Poor black women at greater HIV risk; Survey describes lack of choices

Originally published in The Atlanta Journal-Constitution February 4, 2005 

Copyright 2005 The Atlanta Journal-Constitution  

By: DAVID WAHLBERG


African-American women with HIV are more likely to be poor and unemployed than sexually active black women without HIV, says a survey released Thursday by federal health officials.

Black women with HIV, the virus that causes AIDS, also report having trouble saying no to sex or demanding the use of condoms because they are financially and emotionally dependent on men, the survey found.

"They didn't feel like they had a lot of choices or room to negotiate," said Dr. Peter Leone of the University of North Carolina, who led the study.

"That's what we see all the time," said Dazon Dixon Diallo, chief executive officer of SisterLove, an HIV prevention organization in Atlanta that works to help black women. "We're willing to do whatever it takes, even putting ourselves at risk, to make our partners happy."

North Carolina health officials examining HIV trends in that state conducted the survey, released Thursday by the Centers for Disease Control and Prevention in its weekly report on disease.

A study last year by the North Carolina researchers uncovered an increase in reported HIV cases among black male college students in the state.

About 40 percent of those surveyed said they had sex with both men and women, potentially putting women unknowingly at risk. Health officials said the same trend is probably occurring in Georgia and elsewhere.

Nationwide, the CDC says, more than half of new HIV/AIDS cases are among blacks, who make up 13 percent of the population. Black men are seven times more likely to be infected than white men, and black women are 18 times more likely to carry the virus than white women.

Among women in Georgia, blacks account for about 90 percent of AIDS cases, state health officials said.

The North Carolina researchers surveyed black women ages 18 to 40 to discover which factors put them most at risk for HIV.

They interviewed 31 women with newly acquired HIV and 101 women who were sexually active but HIV negative.

Those with HIV were more likely to be on public assistance, have no job, have many sex partners, receive money for sex and use crack cocaine. They were also much more likely to have herpes, another sexually transmitted disease, which may make genital tissues more susceptible to HIV.

Perhaps most strikingly, more than half the women with HIV said they hadn't thought they were at high risk of becoming infected.

"HIV is still very much pegged as somebody else's disease," Leone said. "They view themselves and their male partners as only hetero- sexual."

Of the six HIV-positive male sex partners identified by the women who agreed to be interviewed, three had previously acknowledged --- anonymously, in state records --- that they had also had sex with men. In the interviews, only one acknowledged it, Leone said.

That denial, which some African-Americans call living "on the down low," mirrors what was found in the larger study of college students, Leone said.

None of the women or men interviewed said they used injection drugs, the main way HIV is transmitted besides sex.

Leone said reducing HIV in black women is difficult because the problem stems from so many factors. "It's about economics, marginalization, racism and sexism," he said.

At SisterLove, which is partly funded by the CDC, women gather for "healthy love" parties to discuss HIV, condoms and self-empowerment, Diallo said.

"We tell them they are entitled to practice safer behaviors, not that they are bad people if they don't," she said.