AIDS Among Black Women Seen as a Growing Problem
One winter long ago, Lynn Chamberlain, then a robust 21-year-old, suddenly felt faint with exhaustion. Puzzled but not terribly concerned, she walked into her doctor’s office and said, “I don’t know what’s wrong. Test me for everything.”
A blood test for the AIDS virus came back positive. Overcome by fear and heaving with sobs, Chamberlain shouted over and over: “Oh my God. I’m going to die.”
But her doctor stayed calm. He had seen this before. “Tell me about your boyfriend,” he said.
Chamberlain, now 28, is part of the fastest-growing sorority in Los Angeles County--black women infected with the AIDS virus. Black women are eight times more likely to contract the virus than white women. Their odds of infection are three times greater than those of Latinas. Nationwide, nearly half of all American women infected with the virus today are black, and their numbers are growing.
For years, doctors and AIDS prevention activists have expressed deep concern for black women as their rate of infection has skyrocketed. Researchers point to the dangers inherent in engaging in unprotected sex with men who keep their intravenous drug use or bisexual encounters hidden--problems that some theorize are more pronounced in the black community, where the stigma of bisexuality is thought to be particularly intense.
And now, for the first time, officials are discussing an even more provocative notion. Some researchers have begun to question whether the tragic reality of black men being marched through the penal system--where homosexual sex is widespread and AIDS infection is generally six times higher than on the streets--is contributing to the growing infection rates of black women.
“We would like to decipher what is really going on in prisons,” said Norm Fikes, special populations and programs manager for the federal Centers for Disease Control and Prevention. “We feel that people who are incarcerated are part of the community. It’s a revolving door.”
AIDS Behind Bars
Any social or health crisis linked to prison is bound to take a disproportionate toll on black men. According to a 1996 California study by the Center on Juvenile and Criminal Justice, a staggering 39% of black men in their 20s were either on probation, in jail or on parole.
A separate study by the state Judicial Council reported that 33% of all state prisoners are black. A nationwide study by the left-leaning Sentencing Project in Washington stated that more than 30% of African Americans in their 20s were touched by the penal system.
With so many black men in custody, and with AIDS particularly widespread behind bars, researchers worry that the potential for crossover between the social crisis and the health crisis is profound.
The relationship of AIDS to prison was important enough for the Los Angeles County Department of Health Services to address it in a survey about the risk behavior of African American men throughout the area, said Dr. Amy Wohl, an epidemiologist for the HIV epidemiology program at the health department.
That two-year study should be completed by the end of the year.
Meanwhile, Dr. Wilbert Jordan, director of the Oasis Clinic and AIDS Program in Los Angeles, said the heightened possibility of HIV exposure in prison has long been a concern of his.
It was Jordan, in fact, who treated Chamberlain. Asked about her boyfriend, she eventually went on to sketch a picture of a man who lied to her about his bisexual lifestyle and AIDS infection. Although he had not been in prison, Jordan said, “you wouldn’t believe how many ex-inmates tell me that they are having sex, and they never tell these women about what they did in prison.”
“When you have this many men going to jail, it’s going to have an effect on the community, and many women will have sex with men who were in jail,” Jordan said.
Others echo that observation, and are beginning to express alarm about its implications, particularly for black people.
Dr. William K. Hunt, a research psychologist at UCLA, said the prison system has “the highest concentration of people who are HIV-positive in the world,” and it provides at least temporary quarters to a huge percentage of the black male population.
Some of those men are being exposed to AIDS. How many is difficult to say, but researchers agree that the numbers may be daunting.
“The question is how much sex is going on in prison,” Hunt said. “We know the rate of venereal disease among prisoners is steadily rising . . . so there has to be sex going on.”
Although he is hesitant to venture a precise estimate of AIDS infection, Hunt added: “Some of the research we’ve done seems to indicate that 20% of the guys say they’ve engaged in sex with other inmates. Of those guys who said they had sex, all were HIV-positive.”
There are few documented cases of AIDS infection in prison, he said. But then again, prison officials do not test for infection unless they are aware of an inmate’s illness before he arrives, or he shows obvious symptoms during incarceration. Safe sex is all but unheard of in prison, where officials do not distribute condoms because sex is prohibited.
“We know there is AIDS in prisons,” Hunt said. “It’s really insane for prison officials to say sex isn’t allowed, so we won’t give these guys condoms. It doesn’t take into consideration the wider public health. AIDS is 100% preventable. But once you have it, it’s 100% fatal.”
And because most of those prisoners with the disease eventually are released, they bring AIDS with them, infecting women and often black women.
“Do these prisoners come out and have sex with women?” said Hunt, who has recently completed a study on sexual behavior of 260 male and female inmates in two Southern California prisons. “Of course they do.”
Chuck Henry, director of the Office of AIDS Programs and Policy for the Los Angeles County Department of Health Services, urged caution. “It’s hard to prove men are being infected in prison because there’s so little research.”
Still, the implications for the black community--where so many women are single mothers--hits some activists hard. One goes so far as to compare the epidemic to the health and social crises that devastated so many Native American nations.
“I think that of all things that might really and truly point to the demise of African Americans, or a real depletion of African Americans in general society, this is it,” said Genethia Hayes, executive director of the Southern Christian Leadership Conference of Greater Los Angeles. “I think this is what threatens us the most in terms of a real issue that can devastate black Americans the way Native Americans were decimated.”
AIDS as a Racial Issue
Whatever the causes or long-term prospects, infection rates for black women are far out of proportion to their place in the population.
As of 1996, when Los Angeles County researchers last counted, the number of black women with full-blown AIDS was three times higher than Latinas and eight times higher than white women.
Black men were far worse off than their counterparts as well, with 142 cases of AIDS per 100,000. That compares to 70 per 100,000 white men and 56 per 100,000 Latinos.
Nationwide, black people comprise about 12% of the population, and yet account for an estimated 39% of all cases of HIV and AIDS. Braced by such numbers, the NAACP at its recent convention took its most aggressive position ever on the need to face AIDS as a racial issue.
At its convention in Atlanta, newly installed NAACP Chairman Julian Bond vowed to attack the disease. Meanwhile, the president, Kweisi Mfume, appeared on Black Entertainment Television saying that action could manifest as marches on government programs that fail to distribute AIDS relief funds and programs equally in black communities.
But AIDS has been around for nearly two decades, and some health professionals criticize the NAACP’s response as too little, too late.
Jordan of the Oasis Clinic and AIDS Program scoffed at what he considers the NAACP’s sluggish response to the epidemic. “It’s disgusting to me, and they probably won’t do much.”
Caya B. Hayes, national health coordinator for the NAACP, has heard such criticism before.
“It’s unfair,” she said. “We can’t be all things to all people. African Americans are overrepresented in almost every disease category there is. African American leaders and organizations and individuals all need to do more. To say we haven’t done enough is a misnomer.”
Although the NAACP and other organizations are beginning to speak out, their action may come too late for Diane, a 38-year-old woman who believes her husband infected her after returning from prison in 1980.
“My husband was gay, and I didn’t know it,” said Diane, who like many AIDS victims seeking anonymity revealed only one name. “I found out when a man called our house. He said he’d been sleeping with my husband for most of my married life. He said he was tired of me being with him and wanted him for himself.”
So enraged was Diane that she said she tried to kill her husband, shooting at him but missing. He died last year. At the time of his death, he weighed 40 pounds.
Sexual habits also have contributed to the disease’s spread among African Americans, doctors say.
Among other things, black men are reluctant to acknowledge homosexual contact inside jail, sometimes rationalizing their silence by denying the significance of their sexual behavior.
“We look at a group of heterosexual men, a significant number of whom have been in jail, perhaps infected in jail, and get out and have sex with women,” Jordan said. “They don’t acknowledge terms like homosexual or heterosexual because their contact is incidental.”
Wohl of the county health department agreed.
“If you’re a black woman, and you are having sex with your long-term boyfriend or husband thinking that he’s heterosexual, you’re not going to think that you’re at high risk for contracting HIV,” she said. “But we do know that black women are being infected heterosexually at a rate of 42% of AIDS cases.”
Cultural Attitudes
Although much of the recent research is focusing on African Americans, Wohl said epidemiologists fear a similar rise among Latinas because of social patterns similar to black women.
“We’re concerned because it’s growing for Latinas,” said Aizita Magana, director of the Partners Project for the Pacific Institute for Women’s Health. “I don’t think straight Latinas think about bisexuality a lot. The culture doesn’t offer a lot of room to disclose homosexuality or bisexuality.”
Bisexual men with the AIDS virus are out there, and Duane, who would only reveal his first name, is one of them.
Since his positive diagnosis two years ago, “I’ve had sex with six women,” Duane said. “No, I don’t tell them, but I always use a condom.”
Duane said that deceiving women about his health and lifestyle was acceptable as long as he wore a condom. He added that he never tells them why he’s so adamant about using one, even when the women beg him not to.
According to some physicians and activists, African American attitudes about condom use has long been a problem.
“When a person comes to me, I say you need to use a condom,” said Dr. Chancelor Daniel, who is black. “White people are more likely to want to use a condom. It’s not explainable. Maybe there’s a black myth. It’s the same with the black middle-class. I see it in Long Beach.”
Marilyn Chamberlain, Lynn’s mother, agrees with Daniel’s conclusion, but attributes it to education, not myth. Chamberlain believes white people prefer condoms because county-funded AIDS education programs fail to target nonwhite communities.
“They didn’t put any dollars in South-Central Los Angeles,” said Chamberlain, who started a residential care home for AIDS-infected clients in honor of her daughter.
“Individuals are really selfish,” Marilyn Chamberlain said. “You’ve got competition for AIDS dollars, which is the most ridiculous thing I’ve heard in my life.”
Lynn Chamberlain, meanwhile, overcame a three-year bout with depression after her 1991 diagnosis and now works as a spokeswoman for AIDS prevention. She stars in state television ads and tours the nation giving speeches to colleges, women’s groups and even National Football League players.
Miracles are not happening, she said.
“I can speak to a group of 100 women, and maybe, hopefully, I think that I impact five,” Chamberlain said.
“Because I’m so public about being infected, I discuss it,” she added. “And they say their man wouldn’t do that to them. They say, ‘My man isn’t doing anything. I’m a woman who takes care of my man.’ Well, if it were not a possibility, you would not have so many African American women becoming infected. We’ve been in denial for too long.”
