social services that young women use, so there's almost an AIDS, Inc., if you will, that exists completely outside of the realm of other issues that young women care about, need, depend on.
And we miss logical opportunities to integrate HIV testing and the idea that knowing your status is part of good health. One of the ways that we do that that's problematic is the bifurcation between HIV services and STI [sexually transmitted infection] services, which means that we're having young people getting treated for STDs [sexually transmitted diseases] -- and certainly in the areas in the city where there's high prevalence of HIV, there's also high prevalence of STDs -- but we have separate systems, separate funding, separate programming that doesn't fully integrate the awareness of sexually active young people. And the opportunities, when they come into care, are opportunities that have to be fully exploited in order to really take advantage of the opportunity. And we don't have things in place that do that.
So there's that, at the program and ground level, and bubbling up to the policy and legislative and funding level. The funding is also siloed, and so it makes it hard to deal with different components of people when, in fact, we need to be dealing with people's holistic self. Everything that goes on below the bellybutton is what we should be attending to, in one fell swoop, in one visit, in one engagement -- if not repeated engagements.
Kellee Terrell: Claire, Tracie just brought up a really good point: Who cares about young girls? Who is advocating for them? Who's the mouthpiece for them?
Claire Simon, Co-Director of the Young Women of Color HIV/AIDS Coalition
Claire Simon: I think for the women who are advocating for younger women, it's because: One, they come to us. And they don't feel that they have a voice in this process.
I also feel like many providers don't think young people should be having sex. So, as a result, they don't address the issues that a young person may come to them with. And the messaging that they're getting from many adults about sex is not to do it. But then the mainstream media tells them to "do it all the time" and "this is how you're going to get accepted." From all the teenybopper shows, to anyone; there is sexuality, there are things that are in their face, but no one's talking about it to them.
I think the beautiful thing about the coalition is that we have a group of young women who are interested in these issues, who are talking about it, who are sharing the message, and giving voice to it from a youth perspective. That's very powerful and impactful. Because having a peer who can say to you, "Have you thought about this? Have you thought about that? Let's talk about these issues," can propel other young people to feel comfortable talking about it.
Kellee Terrell: Jennifer, when looking at sex education in this country, do you feel like it incorporates those contradicting attitudes?
"[Sex-ed] is often not taught in the schools. It's really at the whim of the principal -- if the principal feels comfortable having it taught, it gets taught." -- Jennifer Irwin
Jennifer Irwin: It depends. The whole sex-ed thing is an issue in itself. But I think one of the problems in New York City with sex-ed is that, although there's a curriculum, it's often not taught in the schools. It's really at the whim of the principal -- if the principal feels comfortable having it taught, it gets taught. And because there is not an emphasis on sex-ed at all, a lot of teachers either rush through the curriculum, or they allot one health class to it.
In my program, we do a lot of workshops in high schools and middle schools. But even in that there are issues. For example, there are plenty of times when a teacher will call us and say, "We'd really love for you to come do an HIV 101, or an HIV/STD workshop." And they will come right out and say, "But listen. This is not really OK with the principal; we're going to kind of do this on the sly. Don't bring condoms. Don't do a demonstration about how to properly wear a condom."
So, sure, you can talk about sex. But you can't actually show youth how to protect themselves having sex.
I think that part of it is that the teachers out there -- those that are supportive of it -- are up against a lot of battles in their schools with parental involvement. There are a lot of parents making noise, a lot of principals that aren't necessarily supportive of it. I also think a downfall in our current curriculum is that oftentimes it doesn't take into account cultural issues, religious issues, and other important issues that impact young women living in New York City, such as different social and economic issues that they deal with around sexual education in school. I think that kind of rubber-stamp, one-size-fits-all approach doesn't work as well when you have such a varied population of young women.
What I really want to stress as well is that sex-ed needs to start at a much younger age. That's part of the big problem: A lot of the youth who are part of our program will say that they never got it, or they got a few classes in it in a health class. Or they'll say that they didn't get anything until high school. We're having young women who are HIV positive at age 12. And so there is clearly a huge disconnect, in terms of these young women getting sexual health information, either at home, or at school, or in another forum. It's just not happening in an effective way at all.
Comment by: Kent Denning
Fri., Jan. 6, 2017 at 4:05 pm UTC
Great forum and a good article for all of us at "AIDS, Inc.". The comments speak well of the internal dialogue that we all have around sexuality and survival.
Comment by: Pastor Concerned
Fri., Jan. 6, 2017 at 1:00 pm UTC
The only way to effectively address this issue is to enter the battlefield that is most effective in enticing people to be sexually active and appealing only to the arousal factor with no emphasis whatsoever placed on safety, risk, or responsibility.
It is entirely impossible to effectively change this dynamic with getting this information out to the males that are largely responsible for the infecting of females.
So, commercials, as well as the interjection of discussion of responsibility and caution should be a requirement television show encouraging the engagement of sexual activity.
The sexual revolution which has experienced unforeseen nuances and liberties in the last few years has had an incredible effect on this phenomenon. Since society has empowered and incorporated into the realm of acceptability, to a large degree, the LGBT lifestyles, emphasis has shifted from the concerns of contracting HIV to the establishment and push for more acceptance and entrenchment into the bedrock of society for LGBT issues.
However, because of the huge part of human interaction that sexual relations occupies, this issue unaddressed has surged due to a lack of emphasis on and focused warnings and consistent public awareness efforts. It's almost as if HIV has been cured, the way the warnings have disappeared from the public forum, which I believe is central to the increased diagnosis that is heartbreaking.
A/A family life is the most fragile as it has been under attack since slavery and every government experiment or change of agenda, like frogs in the ecosystem, A/As are effect, due to a constant quest for betterment which they were so deprived from for generations. This rest lenses has cause a vulnerability, die to a lack of foundational stability that a proper family unit, replete with traditional values instilled from one generation to the next would naturally pass down..
Comment by: Eric
Sun., Dec. 18, 2016 at 7:38 pm UTC
Education and prevention is key. I would imagine that reaching whatever demographic is having sex with this demographic would be important, but that might take some people leaving their comfort zone in a day where we dance around the real root of problems at the expense of those who can do little to protect themselves.
Comment by: roger
Mon., Aug. 22, 2016 at 3:10 pm UTC
I believe that the rise in HIV is contributed the prison system. Where were there a large pop. Of aids. When these guys come on the street the y should be screen more. Tm
Comment by: Robert Russell
(Atlanta Georgia )
Sun., Jun. 26, 2016 at 4:03 am UTC
this is an excellent article
I was intrigued by the article for two reasons 1 I have a 19 year old daughter 2 I worked for an organization that provided free HIV and Hep C testing not to mention that some of our grants where i CDC or HIV testing and prevention grants.
I can see the need for going beyond the traditional walls of schools and health centers to educate people.
the church and the community at Large must participate an education prevention testing and abstinence seminar
Comment by: R. Loggins
Thu., May. 5, 2016 at 2:41 am UTC
Stop! Stop perpetuating this fallacy - uhgg. The higher numbers of AIDS in the AA community can be largely attributed to the fact that AFRICAN immigrants are included in these numbers and African immigrants are 6x more likely to have AIDS than there American counterparts. Also it affects heterosexual Africans at a higher rate - many who are born with it. The African continent ALSO has had the highest rate of legal immigration to the US since the 90's.
These numbers are calculated without country of origin for the black community (although they are broken out in the Hispanic community in many studies) SPECIFICALLY to further the negative narrative and stereotypes of AA's. Teenage black girls are NOT more promiscuous or risk takers than their beer pong, binge drinking heroine addict white counterparts - stop it!
Comment by: william jones
Mon., Apr. 18, 2016 at 8:05 am UTC
I realize the focus here is on health issues related to sexual activity. Another important issue that should be addressed is the financial aspects of child rearing. This cycle of state support to these young mothers really should be put in check. In addition to overcoming this power struggle with these men with no sense of responsibility, these young girls need to be taught o sense of financial responsibility.
Comment by: Erica
Thu., Apr. 7, 2016 at 6:11 am UTC
They are not telling themselves that, doctors are telling them that!
Comment by: Brenda
Thu., May. 3, 2012 at 12:39 am UTC
I really enjoyed reading the whole conversation.I was diognosed 2009. I got it fom my husband, who did many things behind my back. He used heroin, which lead to him sleeping with whomever had what he wanted. Enough anout that.
The day I was told. I was devistated, thought I was gonna die. So, now that I know I'm NOT gonna die. My goal is to bring awarness & prevention to my community.To talk to youths anywhere that I can.My 11 year old talks to her friends & educates them. At least the ones that stick around to listen.I'm so proud of her.
The only support thats in nmy area is the Rainbow communtiy center. & to be honest,I didn't feel welcomed. I'm not a gay man or a gay women. So basicaly there 's nothing for straight people. So I started a small group in Pittsburg & working on getting word out that I'm here to support you & to listen to you. This is my calling. But its going to be a very long road.Baby steps to glory.
I believe people need to see AIDS/HIV signs more often, more commercials ect.
Great job ladies.
Comment by: Christine Makena
Tue., Feb. 8, 2011 at 2:16 am UTC
I like your views and contribution in trying to control the HIV/AIDS pandemic among the youth.Young people should be involved more in healthy activities to occupy their minds so as to keep them away from negative activities.atahis is because at this age they have a lot of energy,so many ideas and they want to experiment hence the need to push them into productive activities.
Comment by: Justified
(Little Rock, AR )
Sun., Feb. 6, 2011 at 2:35 pm UTC
What saddens me is the fact that the African American Community has for so long push things aside they don't know how to face tings head on thinking we always were struggling. Now I say to mu friends we need to talk about it, even if it's not you, if it's someone you know or don't know it affects you this is our community! I had the experience of going to an event held by the AAF in Little Rock, AR...to my dismay their were more Caucasions than African American. They attack this with strength and character. Why do we "African American" Women and Men, look at this as danger? No matter how a person contracted the fact remains getting them to a point where they can access better judgement from that day forward, and access better judgement before it happens. Where does it start and will it ever end. We talk until no more words are spoken and everyone still walks around like it could never happen to them. Aids and Me!
Comment by: Graham
(Little Rock, AR)
Wed., Feb. 2, 2011 at 10:38 am UTC
This was FANTASTIC! My heart breaks for all the young women who only know this type of "love".
The only type of love they really need is to love themselves and protect their bodies and hearts at the same time. If he REALLY loves you, he'll strap up, be faithful and get tested! Nothing is better than a Woman's peace of mind. How does this message get out? How does it become ingrained in their heads? How do you teach people to respect themselves when they learn from their family a completely different set of values?
God bless you Ladies and the work that you do.
Replies to this comment:
Comment by: Real
(Little Rock, AR )
Sun., Feb. 6, 2011 at 2:19 pm UTC
First It starts with knowledge and a solid strong bond within our community inwhich we don't have. The problem is for so long young lady's in our community never knew anything other than we lay we get payed, pleasure became an object of being taken care of. Trust became an object of distrust. I am a single mother and I tell my daughter often take care of you, no one else will and protect yourself at all times, the feeling will be more profound if you insist he wears a condom, because no one will ever disclose what's going on with them. To that I add, no one told me 19 years ago...
Comment by: Reuben K.Harpole,Jr.
Thu., Jan. 27, 2011 at 8:18 pm UTC
No strait anwsers. I had the medical person of our county jails tell me one day "The black community is in deep trouble" I asked why? He said that the men in the jails are have sex in prison and coming out and having sex with their girlfriends anthere wives and giving the HIV. Now that is one way in which this is spreading.
Comment by: Rena Greifinger
Thu., Jan. 27, 2011 at 2:05 am UTC
Thank you so much for initiating this powerful and informative discussion. Your passion really came through in your candid and informed remarks. I was particularly struck by the realization that so little attention/funding is paid to young heterosexual men of color. We work with many of these young men and are always struggling to find funding and mentors for programming geared towards them. If you have any ideas, please share! Thanks so much for all of your incredible work.
Director, One Love Project
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