New York Times Reports on HIV/AIDS Epidemic Among Rural Southern Women
In a front-page story, the New York Times today reports on how the HIV/AIDS epidemic has "taken root" among rural Southern black women, with whom the "messages about prevention and protection are often overtaken by the daily struggle to get by." Although the HIV/AIDS epidemic among American women originally centered on intravenous drug users in the urban centers of the Northeast, the epidemic has now shifted to heterosexual women in the South, and black women increasingly make up that total. Sixteen percent of new AIDS diagnoses in 1999 were among black women, who account for 7% of the nation's population. The number of cases among black women have "grown steadily" over the past 20 years, especially in the South, where the high prevalence of other STDs such as gonorrhea and chlamydia leave women more vulnerable to HIV infection. Poverty, low employment rates, drug use, teen pregnancy, "minimal" health care access and a lack of education have also "conspire[d] to thwart" HIV/AIDS prevention efforts, making the epidemic in the American South "closely resembl[e]" the HIV/AIDS epidemics of many developing nations, the Times reports. However, the "conservative" political nature of the region also preempts comprehensive sex education: Prevention programs tend to be "episodic" rather than provided on a regular basis and are usually "focused" on abstinence. Researchers said that women "hold no misconceptions" about HIV/AIDS being a "gay" disease, but many continue with "reckle[ss]" sexual behavior despite the risks. "There are issues of looking after children, trying to get insurance, the lack of a father in the home, alcohol, drugs. They have so much going on," Dr. Hamza Brimah, a Nigerian-born physician who practices in Greenwood, Miss., said. Many women only learn of their HIV status after becoming pregnant. Once women become aware of their status, they may decline to seek treatment or tell their families of their status because of the "suffocating" stigma attached to the disease and fear of rejection by their family members and friends. In addition, it is often difficult for them to get treatment because of a lack of health care facilities and because of the "prohibitive" cost of treatment, despite government subsidies. The old disbursement system for Ryan White CARE Act funds allocated the most money to states with the highest number of AIDS cases. The Times reports that the epidemic in the South is "relatively recent," so while major urban centers in the North and on the West Coast receive the majority of funding, the South continues to receive a "disproportionately small" cut of the federal money. A new disbursement formula was passed last year by Congress, but the system is not yet in place (Sack, New York Times, 7/3).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.