This post is 4 of 4 in Women with a Vision’s series on HIV/AIDS in honor of the 21st annual AIDS Education Month, developed by Philadelphia FIGHT!
The narrative around HIV/AIDS, like many surrounding oppression, centers men at the expense of women and their experiences. Since the narrative of HIV/AIDS (from the start) generally focuses on white, gay men, people on the other side of the spectrum, Black women are often overlooked.
In the United States, roughly 25% of people living with HIV are women, and the overwhelming majority of those diagnoses are the result of heterosexual contact (84%). This is because in heterosexual couples, the risk of getting HIV from a partner is significantly higher for women than men because of how the virus is transmitted.
The most salient problem with women who contract HIV is that they aren’t able to get the care they need to keep the virus under control, even when they are diagnosed. Of the women who have HIV, 88% know they have it (a higher rate than men – this is partially due to the fact that straight women often have more interactions with doctors like gynecologists where their
sexual health is checked and testing is available). In 2011, only 45% of diagnosed women were receiving care, and only 32% of women who were diagnosed had the virus under control.
When taking race and gender into consideration, Black heterosexual women have the highest transmission rate, although that number is decreasing. In 2010, they accounted for 64% of new HIV diagnoses among women, as well as representing the 4th highest transmission sub-category after white men who have sex with men (MSM), Black MSM, and Latino/Hispanic MSM. They are followed by white heterosexual women and then Latina/Hispanic women.
Queer women are almost never mentioned in these statistics because according to the CDC, there has been no confirmed case of female to female HIV transmission. However, this does not mean that there are not lesbians and bisexual women living with HIV. These women are either injection drug users themselves, or have sexual histories with HIV positive men. Their erasure shows the necessity of centering women, especially multiply marginalized women, at the center of conversations about HIV/AIDS.
Black heterosexual women are one of the highest risk categories for contracting HIV, even when they don’t have any of the normal risk factors (these risk factors include intravenous drug use, having multiple sexual partners, not using condoms, and being a man who has sex with men). Women are also more likely to face violence from a partner when suggesting condom use, especially if it is not a new partner but rather a long term relationship, decreasing the chances of using protection and increasing the chance of transmission.
Black women are at a particularly high risk because Black men, gay, bisexual, and straight, have the highest diagnosis rate of HIV. Because people are most likely to engage in sexual intercourse with people of their own race/ethnicity, the risk of transmission is statistically higher for Black women with each new partner.
As we continue the fight against HIV/AIDS, we have to remember who we’re centering, who we’re leaving out, whose voices need to be amplified and be careful not to repeat the mistakes of the past in terms of narrowly framing those impacted by the disease. In 1989, when the narrative was mostly still focused on the at risk groups called the ‘4H’ (hemophiliacs, heroin addicts, homosexuals and Haitians), 9 Black women social workers in New Orleans came together after realizing the most impacted in their communities were actually Black women. They took to the streets and started an underground needle exchange program as well as providing HIV testing to the community while operating from a harm reduction framework. From this initial recognition of the diseases’ impact on Black women, Women With A Vision, Inc was formed and continues to intentionally center Black women in our work in HIV/AIDS and beyond. For more about WWAV’s work with HIV/AIDS, visit our website.