HIV-positive black women in North Carolina are more likely to be poor, unemployed and willing to trade sex for drugs, money or shelter than HIV-negative black women, according to a study published in the Feb. 4 issue of CDC's Morbidity and Mortality Weekly Report, Reuters reports (Simao, Reuters, 2/3). CDC researchers and North Carolina Department of Health officials reviewed public health surveillance data for 1998-2004 for newly reported HIV infections and HIV contact-tracing records of the North Carolina Disease Intervention Specialists. The researchers used the records to select a group of black women in North Carolina who were diagnosed HIV-positive between January 2003 and August 2004 and compared epidemiologic and behavioral factors from that group with factors from a control group of HIV-negative black women. The researchers selected 31 heterosexual, non-injection-drug using HIV-positive black women and 101 heterosexual, non-injection-drug using HIV-negative black women who were "demographically and behaviorally similar," according to MMWR.
The researchers found that the HIV-positive black women were more likely to be unemployed; receive some type of public assistance; have 20 or more lifetime sex partners; and be willing to trade sex for money, shelter or drugs. Women who discussed sexual or behavioral history with male partners were less likely to be HIV-positive. About 71% of the HIV-positive women believed they were infected by a "steady partner," according to MMWR. Although the most common reason reported by the HIV-positive women for not using condoms was that they "trusted their partners," only 33% of the HIV-positive women said that the relationship with their steady partner was "mutually monogamous," according to MMWR. Three of the six male partners of the HIV-positive women interviewed by researchers had engaged in sexual activity with another man, although only one admitted this behavior during the interview. The most common reasons reported by the black women for engaging in behavior that could put them at risk for HIV infection included financial dependence on a male figure, alcohol and drug use, "feeling invincible" and low self-esteem combined with a need to feel loved by a male figure. The researchers found that while both the HIV-positive and HIV-negative black women reported engaging in high-risk activities, the majority of women perceived themselves to be at low-risk of HIV infection. The researchers concluded that the findings demonstrate that more public health attention needs to be focused on black women who are at risk of HIV infection (MMWR, 2/4).
Dr. Lisa Fitzpatrick, director of CDC's minority HIV/AIDS research initiative and a study author, said that the finding that HIV-positive black women are more likely to be poor and unemployed "suggests that it's a lot more difficult for women who are poor to even think of HIV as a health priority when there are so many other issues that they are dealing with," adding, "I think this mirrors a lot of the epidemic in the rest of the country. This is not unique to North Carolina" (Reuters, 2/3). Dr. Peter Leone of the University of North Carolina, the study's lead author, said that many black women do not feel that they have "room to negotiate" condom use because of dependency on male partners, according to the Atlanta Journal-Constitution. "That's what we see all the time," Dazon Dixon Diallo, CEO of SisterLove -- an HIV prevention organization in Atlanta -- said, adding, "We're willing to do whatever it takes, even putting ourselves at risk, to make our partners happy" (Wahlberg, Atlanta Journal-Constitution, 2/4). The study participants suggested several ways to reduce HIV transmission among black women in North Carolina, including introducing HIV/AIDS and sexually transmitted disease education in elementary and middle schools, increasing condom availability and use, and integrating HIV/AIDS education and prevention messages into church and community activities, as well as media and popular culture (MMWR, 2/4).
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Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2004 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.