HIV and African American Women

What's the Problem?

African American women are disproportionately affected by HIV. Of all the women living with AIDS in the U.S., 60% are African American and two out of three African American women got HIV from having unprotected sex with a man. In 2002, HIV/AIDS was the number 1 cause of death for African American women aged 25–34 years. Studies show that African Americans are likely to get tested for HIV late in the course of the disease. Late testing results in missed opportunities for prevention and treatment of HIV. This means that by the time many African American women are tested for HIV, they already have AIDS―when it is too late to gain optimal benefits from drug therapy.

Who's at Risk?

Anyone who engages in risky behaviors, such as having unprotected sex (especially with multiple partners) or sharing injection equipment, is at risk of acquiring HIV. Because unprotected heterosexual intercourse is the leading cause of HIV infection for African American women, it is important for African American women to identify risky behavior as unprotected sex with any male partner who has HIV infection or does not know his HIV status.

Can It Be Prevented?

HIV transmission can be prevented. To prevent HIV transmission, a person should

• avoid unprotected sex with a partner who is HIV infected or who does not know his or her HIV status,
• use condoms with male partners during every sexual act,
• practice monogamy (that is, have sex with only one partner who has sex with only him/her) or abstain from sex, and
• avoid sharing injection equipment.

By getting tested and learning their HIV status, women can take responsibility for their own health and reduce the likelihood that they will acquire HIV infection. Additionally, research shows that persons who are aware that they are infected with HIV are more likely to reduce risky behaviors, thereby reducing overall rates of HIV transmission.

The Bottom Line

• HIV disproportionately affects African American women.
• HIV testing and counseling are essential for African American women who have risky behaviors, regardless of age, socioeconomic status, or sexual orientation.
• Women need to communicate openly and clearly with their partners to assess their risk for acquiring HIV.
• Partners must act responsibly (for example, use condoms during every sex act, not share injection equipment) to avoid HIV transmission, especially if one partner has HIV risk factors (for example, injects drugs, has multiple sex partners, or is a man who has sex with men).
• Diagnosing HIV early can often delay the onset of AIDS for many years if the HIV-infected person has access to medications and uses them as directed.

Case Examples

1. Natasha, a 30-year-old African American woman, meets a group of girlfriends every month for dinner. During dinner conversation, a woman mentions that her friend Michael recently found out he was infected with HIV and that he confided he'd had a sexual encounter with another man who tested positive for the virus. Natasha is shocked—she dated Michael for a few months during the previous year. While they were dating, they had open conversations about their past relationships. She never had a reason to think he was bisexual and had recently heard he was engaged to be married. The next day, Natasha gets tested for HIV. She is relieved to find out that she is HIV-negative and vows to never have unprotected sex again, regardless of how well she thinks she knows her partner. She volunteers for a new program at her church to educate women on the importance of partner communication and HIV testing.
2. Evelyn is a 23-year-old African American woman and mother of a 4-year-old son. Earlier in the year, she was diagnosed with an STD. During a follow-up visit to the local health clinic she finds out she is also infected with HIV. Devastated, she realizes that she must have been infected through sex with Trey, a guy she used to date from her old neighborhood who refused to wear condoms. Trey used to tell her that by not using condoms, he felt more connected to Evelyn. Not wanting to risk losing Trey, Evelyn often consented to having sex without condoms. Evelyn confronts Trey about her diagnosis and suggests that he get tested for HIV as well. He reluctantly agrees and goes to the clinic to get an HIV test. He is told he is infected with HIV. Suspecting that some of her girlfriends from her neighborhood may have also had sexual encounters with Trey, she urges each of them to be tested for HIV. Through their social circle, two of Evelyn's friends discover that they have unknowingly been living with HIV.

Spanish Version of HIV and African American Women [PDF – 220K]