Although African Americans represent one eighth of the U.S. population, they make up half of the people living with HIV in the country, according to the Los Angeles-based Black AIDS Institute's 2008 report Left Behind - Black America: A Neglected Priority in the Global AIDS Epidemic." An African American woman is 23 times more likely to get infected with HIV than a Caucasian woman. And the overwhelming risk for black women is unprotected sex with men.
The reasons why African Americans are so burdened with HIV are complicated, says doctor Edward Machtinger, director of the Women's HIV Program at UCSF. The high rate of incarceration of African American men plays an important role, with men carrying HIV back to their female partners when they get out of prison.
HIV/AIDS is a disease of poverty. "Sexually transmitted diseases, in general, disproportionately afflict the poor," says Ruth Greenblatt, who is the founder of the Women's HIV Program and the principal investigator of the Northern California site of the Women's Interagency HIV Study. "If you have poor access to health care, you're less likely to see a doctor early on in your HIV infection, and thus you may be more likely to transmit infection, and you may be less likely to be able to afford condoms and medication."
HIV is now the leading cause of death for African American women between 24 and 35 years old. "Women tend to get sicker and die faster and more often than their male counterparts with HIV," says Machtinger. "One reason is that women don't perceive themselves to be at risk."
In its report, the Black AIDS Institute says that turning the tide is possible, but that it will require better planning and more funding from the federal government, and a stronger commitment from African American leaders. And the report calls for people to get tested. "Knowing your HIV status early can save your life," it concludes.