Curbing the Spread of HIV among Black Women in Washington, D.C.


Current HIV Rate at Severe Epidemic Level

It’s hard to believe that the HIV rate in our nation’s capital is almost as high as those of some African nations. In 2009, almost 3% of D.C. residents were living with HIV, three times the World Health Organization’s classification for a severe epidemic, and comparable to or even higher than the rates of Ghana, Rwanda, or Ethiopia.

Thanks to initiatives like condom distribution, needle sharing programs, and increased access to testing, new diagnoses in the city have dropped by nearly 60% since 2007. Despite the overall decline in new diagnoses, HIV still disproportionately affects African Americans, particularly black women.

black-hiv.jpgAfrican Americans make up almost half of D.C.’s population, but account for 75% of newly diagnosed cases. After black men who have sex with men, black heterosexual women are the second highest demographic of new infections. One in every five new HIV diagnoses comes from a black heterosexual woman, and a whopping 92% of HIV-positive females in the city are black.

D.C. Investing in HIV Prevention

To curb the spread of HIV, D.C. Mayor Muriel Bowser announced her “90/90/90/50 by 2020” plan last summer. The goal is to ensure that 90% of D.C. residents with HIV know their status; 90% will be in treatment; 90% will reduce their viral loads to undetectable levels; and that the rate of new infections drops by 50% by 2020.

As part of the plan, the city is investing in programs to promote PrEP (short for pre-exposure prophylaxis), a pill geared toward the HIV-negative population that reduces the chance of contracting HIV if exposed. If taken daily, PrEP reduces a woman’s risk of being infected by nearly 90%.

Since being approved by the FDA in 2012, PrEP has largely been targeted toward men who have sex with men. In fact, most women didn’t even know it existed. Even though PrEP use has increased, its uptake has not been proportional to the racial demographics of new infections. White women’s risk of acquiring HIV is very low - about one woman in 880 - yet they are six times more likely to initiate PrEP use than black women, whose risk is significantly higher - one in 48.

Raising HIV Awareness Among Women in D.C.

Now D.C. is investing in programs that will raise awareness among women, particularly black women, about the drug and encourage healthcare providers to prescribe it.

With these new initiatives city officials hope to curb the rate of new infections and get the buy-in of healthcare providers who have traditionally associated HIV with gay men. Doing so will give women more agency over their sexual health by relieving the stress of relying on partners to use condoms and reducing the spread of HIV to newborns. And, by promoting PrEP as first female-controlled HIV prevention method, D.C. may finally be able to curb the spread of HIV among its most vulnerable populations.
Topics: social determinants of health health disparities public health

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