Janell Hill, MD, PhD
When HIV was first recognized in 1981, the face of AIDS was the gay Caucasian male, stigmatizing the gay community as the carriers of this debilitating disease. Over the years, HIV/AIDS has affected everyone from I.V. drug users to babies experiencing their first breaths of life. Recent attention has been given to the increased incidence of HIV/AIDS in the MSM (men who have sex with men) population, a unique challenge compounded by issues already affecting the African-American male in today’s society. However, a new face has emerged alongside the MSM – the heterosexual African-American woman. According to the latest statistics from the Centers for Disease Control (CDC), AIDS (and its related health conditions) is currently the leading cause of death in African-American women age 25-34. African-American women in the U.S. are diagnosed at a rate of nineteen times that of their white counterparts.
In response to these staggering statistics, the CDC has initiated a heightened national response to the HIV/AIDS crisis among African-Americans. The leaders of several national organizations convened to discuss what needs to be done to circumvent this growing epidemic and identified four main areas of focus; 1) expanding the reach of prevention services; 2) increasing opportunities for diagnosing and treating HIV; 3) developing new, effective prevention interventions; and 4) mobilizing broader community action. The HIV/AIDS crisis has gained exposure in popular media as well. It was recently featured as a topic of discussion on The Oprah Winfrey Show, where Oprah was surprised to discover that many HIV positive women contracted the disease when they were in serious, monogamous relationships having unprotected heterosexual sex. One guest stated, “I used condoms with people I was with, but I didn’t use them consistently…and I probably didn’t use them correctly.” Dr. Kimberly Smith, an infectious disease doctor at Chicago’s Rush Medical Center and consultant on the show, pinpointed three important reasons for why she believes infection is on the rise in this population – lack of perception of risk, lack of power in relationships, and the role of substance abuse.
Most African-American women do not believe they are at risk, especially those in monogamous relationships. They tend to reject the notion that their partner could be going outside of the relationship for unprotected sex, homosexual sex or injection drug use. This confidence in relationships leads to inconsistent or nonexistent condom use. This problem illustrates the need for women to empower themselves in the relationship. This not only includes always carrying their own condoms and insisting on HIV and other STD testing before participating in intercourse, but also staying independent in relationships and not reliant upon men for money, housing and/or emotional support. Lastly, some women fall victim to a life of prostitution and drug abuse. When substance abuse becomes a part of their lives, thoughts of practicing safe sex are replaced by the need to obtain drugs, money, and a false sense of power over men by using sex.
Though nationwide interventions are lacking due to a need for increased funding, steps have been taken to implement programs to address these issues. In the area of prevention, there are various social support organizations and outreach programs providing prevention education, including local community-based organizations as well as large AIDS service organizations such as the Magic Johnson Foundation. Sisters Informing Sisters on the Topic of AIDS (SISTA) is a unique program specifically targeted towards African-American women, providing education of both HIV-infected and HIV-negative women. There has been dramatic improvement in increasing opportunities for the diagnosis and treatment of HIV made available through mass HIV testing events, national and international observance days, and government funding of AIDS medications for the underserved and impoverished. So why does the rate of infection continue to rise, especially in the African American community?
There exists a need to focus efforts on reshaping the message and redefining risks by thinking outside of the box. This is where the Student National Medical Association and its members can play a significant role. Members can start by educating themselves on the proper care of HIV/AIDS patients and educating our communities on safe sexual practices, especially the youth of today who will become the adults of tomorrow. Not only will this produce more culturally competent physicians, but it will also develop the skills to treat an underserved, stigmatized population with specific needs. They, like any other population, deserve compassion, respect, and the best care possible. Controlling the crisis through education can take place on several different levels. For example, as a SNMA member and future physician, one could take a few extra minutes to discuss sexual health awareness with a precocious 15 year-old girl during a Pediatrics rotation. An SNMA chapter could organize seminars at local high schools, churches, and community centers. As an SNMA region, members can hold HIV testing for participants and the community. And as an organization, SNMA has the power to truly change the face of HIV/AIDS in the African-American community.
This article first appeared in the Fall 2008 JSNMA, Volume 14, Number 4
Filed Under: Inside SNMA
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