HIV/AIDS Among Women of Color

 January 19, 2006

The HIV/AIDS epidemic disproportionately affects women of color, particularly African Americans and Latinas. While these two populations accounted for less than one-fourth of all U.S. women in 2004, African American women and Latinas represented 67% and 15% of new AIDS cases, respectively. In 2001, HIV/AIDS was the leading cause of death for African American women aged 25 to 34 and the fifth leading cause of death for same-aged Latinas.

Although HIV/AIDS diagnoses for Asian American and American Indian women comprise only 1% of all diagnoses combined, lack of detailed HIV/AIDS data, underreporting of HIV/AIDS cases, and racial/ethnic misclassification could mask the true impact of HIV/AIDS within these communities. Current research suggests that HIV/AIDS rates might be increasing in these populations.

Strategies for Prevention

Women, particularly African Americans and Latinas, are most likely to be exposed to HIV through heterosexual contact, followed by injection drug use. Gender inequality frequently contributes to women’s inability to negotiate HIV prevention efforts with their partners. Some women may be reluctant to discuss condom use with their partners out of fear of emotional or physical abuse or the withdrawal of financial support. Within Latino and Asian American communities, cultural norms can also prevent many women from engaging in optimal HIV prevention behavior.

Need for Equitable Treatment

Limited access to quality health care can contribute to delays in HIV diagnosis and medical treatment, especially for people of color. They are more likely to lack health insurance and live in poverty. Lack of culturally competent and bilingual health care providers creates HIV testing and treatment difficulties for many Asian Americans and Latinos who have limited English proficiency, as does limited health care access in rural communities for American Indians.

Need to Address Mental Health and Substance Abuse Problems

About half of persons with HIV have a mental disorder, and about 40 percent use illicit drugs other than marijuana. According to the HIV Cost and Services Utilization Study, 62% of people living with HIV suffered from depressive disorders and 16% from generalized anxiety disorder. In general, women are more likely to suffer from mental health problems than men. HIV-positive women who exhibit chronic depressive symptoms tend to have a more compromised immune system and are about twice as likely to die of AIDS-related causes than those who are not depressed.

According to a 2004 Institute of Medicine report on HIV/AIDS care and treatment, mental health and substance abuse treatment can help stabilize the health and well-being of individuals with HIV and potentially contribute to better adherence to antiretroviral drug treatment. One study found that HIV-positive women were half as likely to die if they received mental health services, as compared to women who did not.

Recommendations

The American Psychological Association strongly recommends:

  • Increased availability and access to culturally competent and linguistically appropriate prevention and treatment services for women of color.

  • Widespread adoption of an integrated HIV care and treatment model that includes mental health and substance abuse services.

  • Greater professional and in-service training for community providers to provide culturally competent and linguistically appropriate HIV/AIDS care and treatment.

  • Further research on the epidemiology and HIV/AIDS prevention and treatment needs of women of color, with particular attention to Asian American and American Indian women.