HIV infection rate soaring among black women in US
WASHINGTON -- He was, Precious Jackson said, a very fine black man. He was height 6 feet 2 inches tall with an almond-milk complexion, dreamy dark eyes, and a deep voice. During their nearly two years together in Los Angeles, he was the sunshine of her life, even though he had a habit of landing in jail and refused to use a condom when they made love.
''I didn't ask him about his sexual history," Jackson said in a recent interview. ''I asked him if he had been tested, and he said one test came back positive but another one came back negative. I was excited to have this man in my life because I felt I needed this man to validate who I was."
The man is now Jackson's ex-lover, but the two are forever attached by the AIDS virus she contracted from him, becoming, in the process, a part of the nation's fastest-growing group of people with HIV: black women.
That development, epidemiologists say, is attributable to socioeconomic and demographic conditions specific to many African-American communities. Black neighborhoods, they say, are more likely to be plagued by joblessness, poverty, drug use, and a high ratio of women to men, a significant portion of whom cycle in and out of a prison system in which the rate of HIV infection is estimated to be as much as 10 times higher than in the general population.
For black women, the result has been devastating, said Debra Fraser-Howze, founding president and CEO of the National Black Leadership Commission on AIDS.
''We should be very afraid," she said. ''We should be afraid, and we should be planning. What are we going to do when these women get sick? Most of these women don't even know they're HIV-positive. What are we going to do with these children? When women get sick, there is no one left to take care of the family."
In 2003, the rate of new AIDS cases for black women was 20 times that of white women, according to a report by the Centers for Disease Control and Prevention. Black and Hispanic women accounted for 77 percent of all new AIDS infections in 1994. Nine years later, the rate was 85 percent, according to the agency.
That same year, black and Hispanic women made up 83 percent of reported AIDS diagnoses among women, although they represent only 25 percent of all women, according to Fraser-Howze's commission, which is based in New York. AIDS is among the three top causes of death for black women ages 35 to 44.
Reducing HIV infections among black women will involve more than appeals to avoid risky behavior, asking women to remain abstinent, and passing out condoms, said Adaora Adimora, an associate professor of medicine and an adjunct professor of epidemiology at the University of North Carolina at Chapel Hill.
''You also have to eliminate the economic factors that dramatically influence behavior, disease, and risk," she said.
Living conditions are ''critically important" to fueling the spread of the disease, Adimora said. Communities influence ''social networks, partner choices, likelihood of marriage, types of risk behaviors, as well as the consequences of risk behaviors," she said.
Jackson lived in South Los Angeles, formerly known as South Central, a world very much like the ones Adimora has researched. When she found her boyfriend, whom she declined to name for his protection, she said she held on to one of the few men she liked ''no matter what."
The man seemed as honest as he was charming. He told her about his crack-cocaine habit and about his frequent arrests. Looking back, she now wonders whether he picked up another habit in jail, where men have sex with other men, by consent and by force. She wonders whether he was one of the many African-American men who hide their sexual orientation from others in the black community, a conspiracy of silence called the ''down low."
In 1998, Jackson's boyfriend was arrested for drug possession and taken to Los Angeles County Jail, where he had a routine HIV test for inmates entering the system. A short while later, a letter was delivered to Jackson from jail ''telling me he tested positive and that I should get checked out."
Her positive result arrived in May 1998.
''I was 26. I was shocked. I was stunned," said Jackson, who is now an AIDS activist working for a Los Angeles treatment center called Women Alive. ''A lot of emotions went through me. I was sad. I was angry at myself because I got caught up. 'Caught up' meaning I was so into keeping this man at all costs."
Other black women have said they were married to men who hid their gay lifestyles while pretending to be exclusively heterosexual. Fraser-Howze said she has encountered dozens of African-American women who were infected by husbands who were also having gay relationships.
Black gay-rights activists have said that black men are more likely to hide their sexual orientation because the stigma against homosexuality is strong in black communities, particularly in the church.
Studies have indicated that African-American churchgoers are the least likely of all faiths to support gay rights.
A study by the Pew Forum on Religion and Public Life indicated that since 2000, black Protestants have become much less likely than other Protestant groups to believe that gays should have equal rights. Black Protestant support for gay rights dipped to a low of 40 percent last year, down from 65 percent in 1996 and 59 percent in 1992.
Black women are the least likely to be married of all women because most live in communities where men are more scarce, Adimora said.
As black men cycle in and out of jail and prison, black women are torn from relationships and go on to have ''more concurrent relationships," or more than one partner in communities where more people are infected, according to an article, ''Social Context, Sexual Networks, and Racial Disparities in Rates of Sexually Transmitted Infections," written by Adimora and Victor J. Schoenbach, an associate professor at the UNC school of medicine.
