2005 New Cases: 1,806*

Black: 63%
White: 28%
Latino: 7%

Children
College Students
Women

Adolfo Aguilar
Outreach Worker, Chatham Social Health Council
Coleen Cunningham
Chief of Pediatric Infectious Diseases, Duke University Medical Center
Milford Evans
Benefits Advocate
Gerrod Henderson
HIV Positive teenager
Peter Leone, M.D
Medical Director, HIV/STD Prevention & Care Branch
Jonathan Perry
HIV Positive
Fred Wiggins
HIV Positive
Del Williams, Ph.D
Manager, Epidemiology & Special Studies HIV/STD Prevention & Care Branch

HIV/AIDS on Campus
HIV/AIDS & Kids
HIV/AIDS & Latinos
HIV/AIDS & Women

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*NC Department of Health and Human Services

HIV in Women

Of the more than 40 million people worldwide who live with HIV and AIDS, the United Nations estimates almost half of them are women. And the number of new infections among women and girls is increasing every year.

“We're not seeing a dramatic increase in the percent of new reports that are made up by women,” says Dr. Del Williams, epidemiologist for the state's HIV/STD Prevention & Care Branch. But that doesn't mean we shouldn't be concerned. Dr. Williams says 498 women in North Carolina were diagnosed with HIV or AIDS in 2005, or about 28% of all new cases.

Dr. Williams is quick to point out, “One of the reasons I consider we should be concerned is it's not going down.”

It's Bryn Mccall's job to try and help the numbers go down. She's a health educator at Triad Health Project in Greensboro. She says her agency is seeing more women infected with HIV, and she gears much of her work specifically toward women.

“I really enjoy working with the women's groups because without having the males there we can really sort of address some sexuality issues and also other things that are gender specific,” McCall says.

She does educational programs in shelters, drug and alcohol treatment centers, with community groups, and on the street - walking the neighborhoods of Greensboro, talking to anyone who'll listen about HIV and AIDS.

She meets one woman who tells her, “I took a test with them, but I never could get my results because I had moved out of there.”

Lloyd Mickens from the Guilford County Health Department often joins McCall, both to educate and to offer free HIV tests.

“They call me,” he says, “I come out to the house and test them and I'll bring the results back to their house.”

Mccall says she's encouraged by how receptive people are to their message. One man is proud of his recent test. “I just went up there and got me an HIV test,” he says. “Everything's negative with me.”

McCall is also encouraged by how active the community has gotten in raising awareness, especially African Americans. That's critical because in North Carolina, the Department of Health And Human Services says the rate of infection for black women is 12 times greater than for white women, what Del Williams calls a troubling disparity.

“It's a pretty alarming picture,” he says.

McCall says, “I am truly encouraged because I do see so much more community activity within the African American community. I really think before long as a result of their own efforts, I'm hoping that the tide will turn.”

So what puts women at risk for HIV? Experts say there are many answers.

“The primary risk factor is still heterosexual transmission,” Dr. Williams explains. “Injecting drug use in previous decades had a relatively sizeable component as far as transmission risk, but that's declined pretty dramatically through the 90s.“

He says another factor is access to health care.

“That can mean just the ability to get from home to a doctor's office or a clinic. It can mean not having insurance that would allow you to be treated or receive medications. It can mean being reluctant to ask for time off from a job where you do have some sort of health benefit to go to the doctor for treatment or testing for HIV.”

McCall cites other risk factors as well. “Their partner may have been an IV drug user - and maybe not a consistent user, a recreational - and the female partner was not aware of it. Also the male partner could have outside partners male or female.”

Mccall and Mickens say there's also a problem of prostitutes whose customers pay them not to use condoms. And they say female empowerment and self-esteem are major obstacles with many of the women they meet.

Mickens says, “I've met a lot of women that are in abusive relationships, and they're afraid to say no or they're afraid to say well, honey, why don't we try and use a condom or whatever because they're afraid of being beaten.”

McCall agrees, “Even though in the U.S. women have more, they're more on equal footing with their male counterparts, it's still not quite the same. We're still buried into a lot of our old gender roles where women are submissive. Women don't ask. Women wait for the man to make the decisions.”

That's why she says it's essential to educate men, too.

Lloyd Mickens helps her, talking to a group of young men hanging out outside a Greensboro home. “This is my number here,” he tells them. “So if you guys ever want to get tested or have questions, just give me a call.”

“If we work with women and help to increase their perception of risk, hopefully they will feel enabled to take the protective steps they need to take, but if we're not reinforcing that with males or with the greater community, then we may just be wasting our time,” McCall says.

Del Williams says he hopes not. He wants to see a day where people can talk openly with their partners about HIV.

“And until we get to the point where that becomes an issue where a person does not have that reluctance, I'm worried that we're going to continue to see the lines on the charts that I draw staying relatively flat instead of having a downward slope,” he says. “What I'd really love to do is to draw you a chart where rates are going down instead of up or are level. And right now we're not at a point where we do that.”