Human Immunodeficiency Virus (HIV) is believed to be the virus that causes Acquired Immunodeficiency Syndrome (AIDS). Since it was first recognized in 1981 the virus has spread throughout the world, sparing no one – irrespective of race, gender, age or socio-economic status (CDC, 2008).
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Today HIV/AIDS pandemic proceeds to impact black men and women disproportionately across United States. Although these communities constitute a small percentage of U.S population, they account for almost 50 percent of all HIV/AIDS cases detected in 2006(NASTAD, 2008). Black women or rather African American women are more susceptible to HIV/AIDS despite the advancement of treatment that has been experienced in the recent years.
In this light, this paper analyzes the HIV/AIDS pandemic among the black women; detailing how the disease is transmitted. In addition, it shows the recent surveillance carried out on HIV/AIDS, why black women are at risk of being affected and the ways to prevent the disease in black women and all African Americans.
Infection with HIV requires contact with body fluids from an infected person, especially blood, semen and vaginal secretions. All over the world, HIV/AIDS is mainly a sexually transmitted disease (STD). The main mode of HIV transmission is through sexual intercourse between men and women where one partner is infected (Mati, 2007). This mode of transmission is referred to as “heterosexual”. The second most important mode of transmission is from an infected pregnant woman to her child (known as mother-to-child transmission). According to CNN Health (2008) these two ways of transmission account for nearly 98% of all HIV infections.
Other modes of spread of the disease include transfusion with non-screened infected blood, sharing of needles among intravenous drug users, and injections using non-sterilized syringes and needles(in hospitals, doctors offices, clinics or by quacks), skin piercing and other operations(including circumcision) using contaminated equipment.
Black women are the worst hit by the AIDS epidemic; US Centers for Disease Control and Prevention (CDC) estimates that black women accounted for 64 % of women living with the disease at the end of 2006. The reasons for higher infection rates among African American women compared with other women are not fully understood, but are related to the social and economic disadvantages that these category of women face, which makes them especially vulnerable to HIV infection. Black women of childbearing age are especially at greater risk of acquiring HIV infection through heterosexual transmission, which has a bearing not only on the impact of the disease on women themselves, but also on children.
Diagnosis of HIV infection
The diagnosis of HIV infection is mostly based on the presence of anti- HIV antibodies in the blood, and it is also known that it takes several weeks before these antibodies become measurable in blood specimens (Mati, 2007). The period between infection (entry of the virus) and appearance of antibodies in the victim’s blood has been referred to as the “window period”, the length of which ranges between three and four months.
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During this period the commonly used antibody tests cannot detect the virus. Thus, where the antibody test is the only one existing, it is not likely to guarantee the safety of blood for transfusion, before more accurate tests have been carried out. Therefore, in the context of black women HIV diagnosis, Philadelphia Black Women’s Health Project (2002) outlines that black women between the age of 25 and 34 represent the highest rate of HIV diagnosis among women. In light of this, the following section analyzes the HIV/AIDS infection in a broader context.
In the United States, women constitute a greater rate of new HIV/AIDS analysis and deaths caused by the disease. It is reported that the proportion of AIDS diagnosis among women has increased since 1985(Amfar AIDS Research, 2008). CDC report outline that the HIV/AIDS rate among all women had increased from 7% of the whole cases of AIDS in 1985 to a higher percentage of 23% in 1998. Although black women comprise a small percentage of the American population, they were the majority of the 71% women who were tested as people living with AIDS in 2005.
This category of women are believed to have contracted the disease by the means of heterosexual sex(37%) and injection drug usage(44%); however, heterosexual contact constitute a greater risk factor for the transmission of the disease among black women in the present days. CDC surveillance report shows that black women accounted for 66% of women living with HIV/AIDS during the year 2005. Consequently, in the same year, young girls constituted 43% of AIDS cases reported among individuals aged between 13 and 19.
In 2006, black women constituted 64% of women diagnosed with HIV/AIDS although they represent only 12 percent of female population in the US. As illustrated in Chart 1, the higher rate of infection is as a result of heterosexual sex involving infected individuals. In essence, the rate of infection among black women has increased up to 20 times the rate of white women (NASTAD, 2008). As described earlier, high-risk of heterosexual sex and drug injection still remain as the main methods of HIV transmission among the black women, hence making AIDS as the main leading cause of deaths among black women aged 25 to 34.
In the world, women comprise half of all HIV/AIDS diagnosis since most of them are at least twice susceptible to acquire HIV from their male counterparts during heterosexual sex. Biologically, because of the anatomy of women, during sexual intercourse women are exposed longer to potentially infectious semen than men are exposed to female secretions. Vaginal intercourse exposes a larger surface area of the vagina and the cervix, to semen, compared to surface area of male penis exposed to vaginal/cervical secretions (Mati, 2007). In low and middle income states, only few pregnant women are offered the services that prevent mother-to- child transmission.
In addition the women from Sub-Saharan Africa account for 59% of all individuals living with the disease; the HIV prevalence rate for young females aged between 15 and 24 is nearly three times higher than that of their male counterparts.
Factors influencing HIV infection among Black Women
The race and ethnicity are not the risk factors for the infection of HIV among black women. Apart from heterosexual contact, there are other risk factors that make black women susceptible to HIV infection. These factors associated with challenges include the following:
Biological Vulnerabilities and STD prevalence
Heterosexual female’s reproductive nature puts black women at a higher risk of HIV as compared with heterosexual male (The Body, 2008). As a biological fact, a woman is much more susceptible to HIV infection as compared to a man, during sexual intercourse with an infected individual. In addition, STDs increases the likelihood of a person being infected by the disease. These infections include gonorrhea, syphilis, and trichomoniasis. According to CDC, the analysis of 2003-2004 showed that black teenage girls had a higher percentage of sexually transmitted infections as compared to Whites and Mexican Americans; the rate was 4 to 2. This high rate remains at rise since many blacks are perceived to engage in sexual relationships with other blacks.
Due to the imbalance of black men and women in relation to population, many black women are less likely to get married. This implies that African American women have much less interpersonal strength since their male counterparts have many options available to them(Monroe, 2008). In addition, this disparity makes women less likely to discuss condom use with their partners hence the spread of the disease.
Structural barriers and other social influences contribute to the higher rates of HIV prevalence among black women (CNN Health, 2008). Due to poverty, racism, and discrimination many blacks are in despair about the future. Poverty is one of the most risk factor that increases HIV infection; most of young poor black women seem to devalue themselves when engaging in sexual relationships. In addition, the lower rate of employment among this cultural group due to many school dropouts leads to black women being forced to engage themselves in activities that negatively impact their health.
Barriers to Care and Treatment Services
Health care coverage affects the health protection for people living with HIV/AIDS and it is the major factor in access to health. NASTAD (2008) researched that in 2005, 19% of all women were living without insurance coverage in the United States, 10% were insured by Medicaid, 75% were protected through private insurance, employer-based coverage, and other public bodies dealing with health care programs. Through the NASTAD report, health coverage for black women does not provide sufficient resources when it comes to a demanding disease like AIDS; these health insurance are governed by rules and procedures that may hinder an individual from getting proper health care.
Drug injection is another major leading cause of HIV prevalence among black men and women (Monroe, 2008). This implies that, there is a higher risk of sharing needles which leads to unethical behaviors, such as unprotected sex. More so, the use of drugs affects the rate of achieving proper treatment. Therefore, women infected with HIV as a result of drug use do not take into consideration the prescribed antiretroviral medicines, as compared to those who do not use drugs.
Lack of Awareness
Lack of knowledge about an individual’s HIV status is very risky for black women. Some women may be having no knowledge about the health status of their male partners when engaging in unprotected sex or even drug injection (CDC, 2008). Men who involve themselves in sexual relationships with other men can acquire HIV and later transmit it to their female partners. The research shows that, in 2003 many black men who were infected with HIV engaged in sexual activities with other men and their women counterparts. Thus, because of unawareness of their partner’s bisexual activities, black women are more susceptible to HIV infection.
The more an individual know about the HIV/AIDS disease and the way it is transmitted, the more he/she can take steps to avoid being infected. At the outset one must appreciate that HIV/AIDS is not a disease of certain classes of people, that it spares no one, and therefore one need not be ashamed about it with friends and especially with his/her doctor. In essence, the CDC report for the year 2006 estimates that 56, 300 new HIV infections occurred in the U.S, and co many of the reported cases showed that black women constituted a greater percentage. The government resources must be properly used to reduce the rate of infection among the black women; this is not a fight for CDC alone (NASTAD, 2008).
In its plight to reduce the chances of HIV infection especially among the black women, the CDC initiated a new program known as Advancing HIV Prevention (2003). The initiative comprises of the following four strategies: HIV testing is to be made a routine health care, putting in place new techniques for diagnosing HIV infections, working together with people living with AIDS and other partners, and making proper arrangement to decrease mother-to-child HIV transmission during pregnancy. Consequently, CDC is involved in funding projects that deal with the HIV/AIDS pandemic. These organizations include Access Community Network (in Illinois) and The Orange Bar Foundation (in California).
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The general conclusion that can be derived from this analysis is that black women are more susceptible to HIV infection as compared to other women, this call for the need of proper measures to avoid the disease imbalance among the group. However, there are several challenges that make black women more vulnerable to HIV/AIDS. These include the biological vulnerabilities, relationship dynamics, socioeconomic barriers, barrier to health care and treatment services, drug injection, and lack of awareness.
Therefore, information, communication, and education intervention need to go beyond raising general awareness of HIV/AIDS. Such interventions must incorporate specific aspects of HIV/AIDS that have implications for prevention and AIDS treatment. Messages that focus on HIV prevention methods and misconceptions about HIV transmission should be strengthened in view of the low levels of comprehensive knowledge of HIV/AIDS among black women.
Amfar AIDS Research (2008). Statistics: Women and HIV/AIDS. Web.
CDC: Centers for Disease Control and Prevention. (2008). HIV/AIDS among Women. 1-7. Web.
CDC: Centers for Disease Control and Prevention. (2008). HIV/AIDS Surveillance Report, 2006. 18. 1-54. Atlanta: U.S Department of Health and Human Services. Web.
CNN Health. (2008). Report: Black U.S AIDS rates rival some African Nations. Web.
Mati, J.K.G (2007). My Health my Concern, A Woman’s Guide to Sexual and Reproductive Health. Nairobi: IRBHTR Occasional Publications.
Monroe, I. (2008). This Era of Black Women and HIV/AIDS. Web.
NASTAD. (2008). African American Women. The Landscape of HIV/AIDS among African American Women in the United States. (1). Web.
Philadelphia Black Women’s Health Project. (2002). African American Women and HIV/AIDS. Web.
The Body. (2008). HIV/AIDS among African Americans. Web.