Till Death Do Us Part: Lived Experiences of HIV-Positive Married African American Women

Article excerpt

The HIV/AIDS epidemic continues to take its toll throughout the U.S., particularly within the African American community (Centers for Disease Control and Prevention [CDC], 2008b). A prime example of the HIV/AIDS devastation would be the nation's capital, Washington D.C. It is now estimated that three percent of all residents in the District of Columbia are living with HIV/AIDS; the highest burden of disease is found among African American males at a rate of 6.5% (District of Columbia, Department of Health, 2008). Moreover, the estimates of HIV prevalence among African Americans are strikingly similar to, and in some cases exceed, population-based estimates of HIV seroprevalence among adults, ages 15-49 years, reported by several countries in sub-Sahara African, Asia, and the Caribbean (UNAIDS & World Health Organization [WHO], 2007). At the end of 2006, there were approximately 1.1 million people living with HIV infection in the United States, of which 46% were African American (CDC, 2008b).

Recent U.S. incidence data show that the rate of HIV infection is seven times higher among African Americans than it is among Whites (Hall et al., 2008). HIV/AIDS have hit the African American community the hardest and longest. Although African Americans only accounted for about 13% of the U.S. population in 2006, they accounted for 46% of new infections that year alone (Sutton et al., 2009). African American men and women bear the disproportionate burden of new HIV/AIDS cases.

Despite advances in prevention and treatment of HIV/AIDS, women continue to suffer from this disease at increasingly alarming rates (Armistead, Morse, Forehand, Morse, & Clark, 1999). In the U.S. in 2006, African American women had an incidence rate that was 15 times higher than that of White women and nearly four times higher than that of Hispanic women (CDC, 2008a).

African American women continue to be disproportionately affected by the HIV and AIDS epidemic over time and across circumstances. This disparity has been observed throughout the course of the U.S. epidemic (Hader, Smith, Moore, & Holmberg, 2001). Recent data suggest that African American women represent a disproportionate number (65%) of the total number of women currently living with HIV/AIDS (The Henry J. Kaiser Family Foundation, 2009). In general, women between the ages of 18-44 years constitute the fastest growing group of people infected with HIV/AIDS in the United States (O'Leary & Wingood, 2000).

There is a growing concern about morbidity and mortality associated with HIV/AIDS among African American women across the life span. El-Sadr Mayer, and Hodder (2010) note that more than a quarter of new HIV infections in the United States occur in predominantly Black or Hispanic women. However, one in 30 African American women is estimated to be diagnosed with HIV in their lifetime (Sutton et al., 2009) which is commonly transmitted through heterosexual behavior. Although only 12% of the women in the U.S. are African Americans, 67% of the U.S. women diagnosed with AIDS in 2004 were African American (CDC, 2005). The estimated rates continue to be alarming. Recent research proffers that HIV was the third leading cause of death for African American women between 25 and 34 years of age (National Alliance of State and Territorial AIDS Directors, 2008).

The lives of HIV-positive African American women are complex and unique. HIV/AIDS forces women to incorporate their diagnosis, treatment, and psychosocial factors into their day-to-day life responsibilities as well as experiences. As such, women are often the gatekeepers of care in a family. HIV/AIDS has significantly increased the burden of care for many women. Lack of social support combined with HIV/AIDS has turned the care burden for HIV-positive women into a crisis with far reaching health, economic and social consequences. It is critical to understand the influence of social support on marriage and its relations to medication adherence for married HIV-positive African American women. …