US black women 'unaware' of HIV risk

President Bush spoke of Aids in the US on World Aids Day

HIV/Aids is now the biggest cause of death among young black women in America - but too little is being done to combat it, a leading research organisation has said.

In states like Alabama and others in the country's Deep South, non-white women make up 13% of the population - but make up nearly 70% of Aids infections.

Meanwhile, half of the new HIV victims in the US are people under the age of 25 - and most of them are black, and for black women aged 24-35, Aids is the number one cause of death.

Dr Judith Auerbach, director of public policy for the American Foundation for Aids Research (Amfar) told BBC World Service's Analysis programme that this statistic was "staggering."

"Part of what's staggering is that most Americans - including young women, and young black women in particular - are unaware of this fact," she added.

"How we've got there is probably the result of some neglect in recognising who's really at risk in this country at this point in time.

"Part of what's so shocking is the disproportionate increase in rates, and specifically among African-American women, such that it leads to death."

Abstinence bill

The debate about how best to tackle Aids amongst young black people has been ongoing, but the announcement of the statistics has intensified it.

Aids prevention work in many of the areas where the disease is most prevalent is focused on teaching young people to abstain from sex, which will keep them safe from HIV and other sexually-transmitted diseases.

A lot of African-American women don't realise they're at risk, don't believe that they're at risk, or don't want to be at risk Phill Wilson, Black Aids Institute

In Alabama - a deeply conservative and religious state - the latest legislation regarding HIV and Aids is known as the Abstinence Bill.

But Michelle Lampkin, an awareness campaigner who is herself HIV positive, said that young people are having sex "whether you want to believe it or not."

She told Analysis she has tried advising young people to wear condoms, but is accused of "promoting teenagers to have sex."

"I'm not - what I'm doing is to help to protect them," she argued.

Meanwhile, statistics from the Center for Disease Control (CDC) in Atlanta show that, while Aids is still thought of by some as a disease primarily affecting the gay community and drug users, the biggest risk to women comes from heterosexual partners - husbands or boyfriends who do not know or do not tell their HIV status.

In some of these cases, the partner acquired the virus after having unprotected sex with men - a practice that gave rise to the expression "on the down low."

And Dr Auerbach said the comparatively high mortality rates for young black women with HIV suggest that the disease is being first spotted later in its development than usual - and one reason for this may be the stigma still associated either with the disease itself or the way their partner first contracted it.

"Unfortunately, because of stigma... a lot of African-American women don't realise they're at risk, don't believe that they're at risk, or don't want to be at risk," said Phill Wilson, founder of the Black Aids Institute.

"So they pretend that they're not at risk."

Service cuts

Meanwhile, another reason for the high mortality rate is that funds for treatment are limited.

In Alabama - a comparatively poor state with a substantial black minority - there are currently 15,000 known cases of HIV infection. Of these, 1,100 need state-funded treatment.

But Jane Cheeks, the state Aids director, said that there was simply not enough money.

"We have very limited services," she said

"We fund what we've got now - core services - but there are only six. We can't fully fund transportation, which is a big problem in Alabama."

This is a problem the US shares with people in some of the poorest countries in the world.

"In rural areas, trying to get people into medical care, or into their appointments, is sometimes a problem," Ms Cheeks said.

"We can't fund, because that's not considered one of the core services. So we have to depend on any kind of transportation, anything that we can, to get people into clinics.

"When we announced last year that we were cutting back on services, we got many letters saying they need transportation. I had to say that we can't do that."

However, Mr Wilson urged the black community to help fund itself and not rely on state support.

"In the white gay community, there was a mass movement," he said.

"So we need to develop those same kinds of structures. There needs to be a mass movement in black communities to stop Aids."