As World AIDS Day comes about today, the troubling incidence of AIDS among African-American women serves as a potent reminder about how far we must travel to effectively manage this disease.

Health-care professionals like to highlight the tremendous progress made in treating people with HIV and AIDS. The prescription drugs, long-term care plans and innovative treatments being provided to patients are all getting better. In general, Americans with HIV and AIDS are living longer and stronger lives. We’ve come a long way in the 25 years since the AIDS epidemic began.

But we’ve so much more work to do to battle the spread of HIV among African-Americans, and particularly among women. The Centers for Disease Control and Prevention reports that nearly half of the more than 1 million Americans living with HIV/AIDS are African-American and that 40 percent of the nearly 563,000 Americans with AIDS who died in 2007 were black.

Among all women in the U.S. living with HIV/AIDS, 64 percent are African-American. In fact, the rate of AIDS diagnosis for African-American women nationwide is 22 times the rate for white women.

This problem is more pronounced in places like Washington, D.C., where the prevalence of HIV and AIDS among African-American women rivals that of Nigeria.

What’s most frustrating about all this is that AIDS is generally preventable through changes in behavior, increased use of safer-sex practices, testing, basic health care and other forms of prevention.

Sadly, too many people — especially African-American women and young people — are not getting the message. According to the CDC, the U.S. has the highest rate of teenage infection in the developed world. Every hour, two Americans between the ages of 13 and 24 contract HIV.

We know that regularly testing those most at risk for HIV — and then providing antiretroviral drugs for HIV/AIDS patients — dramatically reduces the number of people who become infected. Without treatment or education, people will continue to transmit the virus to their partners.

Prevention Challenges

Like other communities, African Americans face a number of risk factors that contribute to the high rates of HIV infection:

• Sexual risk factors include high-risk sexual contact such as unprotected sex with multiple partners or unprotected sex with persons known to have or be at a high risk for HIV infection. People may be unaware of their partner’s sexual risk factors or have incorrectly assessed them.
• Injection drug use may add to the higher rates of infection for African Americans. In addition to being at risk from sharing unclean needles, causal and chronic illegal substance users may be more likely to engage in unprotected sex under the influence of illegal drugs and/or alcohol.
• Sexually transmitted diseases (STDs) continue to be experienced at higher rates within the African American community, more so than any other race/ethnicity in the United States. The presence of certain STDs can significantly increase one’s chances of contracting HIV infection. A person who has both HIV infection and certain STDs has a greater chance of spreading HIV infection to others.
• Lack of awareness of HIV serostatus is risky for African American men and women. In a recent study of men who have sex with men (MSM) in five cities, 46% of the black MSM were HIV-positive and 67% of those men were unaware of their infection.
• Stigma, a “negative social label that identifies people as deviant”, [7] also puts too many African American communities at a high risk of infection. Any behavior deemed deviant (i.e. MSM) has been highly stigmatized. Many at risk for HIV infection fear stigma more than knowing their status, choosing instead to hide their high-risk behavior rather than seek counseling and testing. Therefore they continue to be at risk and may infect others.
• The socioeconomic issues associated with poverty, including limited access to high quality healthcare, housing and HIV prevention education may directly or indirectly increase the risk factors for HIV infection.

Preventing HIV is not complicated. If you’re sexually active, get tested. Don’t use IV drugs or share needles. Abstain or practice safer sex. With preventive care, you and your health-care provider can fight and manage this disease and slow its spread.

Perhaps the best advice is to get educated. Don’t be shy about discussing these issues. It’s better to talk about sensitive subjects with someone you trust than to let a lack of information threaten your life.

For more information, visit www.worldAIDSday.org.

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