By Cynthia Davis, MPH, Assistant Professor, College of Medicine, Charles R. Drew University of Medicine and Science and Board Chair, AIDS Healthcare Foundation.
The Centers for Disease Control and Prevention (CDC) currently estimates that there are approximately 1.2 million people living with HIV/AIDS in the U.S. Of these people living with HIV/AIDS (PLWHAs), close to 50% (498,400) are African Americans.* In the early days of the HIV/AIDS epidemic the U.S., HIV/AIDS was an automatic death sentence. However, with the development of highly active antiretroviral medications (ARVs) in the mid-90s, individuals with HIV/AIDS are now living longer lives and maintaining healthier lives. African Americans have been disproportionately affected by HIV/AIDS since the inception of the U.S. epidemic. Though African Americans only represent 12% of the U.S. population, they account for 44% of new HIV diagnoses, 40% of PLWHAs, and 44% of HIV/AIDS-related deaths.
In 1986, five years after the first cases of HIV/AIDS were reported to the CDC, women only represented 7% of new HIV cases. By 1997, that number had increased to 25% of new HIV cases and in 2014, women represented 30% of new HIV cases. In lieu of the fact that HIV incidence (e.g., number of new cases) among African American women declined by 42% between 2005 and 2014, the rates of HIV infection among African American women in 2012 was 20 times the rate of HIV infection among Caucasian women and 5 times the rate among Latinas.
Women’s primary mode of acquisition of HIV is due to unprotected heterosexual sex. Because health care providers and community advocates working in the HIV/AIDS field do not have a handle on slowing the spread of HIV infection among all at risk populations in the African American community including men who have sex with men, transwomen, youth, substance misusers, and injection drug users, it is imperative that anyone who is sexually active needs to know their HIV status. Currently, the CDC recommends that all individuals aged 14 to 64 should take an annual HIV test. HIV is no longer a death sentence as in the early 80s and 90s and women living with HIV/AIDS can have children who are not HIV infected, if taking HIV medications during their pregnancy. There are a number of co-factors which can increase one’s risk for acquiring HIV and other Sexually Transmitted Infections (STIs) including living in poverty, lack of access to health care, homelessness, substance abuse, history of incarceration, history of childhood sexual abuse, history of intimate partner violence, having multiple sexual partners, not using condoms consistently and correctly and having concurrent sexual partners.
In order to slow the spread of HIV among African American women and girls, there are several things that sexually active women and girls can do: 1. Get the facts about HIV/AIDS and other STIs and stay educated and informed, 2. Take an annual HIV test. There are HIV antibody tests available today called “HIV Rapid” tests which are 99% accurate as well as non-invasive and you can get your HIV test results in 1 to 20 minutes, 3. Don’t mix drugs and alcohol when having sex, 4. Always use protection with a male or female condom, 5. If you have an STI, seek immediate medical treatment and let your partner or partners know, so that they can also get screened and treated, 6. If you are HIV infected, seek immediate medical treatment and care and most importantly, take your medications in order to maintain a “low viral load”, which is the amount of viral particles circulating in the blood stream; the lower the viral load, the less infectious an HIV positive person is, and 7. Seek ongoing psychological support. HIV positive people still experience discrimination, and there is still a great amount of stigma, shame and fear associated with HIV/AIDS.
As it’s been said that “women hold up half the sky”, it is important that we as women of color stay educated, stay empowered, take control of our health and know our status. For more information on where to go in your community to get a 1 minute, free, rapid HIV test, visit freehivtest.net.
*(Source: Kaiser Family Foundation fact sheet, 2/2017)
**(Source: CDC, fact sheet 2012)