Rev Irene Monroe

This era of black women and HIV/AIDS

Filed By Rev Irene Monroe | December 04, 2007 1:16 PM | comments

Filed in: Living
Tags: African-American, black church, black women, government, HIV/AIDS, race relations, racism, sexism, women's rights

Black women are dying of AIDS, and is anyone doing anything about it?

With last week commemorating the 19th Anniversary of World AIDS Day and the United Nation's AIDS - fighting agency overestimating the global impact of the epidemic by six million people, we would think we’ve seen the worst of this pandemic.

Not quite!

Are these statistics overwhelming?

Right here in the nation’s capitol, the HIV/AIDS epidemic rivals that of many Third World countries. Washington D.C. (affectionately dubbed as “Chocolate City”) is approximately 60 percent of people of African descent. One in 20 of it’s residents is thought to have HIV, and 1 in 50 of its residents to have AIDS. Of the 3,269 HIV cases identified between 2001 and 2006 who tested positive nine out of 10 were African American.

“The Washington data is really a microcosm of what we already know: that AIDS in America today is a black disease,” said Phil Wilson, founder of the Black AIDS Institute, an HIV/AIDS think tank that focuses exclusively on AIDS among black Americans.

According to the U.S. Centers for Disease Control and Prevention, African Americans account for half of all new HIV cases despite comprising 13 percent of the U.S. population. Equally alarming is that HIV/AIDS is the leading cause of death for African American women between the ages of 25 and 44.

At the “Women and Response to AIDS” panel at the at the 16th International AIDS Conference in Toronto in 2006, Sheila Johnson, founder of the Crump-Johnson Foundation in Washington D.C., pointed out that another at-risk population in the African American community is teenage girls.

Seventeen percent of the U.S. teen population is African American. In 2004, 70 percent of all teens testing HIV-positive were black. One in 10 African American teenage girls test HIV-positive in the nation’s capital, the highest percentage in the country among this age group.

When asked why such a high percentage test positive, Johnson said, “As long as girls see themselves as glorified sex objects in hip-hop videos, HIV/AIDS will increase within this population.”

These statistics overwhelming?! So too is the failure of leadership African Americans have faced since the epidemic began.

No group of women is as affected

No group of women is as affected by the failure of leadership in this country than women of African descent.

American women and their struggle against the AIDS epidemic was never so glaringly obvious than in the 2004 vice presidential debate between Dick Cheney and John Edwards.

The invisibility of my group's plight has less to do with African-American women's agencies to combat the epidemic than with how the government, African-American men, the black church, and race and gender biases inherent in the problem collude with African-American women's efforts to get help.

Gwen Ifill, an African-American female journalist with PBS' "Washington Week" and moderator of the vice presidential debate, brought the issue of AIDS in the U.S. front and center when she asked the men to comment on its devastating impact on African-American women.

"I want to talk to you about AIDS, and not about AIDS in China or Africa, but AIDS right here in this country, where black women between the ages of 25 and 44 are 13 times more likely to die of the disease than their counterparts. What should the government's role be in helping to end the growth of this epidemic?" Ifill asked.

Vice President Cheney responded to Ifill's question by saying, "Here in the United States, we've made significant progress. I have not heard those numbers with respect to African-American women. I was not aware that it was - that they're in epidemic there."

But Edwards' response wasn't any better. Edwards deflected the question by first going back to answering the previous question. Then with the remaining seconds left, he flubbed his way through.

However, three years later at this June’s democratic primary debate at Howard University that focused on African American issues ranging from health care and housing to Katrina relief, the economy and the environment, black women stood on their feet as they applauded Sen. Hillary Clinton’s comment about the impact of HIV/AIDS on African American women.

"Let me just put this in perspective: If HIV-AIDS were the leading cause of death of white women between the ages of 25 and 34 there would be an outraged outcry in this country."

When the color of the epidemic shifted from white to black, the inherent gender bias focused only on the needs of African-American men and rendered women invisible. When gender became a new lens to track the epidemic, white women were the focus.

The invisibility of African-American women in this epidemic has much to do with how the absence of a gendered race analysis makes African-American women invisible to the larger society.

What is also unnerving is that today African American women make up 60 percent of all AIDS cases reported among women, 64 percent of new AIDS cases among women, and are three times the number of new cases reported among white women.

Naming what is responsible

Many African-American women with HIV contracted it from heterosexual sex. Two ways that the virus is contracted heterosexually is through intravenous drug use and African-American men "on the down low."

Men living on the DL is not a new phenomenon in the African-American community. Naming it, however, is. And it was J.L. King who became the country's poster boy by exposing the behavior in his best-seller, On The Down Low: A Journey into the Lives of "Straight" Black Men Who Sleep with Men.

"There are many women, too many women, in relationships with men who they think they know but really don't. He knew he had the disease, his mother knew he had the disease, his doctors knew, everyone seemed to know except me. And no one said a word," LaJoyce Brookshire, author of Faith Under Fire: Betrayed by a Thing Called Love, wrote in the foreword of Browder's book.

While homophobic attitudes in the larger African-American community and church contribute to their behavior, African-American men are also not taking responsibility for how their behavior is killing African-American women, and putting the entire community at risk.

The disparities within the healthcare system also contribute to the disproportionately higher number of HIV cases among African-American women. This directly affects their quality of life and the spread of HIV.

While health disparities in the black community are overwhelming, so too is the failure of leadership African Americans have faced since the epidemic began. Phil Wilson states it plainly:

“I think it’s important for us to take just a moment to realize that we are where we are today because we weren’t concerned when we thought it was somebody else’s disease.”

However, the disease has also taught us about the various faces - across race, class and gender - who wore and continue to wear the face of this disease.

When The New York Native, a now-defunct gay newspaper first reported on a virus found in gay men then known as GRID (Gay-Related Immune Deficiency)in 1981, an editorial noted that "even if the disease first became apparent in gay men, it is not just 'a gay disease.'" And HIV/AIDS, having neither an alliance to nor an affinity for queer sexualities, spread.

Where would the leadership on HIV/AIDS come from?

Let’s confront the elephant in the black community by telling the truth and shaming the devil. The biggest problem that black lawmakers have had to confront concerning the HIV/AIDS crisis in their communities is the political gag order imposed on them by their voting constituency’s homophobia and animus toward any discussion of the disease.

Women with AIDS are as unwelcome in the black church as LGBT people. Within black nationalist milieus like the black church and the Nation of Islam espousing "Save the endangered black family!", African-American women with AIDS are also viewed as race traitors.

By believing that women are to multiply and bring forth new life for the perpetuation of the race, women with AIDS lose their status in the community. Often labeled as "loose" for having contracted the virus, she is viewed now as not only diseased but also dangerous because she could spread the disease.

The feminization of this disease makes many AIDS activists and scholars wonder if the same amount of money, concern, communication, and moral outrage that was put into white gay men with the disease will be put into curbing its spread among black women.

"What do we need to know to provide better HIV and AIDS prevention services to African-American women?" Dr. Gerri Outlaw, an African-American lesbian and chair of the Department of Social Work at Governors State University in Illinois asked in 2005. Her question led to setting up the pilot project "Women Making Meaning of HIV and AIDS in Economically Marginal African-American Communities: Implications for Community-Based Education."

Recognizing the paucity of funds and prevention strategies targeted to African-American women with HIV/AIDS, Outlaw stated she "wanted to examine community-based approaches to HIV/AIDS prevention and education for black women. Few if any services were on the west side of Chicago and women had to go to white gay areas to get services, and the treatment and prevention services were not for women, period."

The AIDS epidemic among African-American women is also symptomatic of the dialogue we need to have about our bodies and sexuality, which has been choked for centuries by a "politic of silence."

In aiming to break to "politic of silence" with her pilot project. Outlaw began interviewing mothers, daughters and grandmothers to access the beliefs, attitudes, experiences and perceptions of HIV/AIDS among ordinary African-American women.

"I began to talk to women about how they learned about sex in the first place. I asked what role mothers and daughters play in communication about sex. I wanted to know how much young women learned from their mothers, and I wanted to know whether others were having conversations without their daughters in light of HIV and AIDS."

Breaking the silence

Having a conversation is hard, especially for young women.

“Many of us sistas find talking about sex difficult. Our partners may get angry or defensive. They sometimes feel that we are accusing them of something or that we don't trust them. Talking is especially hard when a young woman has an older partner because the older partner tends to have more power in the relationship," an African American young woman told me anonymously.

"Often, we look to the older partner for information about protection against pregnancy and HIV and may get wrong information. An older partner usually has more sexual experience and is more likely than the younger partner to have prior experience with illegal substances. Both of these factors increase the older partner's risk of being infected with HIV and put the younger partner at risk.”

The suffering can stop by breaking the silence with SISTA (Sisters Informing Sisters About Topics on AIDS), an intervention program that helps African American women reduce their risky sexual behaviors, and WILLOW (Women Involved in Life Learning from Other Women), an intervention program for women living with HIV.

It's a silence we need to shatter.

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What continues to baffle me is why there is such a marked difference between the infection rates of African American women (versus the quality of treatment they receive) relative to white women, especially as relates to young women.

I don't doubt that any of this is true, but I just don't see the issues around safe sex practices, learning from parents, community programs, etc., being that much more available for young white women, especially underage girls. Perhaps that's because I'm from the South, where infection rates and pregnancy rates are generally higher than in other parts of the country, if I'm not mistaken.

I guess what I'm asking, if anyone has seen this information, is what the concrete differences are between these two groups (and others, for that matter, along racial/ethnic lines). We can all assume what the differences are, especially around quality of treatment, and probably be on the right path. But is there research on this to spell it out?

Thanks for a very important post, Rev. Irene. While we've highlighted the plight of the African-American LGBT community as it relates to the rich white marriage focus, but no one had blogged about women - whether gay or straight.

It's an important discussion.

This is a wonderful post and so very important. Thanks for posting!