AIDS Among U.S. Women Is on the Rise
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In 1989, when a South Carolina hospital offered free tube tying for low-income women, Juanita Williams decided to have the procedure. She didn't know that part of her health screening involved a test for HIV.
"I found out that I was HIV-positive when I was lying on the gurney waiting for surgery," said Williams, a grandmother of three. "The doctor stuck his head in the door and told me they couldn't do the surgery because I had AIDS, and I had to leave the hospital. He pointed my clothes out and pointed to the fire escape. I've been an activist ever since."
Williams was among about 1,000 activists who gathered in Chicago recently for SisterSong's national conference on women of color, sexuality and safety. At a time when HIV and other sexually transmitted infections disproportionately affect African American and Latina women, the gathering stressed the importance of talking openly about sex instead of allowing societal taboos to prevent conversations about risks and safety.
"Everyone is telling us what not to do, but who's telling us what to do?" says Loretta Ross, the national coordinator for Atlanta-based SisterSong, a collective of some 80 organizations focused on reproductive health for women of color. "'Just say no' ain't worked for drugs, sex or politicians."
While men still make up the vast majority of reported HIV-AIDS diagnoses in the United States, the Centers for Disease Control and Prevention reports that diagnoses of women rose 17 percent from 2001 to 2005, with more than 9,800 women diagnosed for the first time in 2005.
Of U.S. women currently living with the virus, about 64 percent are African Americans, and another 15 percent are Latina. HIV-AIDS remains the leading cause of death for African American women aged 25 to 34, and a top-four cause for black women 35 to 54. It's also the fourth-leading cause of death for Latina women 35 to 44. Younger women remain at higher risk and only cancer and heart disease kill more women annually.
Getting the Info to Women
One of the keys to decreasing those numbers is getting good health-care information to women. Religious institutions often provide opportunities for such outreach, says Kate Ott of the Religious Institute on Sexual Morality, Justice and Healing in Norwalk, Conn.
"You have to go to where people are, and they're in churches, synagogues and mosques," Ott says. "Many religious groups do have a broad social-justice framework, and clergy can be allies. Just because somebody's been ordained to do something doesn't mean they always toe the same denominational line."
She tells organizers to identify with supportive clergy and meet with them one on one, and stresses that local grassroots groups can also take pressure off supportive religious institutions. By providing education and resources around sexual health, birth control or domestic violence, groups can reach churchgoers without religious leaders having to educate from the pulpit.
"There's a myth out there that faith communities don't do sexual and reproductive justice work," Ott says. "Every denomination has progressive members who want to work on these issues."
Last week the nation's largest black religious organization, the Nashville, Tenn.-based National Baptist Convention USA, placed AIDS awareness and prevention on the agenda of its annual congress meeting for the first time, signaling a growing concern over the disease among congregations.
Nearly 75 percent of African American women who contract HIV do so through heterosexual sexual activity, as do about 70 percent of Latina women.
New Options for Prevention
While the federal government continues to focus heavily on abstinence education, Bindiya Gillenwater Patel of the Washington-based Global Campaign for Microbicides, says part of talking about prevention is talking about new options.
"Right now our only ways of protecting ourselves are the ABCs: abstaining, being faithful, using a condom," Patel says. "But that doesn't work for all of us. We can't be sure that our partner's going to be faithful or we can't negotiate using a condom ... We need a tool that we can initiate, that we don't have to depend on anybody else for."
One possibility is the female condom, a 6.5-inch sheath with rings on both ends that has proven effective at preventing both pregnancy and sexually transmitted infections. But the item is still fairly new, is not as widely available as other methods, and its average cost nationwide is $2.50.
This summer, a study is examining whether the diaphragm used for birth control can also work to block infections. And then there are microbicides, substances still being researched that would reduce the risk of HIV and other infections when applied to the vagina or rectum before sexual activity.
"It could be a gel, a cream or a vaginal film, or maybe one day a vaginal ring like the Nuva ring," Patel said. "Researchers are looking at products that are both contraceptive and non-contraceptive giving women more options."
Three of those options are furthest along, already undergoing trials, and each attempts to stop the virus from entering healthy cells. Researchers are looking at buffer gels to maintain the vagina's natural acidity, which is too high for HIV to survive, to counteract the presence of semen, which usually turns that natural acidity into a base.
HPV Prompts New Discussions
While those treatments are not expected until 2008 at the earliest, another recently available vaccine prompted its share of discussion at the SisterSong conference. Just as HIV-AIDS remains a particular problem for women of color, so does the human papilloma virus, or HPV.
HPV is actually a group of more than 100 types of virus--with about 30 transmitted by sexual activity--and the primary cause of cervical cancer (as well as genital warts). The highest death rates for cervical cancer come from low-income areas, with African Americans in the South, Native Americans and Appalachian women among those most affected.
While the HPV vaccine has been available nearly a year, Deborah Arindell, vice president of the American Social Health Association, based in Research Triangle Park, N.C., said the lack of access to quality health care often combines with the stigma of sexual transmission to prevent women from getting vaccinated.
She urges activists not only to encourage women to get vaccinated, but to get tested. Most women who have died from the cancer did not have a Pap smear in at least five years. HPV is usually found when Pap tests find abnormal cell changes on the cervix, which then prompt a second test for the virus.
Half the states have debated measures that would vaccinate girls before they enter sixth grade, but some advocacy organizations such as Washington-based Concerned Women for America and religious conservatives have resisted those efforts.
"If it were something we got in our ear, there would be no controversy about it at all," Arindell said. "A lot of what we grapple with HPV is it's caught up in our natural discomfort with talking about sex. But it's just part of being a mammal; it has nothing to do with promiscuity."
Jeff Fleischer is a Chicago-based journalist who has written for publications including Mother Jones, the New Republic, the Sydney Morning Herald, Chicago Magazine and Mental Floss.