Black Womens' HIV Rates Lopsided, Researcher Says

ATLANTA -- Only a quarter of Americans newly diagnosed with HIV are women, researchers said Tuesday, but a significant majority of women who are diagnosed are black, living in the South and facing entrenched social ills: poverty, racism, segregation and the imprisonment of many black men.

"The social and economic environment influences sexual behaviors," said Dr. Adaora Adimora of the University of North Carolina at Chapel Hill, who spoke at the Centers for Disease Control and Prevention's 2005 National HIV Prevention Conference in Atlanta, which continues today.

"The racial disparity in HIV rates in the United States is a major human rights issue, and it needs to be approached as one," Adimora said.

In recent years, diagnoses of HIV, the virus that causes AIDS, have decreased slightly in women overall and increased slightly in men. But the racial gap remains much more pronounced in females: black women were 18 times more likely to be diagnosed with HIV in 2003 than white women; Hispanic women were four times more likely to receive such a diagnosis.

And, while in the mid-1980s most women who contracted HIV did so through intravenous drug use, today more than 70 percent report being infected through unsafe sex with men.

Many of the women with HIV today live in the South. In 1999-2003, women in Southern states, constituting just 29 percent of the U.S. female population, accounted for 76 percent of new HIV cases, according to the CDC.

Researchers say the reasons that women, especially minorities, contract HIV are complicated. A study last year of black women in North Carolina showed that those with HIV were more likely than high-risk women without HIV to have no job, be on public assistance, have many sex partners, receive money for sex and use crack cocaine.

The combination of such broad socioeconomic factors makes it difficult for many HIV prevention progams to reach such women, said Dr. Lisa Fitzpatrick of the CDC's HIV division, who helped conduct the study. "Clearly, this is a marathon, not a sprint," she said.

In a similar North Carolina study by Adimora, many black women said economic and racial oppression contributed to their risky sexual behavior. Another factor was the shortage of available black men, in part because many are in prison.

Another possible factor contributing to women's HIV risk, research found, was childhood sexual abuse. A study by Dr. Gail Wyatt of the University of California, Los Angeles, found that half of women with HIV reported sexual abuse as children.

"It begins to set a template for women that places them in a powerless position," Wyatt said, leading women to trade sex for financial stability with a man. "You have an agreement that goes down, and you don't talk about condoms in those relationships."

A promising tool in development could allow women to take more control over safer sex: microbicides. Women could apply the anti-HIV gels, creams and vaginal rings before sex, often without their partner knowing.

Twenty-nine experimental microbicides are under study, including five in large clinical trials, said Lori Heise, director of the Global Campaign for Microbicides. A small study of one microbicide, funded by the CDC, is about to start at Emory University's Hope Clinic in Decatur, Ga., on HIV-negative women in monogamous relationships.

David Wahlberg writes for The Atlanta Journal-Constitution.

E-mail: dwahlberg@ajc.com Editor Notes: