Academic journal article Harvard Journal of African American Public Policy

The Politics of HIV Prevention and Black Women

Academic journal article Harvard Journal of African American Public Policy

The Politics of HIV Prevention and Black Women

Article excerpt

ABSTRACT

Since the beginning of the HIV/AIDS epidemic in the United States, the burden of the disease has been steadily shifting from White males, predominantly in the gay community, to Black females. Because the root causes of the HIV/AIDS epidemic among Black women are multifactorial, approaches to ending the rampant spread of HIV must be multifaceted. There must be a method of HIV protection that women can control, universal access to quality health for early diagnosis and treatment, comprehensive sex education and empowerment programs, and a mass public education campaign about HIV/AIDS, as well as a safe, effective, and affordable preventative HIV vaccine.

The room erupted with enthusiastic outbursts of approval at our debate watch party in reaction to moderator Gwen Ifill's question about AIDS and Black women. Her question was quite specific: "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 45 are 13 times more likely to die of the disease than their counterparts" (Commission on Presidential Debates 2004). Momentarily motionless, hardly breathing, we awaited the responses from the two 2004 vice presidential candidates, only to have our half-hopeful anticipation turn to exasperation. Both Richard Cheney and John Edwards responded in Media Training 101 style, using the opportunity to reiterate other platform messages and avoid the direct question. At the end of his response, incumbent Vice President Cheney returned to the original question with an open admission that he had "not heard those numbers with respect to African American women" (Commission on Presidential Debates 2004). That moment in history was probably the most profound confirmation of what Black health advocates had previously known--the health of Black women does not rank with any priority on the national agenda.

In describing the impact of HIV/AIDS on Black women, it can be said definitively that it is a disease of mass destruction. Since the beginning of the HIV/AIDS epidemic in this country over two decades ago, the disease burden has been steadily shifting from White males, predominantly in the gay community, to Black females. AIDS is the number one cause of death for African American women in their prime childbearing years, ages 25 to 34 (NCHS 2003). Thus, two generations are being impacted simultaneously. It is among the top four causes of death for African American women aged 20 to 54 years (Anderson and Smith 2003). According to the National Institute of Aging, the number of new AIDS cases is growing faster in women over age 40 than in those under 40. And more than half of the new cases of HIV infection in women over 50 are African American (AA 2005). In absolute numbers, more Black men have AIDS than Black women. But the absolute numbers for Black women are rising at a staggering rate. Black women are the fastest-growing population of new cases, accounting for two-thirds (67 percent) of new AIDS cases among women. The rate of AIDS diagnoses for African American women is 25 times the rate for White women. By contrast, the rate of AIDS diagnoses for African American men is 8 times the rate of White men (CDC 2004c).

In the introduction to the Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior, then-Surgeon General David Satcher stressed that the enemy in this epidemic is the virus, not those who are infected with it (OSG 2001). In the absence of a cure for HIV/AIDS, prevention is our greatest weapon against this enemy. The ABC trilogy of HIV prevention has been the recent mantra of the U.S. government for legislation and programs, domestically and internationally (particularly, the A and the B). A refers to abstinence (or delayed sexual initiation among youth), B stands for being faithful (or reduction in the number of sexual partners), and C is for correct and consistent condom use, especially for casual sexual activity and other high risk situations (USAID 2004). …

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