By Belle Taylor-McGhee
Monday, August 13, 2012
High rates of HIV infection among black women defy the upbeat attitude of the latest global HIV/AIDS gathering. Health reform offers considerable promise, but some key provisions are unlikely in southern states where they are needed most.
Credit: Andy McCarthy UK on Flickr, under Creative Commons (CC BY-NC 2.0).
(WOMENSENEWS)--The ceremonies for the 2012 International AIDS Conference in Washington, D.C., just ended on a high note: Together, we can end the HIV/AIDS epidemic.
But now that the curtains are drawn and the United States no longer has the world stage, the country faces an inescapable backdrop with an inescapable hue. And that hue is black.
Throughout last month's International AIDS Conference, HIV advocates highlighted the enormous disparities afflicting U.S. women of color, for whom HIV infection rates are skyrocketing and reaching levels similar to those of sub-Saharan Africa.
The latest HIV data from the Atlanta-based Centers for Disease Control and Prevention indicated that in 2009 black women accounted for nearly 30 percent of the estimated new HIV infections among all blacks. And although blacks represented only 14 percent of the U.S. population, blacks overall accounted for 44 percent of all new HIV infections in that same year.
Additionally, the rate of new HIV infections among black women was 15 times that of white women and over three times the rate among Hispanic/Latina women.
In the nation's capital, where the 2012 conference was held, officials cited data showing that 90 percent of all women with HIV are black, with the burden falling mainly on heterosexual women.
Everyone agrees these numbers are disturbing, so what do we do about it?
"If we can stop HIV, we can stop AIDS," says Dazon Dixon Diallo, head of SisterLove, Inc., a women's HIV/AIDS organization based in Atlanta and a member of an awareness campaign focused on women.
Called the "30 for 30 Campaign," organizers are using it to call attention to the 30-year U.S. AIDS epidemic and the growing number of HIV-positive women who represent nearly 30 percent of those with HIV/AIDS in this country, and even more in some states.
The 30 for 30 Campaign takes the view that gender inequality drives HIV given the disproportionate number of HIV-positive women, including transgender women, who face barriers in accessing HIV prevention and treatment care, as well as those who suffer violence and stigmatization because of their HIV status.
Diallo says if the United States intends to end HIV among U.S. women–and among African American women in particular–policy makers must address social determinants that make women vulnerable to infection.
Those determinants include access to housing and gender-sensitive care, lack of control over financial resources, as well as gender-based violence that disproportionately afflicts poor women, women of color and transgender women.
C. Virginia Fields is president and CEO of the National Black Leadership Commission on AIDS, Inc., based in New York, and chair of the 30 for 30 Campaign. She says health reform--the Patient Protection and Affordable Care Act--addresses these disparities and offers solutions that are detailed in a recently published guide by the campaign, in collaboration with the Harvard Law School Center for Health Law and Policy Innovation.
The report calls for routine HIV testing as part of comprehensive reproductive health care. It also calls for domestic-violence screening and assistance that relates to HIV prevention with a threatening sexual partner.
"Moreover," says Fields, "it calls on states to expand Medicaid so that poor women, women of color and transgender women can get the HIV care they need."
But that expansion is under political threat.
At least six Republican governors in Florida, Texas, Mississippi, Wisconsin, Louisiana and South Carolina have said they will opt out of the health care law's Medicaid expansion program even though the federal government would foot the bill.
Five of those states—every one except Wisconsin--also have some of the highest rates of HIV and some of the nation's poorest residents.
Harvard Law Professor Robert Greenwald, co-author of the guide on health reform's promise for HIV prevention, says advocates will have to convince those states that the public health and fiscal benefits far outweigh any political party loyalties that have pitted Republicans against health care reform.
"The Supreme Court has spoken and the law is constitutional in all respects. It's smart economically for states to invest now in treatment and prevention for persons living with or at risk for HIV," says Greenwald.
Belle Taylor-McGhee is a freelance journalist based in San Francisco. She is also a health commissioner for the city and county of San Francisco.
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