The New York Times on Monday examined several factors affecting HIV/AIDS prevalence among black women in the United States. Although the number of new HIV cases among black women has remained stable over the past few years, the number of cases linked to heterosexual sex among black women has increased. In addition, black women are 23 times more likely to be HIV-positive than white women, according to government studies using data from 29 states. Some observers say that the increase in the number of HIV cases linked to heterosexual sex among black women stems from men on the "down low," an expression that describes black men who have sex with men but who never mention their male relationships to their female sex partners, friends or family members. One recent study demonstrated a "fast-spreading outbreak" of HIV among male black college students in the South, according to the Times (Villarosa, New York Times, 4/5). North Carolina public health officials at the 11th Conference on Retroviruses and Opportunistic Infections in February presented the findings of a study that found six new HIV cases among male college students ages 18 to 30 in 2000, 19 cases in 2001, 29 in 2002 and 30 in 2003. Of the 84 total new cases during that period, 73, or 88%, were among black men, and 11, or 13%, were among white men (Kaiser Daily HIV/AIDS Report, 3/11). Dr. Peter Leone, co-author of the study and medical director of the North Carolina Department of Health and Human Services HIV prevention unit, said, "This is a big change and may be a defining moment. I don't mean to sound like Chicken Little, but if we don't react to this very quickly and aggressively, it'll be like the 80s all over again." He added, "Instead of gay white men ... we'll be dealing with large numbers of young black men and their female partners."

Reaction
Although prevention messages aimed at blacks in the United States have focused on injection drug users and men who have sex with men, the North Carolina study demonstrates that HIV has "the potential to spread to a wider circle of blacks," including heterosexual women, the Times reports. Dr. Robert Janssen, director of the CDC Divisions of HIV/AIDS Prevention, said that there is not enough evidence to show what is driving HIV infection among black women, according to the Times. He said that the risk of contracting HIV is "highest in the African-American community and there's no question black women are at higher risk compared to other women, but there's still a lot we don't understand." He added, "[W]e are concerned enough to tell women of all socioeconomic groups to ask their partners about their [HIV] status and if they are having sex with men." Phill Wilson, executive director of the Black AIDS Institute, said, "HIV/AIDS is a disease of opportunity, not socioeconomics. The research out of North Carolina reveals that among black folks, no matter who you are or who you think you are, you are not safe from HIV" (New York Times, 4/5).

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