The Feminization of AIDS: Why Our Sisters are Suffering

An epidemic once referred to as “a gay white man’s disease” is now taking its toll on black women.

Today the AIDS virus has found its way into the heart of many black communities, especially in the South, and it is eating away at the life source of the African American family: the black woman. According to the Centers for Disease Control and Prevention (CDC), black women are 25 times more likely to contract AIDS than Caucasian women. Furthermore, African American women now comprise 34% of new AIDS cases in the U.S., making them the most affected group of AIDS victims in the nation.

AIDS is the number one cause of death among African American women between the ages of 25 and 34, according to All About Black Our mothers, daughters and sisters are suffering through “endless rounds of doctor visits, night sweats, debilitating medications, body-numbing fatigue” and ultimately death, the Web site reports.

According to the Henry J. Kaiser Family Foundation, 63% of all female AIDS cases in the U.S. as of 2001 were African American women, and HIV infects one in 160 African American women.

Taking Action in Florida

Research from the Kaiser Family Foundation also indicates that in 2001, Florida was the state with the second largest population of African Americans estimated to be living with AIDS—nearly 20,000 people. (New York was at number one with 27,080 black AIDS patients.) Faced with this grim statistic, many state, county and local health agencies here in Florida are doing aggressive outreach to address the crisis of AIDS in the black community.

Patricia Colson is an African American woman living with HIV. She was diagnosed in 2001. Today Colson is involved in many community outreach programs in the Gainesville, Fla., area as an AIDS advocate for the Gainesville Health Department. She gives talks to students and other at-risk groups about the dangers of drug addiction and how it can increase the risk of contracting HIV. She says she was addicted to crack cocaine for 17 years and her drug addiction drove her to prostitution.



“I share my story by going to drug rehab centers, churches and jails,” says Colson. “Many people have this stigma [that] if you have AIDS, then you’re dirty. My family was going to give me a separate spoon and my own cup.” By helping people see the “real,” human face of HIV, she hopes to spread the facts about AIDS and eliminate misconceptions in the classroom and in inner city neighborhoods.

“In the African American community, we are dying,” she says. “More and more of us are becoming infected.”

Another agency that is working to combat the spread of AIDS among African American women in the Gainesville area is the Alachua County Health Department. Gay Koehler-Sides is the department’s HIV/AIDS Human Services Program consultant. Her office conducts various screening and prevention programs that include HIV testing in jails and at the health department, and distributing condoms at St. Francis House, a non-profit organization that provides services to homeless people in Alachua County. The department also participates in National Black HIV/AIDS Awareness Day.

“We offer video-based [education] programs geared toward heterosexual black females,” says Koehler-Sides. “I believe poverty and lack of education go hand in hand. If we look at the statistics, the higher a person’s education, the [better] that person’s health.”

The Causes Behind the Crisis

According to the CDC, one of the main reasons for the “feminization of AIDS” and its disproportionately high occurrence among black women is the lifestyle of many African Americans. Poverty, unprotected sex, intravenous drug use and the lack of AIDS awareness in the black community are all significant factors contributing to the expansion of the disease.

Nearly 30% of Americans living in poverty are African American women, according to a recent article in The Washington Post. And a recent report in Ebony magazine confirms that many black women with AIDS are intravenous drug users or sex partners of intravenous drug users. Many women also contract HIV through unprotected heterosexual sex with an infected person. The lack of women’s empowerment in regard to “condom negotiation” with their male sexual partners is a leading cause of the proliferation of the disease in black women.

AIDS education programs, affordable medical care and effective social programs, as well as increased funding for HIV/AIDS research, can all make a difference in helping black communities learn from—rather than suffer through—the AIDS crisis, according to the Center for International Development at Harvard University. Some examples of successful educational initiatives in various parts of the country are Blacks Educating Blacks About Sexual Health Issues (BEBASHI) in Philadelphia, The Minority Task Force on AIDS (MTFA) in New York City—whose programs reach about 10,000 people each year—and telephone helplines such as the Florida Department of Health’s Florida HIV/AIDS Hotline.

“AIDS Doesn’t Discriminate”

Addressing the alarming rise in HIV and AIDS rates among African American women must become one of our country’s top public health priorities. But even though the face of AIDS in America today is more and more likely to be that of a black female, we must be careful not to stereotype AIDS as “a black women’s disease.”

Michael Rajner is a coordinator for the Campaign to End AIDS (C2EA), a diverse national activist coalition of people living with HIV/AIDS. He was diagnosed with AIDS 10 years ago. Rajner reminds us that when AIDS was first identified 25 years ago, it was called GRID (Gay-Related Immune Deficiency), a name he feels was imposed as a stigma on gay men. As a gay white man living with HIV, Rajner is very active in the political and social aspects of HIV/AIDS and stresses that the disease does not distinguish between races, genders or sexual orientation.

“AIDS affects everyone,” he says. “It doesn’t discriminate. If you pay taxes, AIDS affects you.”

Rajner encourages Americans to embrace the fight against AIDS as not just the government’s problem but as society’s responsibility as a whole. “The black churches have taken a huge leadership role and embraced their [HIV-positive] brothers and sisters,” he says. “We can end this [epidemic] if we follow the black churches’ lead. We need to spread the word, not just spread the virus.”

Hispanics, Blacks at Greater Risk of Developing Alzheimer’s

Both Hispanics from Caribbean countries and African Americans are more likely to develop Alzheimer’s disease than Caucasians, according to a new study, “Incidence of Alzheimer’s Disease in African Americans, Caribbean Hispanics and Caucasians in Northern Manhattan,” recently published in Neurology magazine.

This area of research is particularly important because the number of Caribbean Hispanics and African Americans who are 65 and older in the U.S. is currently increasing more rapidly than the number of elderly Caucasians.

The study, conducted over a seven-year period by the New York State Psychiatric Institute and Columbia University, examined 1,072 New York residents between the ages of 75-90.

“We are continuing this study and exploring reasons for the differences in rates,” explained Richard Mayeux, PhD, one of the lead researchers from the Gertrude H. Sergievsky Center at Columbia University. “So far, no risk factors completely explain the differences [in Alzheimer’s rates] between the ethnic groups.”

A particularly important finding for all sufferers of Alzheimer’s disease, regardless of race or ethnicity, was the presence of the APOE-e4 gene in persons more apt to develop Alzheimer’s. However, Mayeux adds, “Among the 70% of the population without the APOE-e4 gene, the risk [of developing the disease] is two to three times higher for African Americans and Hispanics than for whites.”

Another factor that increases people’s risk of developing the disease is their education and employment level. According to previous studies, the risk for developing Alzheimer’s is twice as high among those with low-income occupations and less than eight years of education. While this finding does not directly correlate to an ethnic disparity, statistics show that blacks and Hispanics often have lower education and income levels than Caucasians.

Alzheimer’s researchers believe their findings indicate a need for more research into the correlation between race and Alzheimer’s and for increased distribution of information on mental health issues to elderly Hispanics and blacks.

Biological Link to African-American Prostate Cancer Rates Discovered

A new study revels that African-American men have more than 20 times the level of a protein (TIMP-1) that enables the spread of prostate cancer tumors than Caucasian men.

At the recent American Society for Cell Biology meeting in San Francisco, a group of Louisiana researchers presented their findings based on an analysis of nearly 100 tissue samples from prostate cancer sufferers.

While the researchers stressed that black men are often diagnosed with prostate cancer too late and receive inadequate medical treatment, they also believe that TIMP-1 is the main biological factor causing twice as many African-American men to develop prostate cancer and die from the disease than any other racial group.

“This is one of the first functional biological markers we’ve seen,” says Briana J. Williams, PhD, of Louisiana State University in Shreveport, the study’s lead author. “It’s going to be very helpful in developing new treatments.”

Typically, TIMP-1 protects men from prostate cancer by inhibiting harmful enzymes, but in high concentrations it has the opposite effect. In increased amounts, the TIMP-1 protein causes prostate cancer to spread throughout the body, increasing the chance of death.

“We were disappointed when [TIMP-1] was one of the genes that came up, because it’s been considered an inhibitor of prostate cancer,” Williams says. “Now, the key will be figuring out how we can separate the good part of TIMP-1 from the bad part.”

Researchers hope to develop a blood test that will identify patients who over-produce TIMP-1. “It’s not going to be easy or simple, but our priority is to try to use the protein to our advantage,” Williams says.

Darker Skin Tones Slow Detection of Lyme Disease

A recent study finds that African Americans who contract Lyme disease are 10% more likely than Caucasians to exhibit symptoms such as neurological or heart problems, and they are 30% more likely to suffer from arthritis as a result of the disease.

“One of the conclusions from the study is that perhaps African Americans are not recognizing that they have [Lyme disease] as quickly as whites,” says Alan Fix, assistant professor of epidemiology and preventive medicine at the University of Maryland School of Medicine.

In fact, of patients diagnosed with Lyme disease, whites were nearly six times more likely than African Americans to have detected a bull’s-eye rash, according to the study.

Fix states, “This is a perfectly reasonable explanation, since the darker skin color would hide the bull’s-eye rash—the most telltale sign of the disease.”

Because their skin tone hides this key indicator, African Americans may remain untreated longer and therefore suffer more complications from Lyme disease.

This finding highlights the need for increased health care education on Lyme disease in African-American communities. Fix says, “The health care professionals serving these communities need to be more aware of these issues.”

African-Americans Twice as Likely as Africans to Develop Alzheimer Disease

A 10-year study conducted in Indianapolis and Ibadan, Nigeria indicates that African-Americans are twice as likely as Africans to develop Alzheimer disease and other dementias.

Researchers from the Indiana University School of Medicine, Indianapolis, and the University of Ibadan, Nigeria, followed 2,147 African Americans in Indianapolis and 2,459 Yoruba in Ibadan, age 65 and older, to see if they developed dementia and Alzheimer disease. In both locales, two-thirds of the study subjects were female.

Of the African-American subjects, 3.24% per year developed dementia, including 2.52% per year who developed Alzheimer disease. Only 1.35% of the African subjects developed dementia including 1.15% per year who developed Alzheimer disease.

“These findings will allow us to pursue the elusive risk factors for Alzheimer disease in these two disparate populations,” explains Hugh Hendrie, MB, ChB, a researcher at the Department of Psychiatry, IU School of Medicine and principal author of the paper, which appeared in the February 14 issue of the Journal of the American Medical Association (JAMA).

Hendrie established a partnership with Benjamin Osuntokun of the University of Ibadan, Nigeria to form the Indianapolis-Ibadan Dementia Project. Their goal was to search for environmental, potentially modifiable, risk factors for Alzheimer’s disease by studying two populations now living in very different environments: African Americans living in Indianapolis and Yoruba Nigerians living in Ibadan. The project resulted in several important findings, which suggest that there may be environmental risk factors for the development of Alzheimer’s disease.

Although studies of Alzheimer disease prevalence among racial and ethnic groups has indicated that the risk is higher for African Americans and Hispanics than it is for whites, there have been no conclusive results. Nevertheless, the differences are important to study because of the growing percentage of non-whites in the older U.S. population. According to the 1999 Progress Report by the National Institute on Aging/National Institutes of Health (NIA/NIH), by the year 2050, the percentage of the population over the age of 85 that is non-Caucasian will have increased from 16% to 34%.

The NIA funded the study and is also supporting the next phase of the research, which is already underway. This new study will attempt to discover the cause or causes of the disparity between African Americans and Africans contracting dementia and Alzheimer disease. Factors under consideration include hypertension, diabetes and high cholesterol levels. The African group suffers less from all three of these than do African Americans.

The researchers will continue to explore the molecular genetic disparities between the two groups, including the association between Alzheimer disease and a molecular variant of the ApoE gene. Previous research had shown that the Yoruba subjects experienced a weaker association between the disease and the gene than did the Indianapolis group.

They also plan to explore the impact of lifestyle and environmental factors, which are significantly different between the industrialized and non-industrialized groups.

“The reason to choose populations from a developing and a developed country is to increase the possibility of environmental diversity,” says Hendrie. “It is hoped that this report will encourage more research into Alzheimer’s in these countries.”