Black women in six major U.S. cities have rates of infection with the AIDS virus that are five times higher than anyone thought, researchers reported on Thursday.
The findings stunned even the researchers doing the work – who already knew that the HIV epidemic in the United States is worse among blacks, and that young black women have a special risk.
“The fact that the rate for infections in these women is something like the rate in Congo is something that ought to get peoples’ attention,” Dr. Charles Flexner, a clinical pharmacologist and infectious-disease expert at Johns Hopkins University in Baltimore, who led the study, said in an interview.
“What this suggests is that you can’t guess what is happening in any particular neighborhood based on overall estimates. What this is telling us is that there are urban hot spots for HIV acquisition. Those are places where we really ought to be focusing our prevention efforts.”
Flexner’s team focused on more than 2,000 women in six urban hot spots: Baltimore; Atlanta; Raleigh-Durham, N.C.; Washington; Newark, N.J.; and New York. “These were women who were at the highest possible risk for acquisition,” said Flexner, who presented the findings at the 19th annual Conference on Retroviruses and Opportunistic Infections, a meeting of AIDS researchers, in Seattle.
At the start of the study, 1.5 percent of the women were already infected with the human immunodeficiency virus that causes AIDS. Within a year, an additional 0.24 percent had become infected – five times the expected rate.
“While we have always known that African-Americans had a higher risk of HIV infection than other American racial groups, this study confirms it and underscores the severity of the national and local problem, especially in cities,” Flexner said.
“Most of these women were not active injection-drug users. The vast majority were heterosexual.” Some were trading sex for drugs such as crack, but not all.
“A lot of these women are just young, sexually active folks in their teens, 20s, and 30s whose sexual partners are HIV infected and they don’t know it,” Flexner added. More than 40 percent of the women had no idea whether their sex partners had HIV.
“I am hoping that this will raise consciousness about the fact that we still have an HIV epidemic going on in the U.S.,” Flexner said.
Women of all races account for a quarter of the 50,000 new HIV infections each year in the United States, according to the U.S. Centers for Disease Control and Prevention. CDC estimates 1.2 million Americans are infected, and that 20 percent of them don’t know it. While the study found unexpectedly high rates of infection, the findings would not affect overall estimates about how many people are infected, Flexner said.
And 66 percent of the women newly infected each year are black, even though African-American women represent only 14 percent of the U.S. female population. “Nearly one in 30 black women will become infected with HIV in her lifetime,” the CDC says.
On Thursday, the CDC announced a new initiative to try to encourage black American women to get tested for HIV. “The campaign aims to remind black women they have the power to take charge of their health by getting tested for HIV, and by talking openly with their partners about HIV and safe sex,” the CDC said. It will use billboards, posters, handouts, a website, and community outreach.