The growing rate of HIV/AIDS infection among African-American women provides a disturbing, often humbling reminder that prevention and testing messages aren't getting through.
African-American women accounted for 64% of female AIDS cases in 1998 and AIDS is the number one cause of death for African-American men and women between the ages of 25 to 44.
The federal government is pumping millions of dollars into testing and prevention educational programs and sales of HIV/AIDS drugs will soon top $2 billion worldwide. But no
outreach leaders have emerged. After surveying the national landscape of what's being done to target this high-risk group that was the conclusion reached by a qualitative study
headed up by Elizabeth Vogt, executive VP of Cronin and Co. in Glastonbury, Conn. At best, there's a patchwork of grassroots efforts that make a dent in the cultural and
behavioral barriers to prevention, according to the study. "For the most part, [African-American] women are left to deal with [HIV/AIDS] issues on their own, lacking an outreach
program or support group to turn to," says Vogt.
While there are no silver bullet strategies, turnkey educational programs, community partnerships and peer-to-peer campaigns represent the strongest opportunities for turning
the tide from apathy to action.
Turning to the Church
Unlike the collective advocacy that exists with homosexual men's groups, African- American women don't have the same level of organized group solidarity. Family issues are a
top priority for this audience and the church is a central meeting place. "Mobilizing around the church and convincing the pulpit to call for HIV testing and creative support
services for people after they are tested is one way to get their attention," says Pernessa Seele, president of the Balm In Gilead (BIG), an AIDS/HIV advocacy group that targets
churches.
BIG works with 10,000 churches nationwide on HIV testing and treatment programs. Key examples include church basements that have been converted to HIV testing centers and
church/AIDS clinic partnerships.
While the church is a compelling avenue for reaching black women, it's not the only vehicle. Healthcare organizations should target other community resources, like employers,
social groups and entertainment outlets, in order to account for varied economic levels among African- American women.
Earlier this month, Glaxo Wellcome used a concert event featuring well-known gospel and R&B singers as a draw for getting tested in Houston, which has the seventh highest
number of reported AIDS cases among U.S. cities. The event involved a "get tested" rally, followed by free and confidential testing offered at six sites throughout the city. The
first 2,000 people tested received free tickets to the concert.
The campaign is part of the Houston AIDS Outreach Program, developed by Glaxo Wellcome in partnership with the city's health department, physicians and other community
organizations. Throughout the summer, testing outreach efforts have taken place at African-American festivals, sporting events, health centers and churches.
While HIV testing initiatives are critical, Vogt says that's only half the battle. "Healthcare organizations need to do a better job of encouraging women to find out their test
results, so many people are tested and never bother to find out their status out of fear."
(Cronin and Co., Elizabeth Vogt, 860/659-0514; Glaxo-Wellcome, Kristi Reeves, 919/483-0260; Balm In Gilead, Pernessa Seele, 212/730-7381, http://www.balmingilead.org)
Female Condoms Overlooked
One prevention tool that tends to be overlooked by HIV/AIDS outreach efforts is the female condom -- the only safe-sex aid controlled solely by women. Male condoms continue to
command the spotlight. This bias puts an unfair focus on men controlling how safe sex will be. "I don't care how sophisticated and educated women are, when it comes to safe sex,
it's very hard for women to discuss it in the heat of the moment," says Mary Ann Leeper, president of the Female Health Co., the only U.S. manufacturer of the female condom.
Leeper is working with public and private health systems, non-governmental organizations and community-based groups to incorporate female condoms into their HIV/AIDS
educational programs. This has been an uphill battle because of the social stigmas associated with female condoms being uncomfortable and difficult to use. To overcome these
barriers, The Female Health Co. partnered with The Joint United Nations Programme on HIV/AIDS and the World Health Organization to develop an educational guide for the female
condom. The guide demonstrates how to integrate the female condom into existing reproductive health programs, with an emphasis on training health providers to discuss its use with
women and men.
(Female Health Co., Mary Ann Leeper, 312/397-6036)