Black women account for the majority of new cases of HIV and AIDS among women in the United States, and this is particularly true in North Carolina, according to the Centers for Disease Control and Prevention.
In 2003, the HIV infection rate in that state was 14 times higher for black women, compared with white women (MMWR 2005;54:89-94).
An epidemiologic investigation of 31 of the 208 black women aged 18-40 years in North Carolina who were diagnosed with HIV between January 2003 and August 2004 and 101 controls recruited from HIV testing sites showed that most women in both groups engaged in HIV sexual risk behaviors. Those receiving public assistance were more likely to be HIV positive (adjusted odds ratio 7.3), as were those with a history of genital herpes (adjusted OR 10.6). Women who discussed sexual behaviors and history with their male partners were less likely to be HIV positive (adjusted OR 0.6).
The most common reasons given for engaging in risky sexual behaviors were financial dependence on male partners, feeling invincible, low self-esteem coupled with a need to feel loved by a male, and alcohol/drug use.
The findings underscore the need for a multifaceted approach to reducing HIV infection among black women, including programs that encourage delayed sexual activity, condom use, monogamy, and communication.
Improved availability of HIV and STD testing and treatment and attention to the economic constraints that appear to contribute to increased HIV risk in black women are also needed, according to the CDC.