LOS ANGELES - An alarming new statistic shines a glaring light on the increasingly Black and female faces of HIV in New York City. According to the Department of Health and Mental Hygiene (pdf), a staggering 93.4 percent of all new HIV cases reported among NYC women in the first half of 2009 were Black and Latina women, with sistas, who make up more than 66 percent of new infections, beating Latinas two to one. The overall rate of new cases for both groups is up nearly two percentage points from 2008.
While the statistic, displayed prominently on billboards throughout the city, may startle the average pedestrian, it doesn't surprise Marjorie Hill, Ph.D., CEO of the non-profit AIDS service organization Gay Men's Health Crisis--which, despite the name, boasts a 25 percent female clientele, many of whom are Black and heterosexual.
"I am upset by this finding, but it is certainly not shocking," says Dr. Hill, who is Black. "The government has not done an effective-enough job in recognizing that if people are able to receive support in making healthier decisions in their relationships and have economic independence, then they are more likely to be able to negotiate safer sex, thus preventing HIV," she says. "Black women earn less money than [any other group]. They bear a disproportionately greater responsibility when it comes to caring for children and elders. Plus, other STDs among Black women are at their highest levels ever. So when you look at all the variables--financial, social and psychological factors that would contribute to a greater HIV risk--those indicators among Black women are very high."
And, Dr. Hill says, when you consider that many Black women at the highest risk--those between the ages of 30 and 39--are looking to get married and have kids but are often dealing with men who have multiple sex partners or criminal records, the problem gets even worse.
C. Virginia Fields, former Manhattan borough president and now CEO of the National Black Leadership Commission on AIDS (NBLCA), says it's time that Black women got angry about the skyrocketing figures and petitioned the city to better fund and develop specific prevention and outreach methods targeting them.
"There needs to be a clear marketing plan aimed at black women," Fields says, "and it should be done at a geographical, age-appropriate and economic level so that every Black woman can see herself and know she's at risk."
Fields points out that the funding problem doesn't start with the city; it starts at the federal level. "In the latest federal budget, the only new initiative recommended for an increase in funding is for an MSM program," she says. "I applaud and support it, but when are we going to provide programs to combat the increases that are occurring among Black women?"
In November 2009, the NBLCA held a Black women's summit on AIDS that brought together leaders ranging from the Pan-Hellenic Council to the National Council of Negro Women to devise a countrywide plan of action--but the AIDS commission's leader says that more Black women still need to be in a position to affect public policy. "We are not at the table," says Fields. "Outside of people like Congresswoman Maxine Waters, who lives in California, there are not enough of us at the policy level to advocate on our behalf."
For its part, the city of New York admits it has work to do. "Public health is difficult," says Monica Sweeney, M.D., M.P.H., assistant commissioner of the Bureau of HIV/AIDS Prevention and Control at the city's health department. "Mostly, you find out when things don't work. But it's hard to say how many more HIV cases there would be if we weren't doing what we are."
Still, Dr. Sweeney says, the city is aggressively seeking new and innovative ways of reaching out to Black women in its anti-AIDS campaign--from having volunteers hand out almost one million female condoms at bus stops and subway stations to sending out mass text messages on Friday nights, reminding women not to leave their condoms at home. "We maintain a Facebook page for a special 'NYC Condom' where people can write in and give each other advice and support around protecting themselves," she says. "We have more than 13,000 fans so far."
And, the city--which boasts that it has no AIDS Drugs Assistance Programs waiting list, as many other jurisdictions do--has recently embarked on an ambitious mission to find out-of-the-loop infected residents and bring them back into care. "We've hired 28 agencies to find people who had previously been treated for HIV but who are now out of care to bring them back into the fold," Dr. Sweeney says. "These agencies will be doing this for at least the next three years."
But perhaps most important, the city is contemplating mandatory testing for everyone who visits a New York City hospital or clinic. "Our position is that every person needs to get tested at least once a year, so the thought is to make HIV testing a part of routine care," says Dr. Sweeney. "We'd like New Yorkers to be tested in emergency rooms, doctors' offices, during in-patient care, in every hospital, whether public or private. Anything that will help them know their status."
Tomika Anderson is a freelance writer based in Brooklyn, N.Y. Her work has appeared in Essence, POZ, Real Health and Ebony magazines, among others.