HIV/AidsPrevention begins and ends with self-esteem

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By Danielle Douglass
Within the last few years, national HIV/AIDS rates for Black women have steadily increased, according to the most recent data released by the U.S. Centers for Disease Control and Prevention. In 2003, the most recent year for which statistics are available, HIV/AIDS rates for Black women were 19 times higher than white women and 5 times the rate for Hispanic women; Black women’s rates also surpassed those of males of all races/ethnicities other than Black men.
What makes these alarming statistics even more disturbing is that Black women make up less than 15% of the U.S. female population, yet they represent 64% of all new AIDS cases among women in the United States. AIDS has become the leading cause of death among Black women ages 25-32. What are these statistics telling us as Black women? What are we doing to ourselves or allowing others to do to us?
The distressing health trend among young Black women has led to much speculation about the root cause. For the most part the media has presented the same narrow scope of explanations; relying heavily on poverty and the “down-low” scenario. Granted these two components are major contributing factors to the spike in HIV/AIDS cases among Black women, but like any other health or social crisis, the issue must be thoroughly examined from all angles, particularly that which is cultural and psychological.
Truthful Discourse
Heterosexual sex is the leading cause of HIV infection among Black women; within recent years over 81% of Black women diagnosed with HIV/AIDS were believe to have contracted the disease through unprotected sex. One of the more highly publicized explanations for this statistic has been the rise in cases of Black men who secretly engaged in homosexual sex, while sleeping with women. Many HIV/AIDS advocates are speculating whether these men living on “the down low” function as an HIV transmission bridge to heterosexual populations. In a recent study of HIV-infected people, 34% of Black men who sleep with men reported having had sex with women, even though only 6% of Black women reported having sex with a bisexual man. It is apparent that many brothers are not being truthful with the women they are involved with, let alone themselves.
However, the incessant media focus on this one contributing factor in the HIV/AIDS crisis seems somewhat suspicious. It appears that the mainstream press wants to vilify Black men, while taking attention away from other pressing issues, such as inadequate access to healthcare. Often preventing and treating illness depends on people’s ability to access high-quality medical care. In central Brooklyn alone, the New York City Department of Health and Mental Hygiene reports that approximately 29,000 residents are without health insurance, while approximately 30,000 residents did not get needed medical care in the past year. The CDC claims that nearly half of all HIV-infected people are not getting access to necessary antiviral drugs. Treatment can be a central factor in prevention; HIV anti-viral drugs can decrease levels of the virus in the body, minutely reducing the chances that users will infect others.
Yet much of the news about HIV/AIDS rates within the Black community still focuses on the sensationalist stories of Black men living on “the down low.” One has to wonder if the media is not just playing into historical stereotypes of Black men as sexual deviants and a potential threat to society. Granted we must delve into how homophobia in the Black community hinders open and honest discourse, but it is equally important to delve into how inadequate healthcare is a major aspect of the increasing trend.
Sexually transmitted diseases further complicate the issue of HIV/AIDS transmission among Black women. According to the CDC, Blacks were 20 times as likely as whites to have gonorrhea and 5.2 times as likely to have syphilis. Partly because of physical changes caused by STDs, including genital lesions that can serve as an entry point for HIV, the presence of certain STDs can increase one’s chances of contracting HIV by 3 to 5-fold.
Many Black women know about safe sex practices and their ability to reduce the risk of contracting HIV/AIDS; however, denying their own risk, neglect to adopt them. Much of this behavior can be attributed to issues of cultural norms and self-esteem. We are a people who can listen to songs about explicit sexual encounters, but cannot bring ourselves to honestly discuss sexual behavior with our children, particularly our girls. Although Black women are readily portrayed in pop culture as being highly sexualized, there is no sense that we have ownership of our sexuality, which leaves us vulnerable to emotional and physical exploitation in our relationships. Self-love is a key aspect of self-esteem and loving yourself makes you less likely to play Russian roulette with your life. If you are willing to give your body to someone, there should be no hesitation in asking them about their sexual history, wearing a condom or better yet taking them with you to get tested.
Prevention begins and ends with self-esteem; taking precautions to make sure you don’t contract the disease and being honest in your intimate relationships if you do have HIV/AIDS.