Excerpts from: Living Positively: Narratives of Forgiveness and Imagination among Women with HIV. Copyright © 2010 Hamaseh Kianfar, Ed. D
African American Women and HIV
February 7, National Black HIV/AIDS Awareness Day, was created in partnership with the Center for Disease Control and Prevention (CDC) in order to plan and raise awareness about HIV/AIDS among African-Americans. According to a fact sheet published in 2008, since the beginning of the HIV/AIDS epidemic, African Americans have accounted for more than 42% of the estimated 952,629 HIV/AIDS cases in the United States alone (Center for Disease Control 2008: 1-7). In addition, as Figure 3 illustrates, the rate of HIV transmission among African American women is nearly 23 times that of white women (Center for Disease Control 2008: 1-7). African American women are 74% more likely to be infected with HIV because of unprotected heterosexual intercourse, followed by injected drug use (24%) (Center for Disease Control 2008: 1-7). Given that the main form of HIV transmission among African American women is through unprotected heterosexual intercourse, it is important to explore why and how.
According to a study published in 2003 that looked at the role of African American male hypermasculinity in the epidemic of unintended pregnancies and HIV/AIDS cases with young African American women, it was reported that “there is a greater tendency of hypermasculine behaviors characterized by having more multiple partners and a stronger aversion to condom use among African American men compared to men from other ethnic groups (Wolfe 2003: 846-852). Sexual assertiveness, a predictor of condom use according to a number of studies (Ehrhardt et al. 2002 and Wingood et al. 2004) was found less likely in African American woman 50 and older (Schable et al. 1996). Heckman et al 2003 further stated that “women over the age of 40 and 50 were more likely to interpret condom use as a sign of mistrust between partners.” In addition to gender roles and sexual relationships among African Americans, it is equally important to look at the role of power between African American men and women.
In a study published in 2004 it was reported that, “financial, social and emotional dependence on their partner contribute to a power imbalance” and makes African American women less likely to be “concerned for their own health and welfare” (McNair and Prather 2004). Furthermore, African American women have fewer eligible African American male partners “due to socio-economic and education differentials, higher levels of incarceration among African American males and sex-ratio imbalances” (McNair and Prather 2004). According to Sikkema et al. (2000), “a woman who depends financially on her male partner for basic needs may be more likely to comply with her partner’s sexual wishes for fear of abandonment” therefore, requesting “condom use may be perceived as risk for these women as they may risk relationship conflict, loss of partner and partner anger and abuse” (Wingwood 2000). These sociocultural factors can play an integral role in determining sexual practices among African American women and can impact HIV risk behaviors. It is thus important to continue exploring and identifying these factors so that models of care can be more effective in addressing HIV as it relates to African America women.
Ehrhardt et al. 2002 and Wingood et al. 2004.
Schable et al. 1996
McNair and Prather 2004
Sikkema et al. 2000