The face of AIDS is changing. Of the 40 million people around the world living with AIDS, half are women. In the United States, AIDS is now the leading cause of death among African American women between the ages of 25 and 34. Although American women have greater access to care and treatment than women in other parts of the world, the rate of infection with HIV, the virus that causes AIDS, continues to rise especially among minority groups.
One Woman's Story
Karina Danvers, 42, is living with AIDS. At a Congressional briefing on Capitol Hill in Washington she explains that she contracted the disease from her first husband who had - she learned many years later - a sexual encounter with an HIV-positive man.
As director of the Connecticut AIDS Education and Training Center at the Yale School of Nursing, Danvers' mission is to raise AIDS awareness among health care workers. She tells the audience of Capitol Hill staffers and AIDS activists that she is at the meeting "to bear witness to the suffering of people with HIV in the United States."
Danvers says the first time she talked about AIDS in public she addressed a group of high school boys in baggy pants and oversized t-shirts. One 14-year old in the first row with big brown eyes asked her how she could be so chubby and have AIDS. "What he was really asking," she says was, "How could I have AIDS and look so healthy?" At the time she says she didn't have a very good answer. Now - 11 years later - say does: "Because I am not poor," she says. "I not only have a good high school education, but I also have a graduate degree. I have good private medical insurance. I am middle class. And, although I am a minority - I am a Latina - I'm bilingual, not monolingual. I am a person living with AIDS, a person who has experienced nothing but good care and good access to medications."
Danvers Not Typical of Women with AIDS
Danvers says many of her sisters in the Latina and African American community haven't been so lucky. Together, African American and Hispanic women represent less than 25 percent of all U.S. women, yet account for 82 percent of female AIDS cases.
Take Maria, an African American mother of two who is rail thin, always fatigued and dying of AIDS. Her life was compromised by her husband who refused to practice safe sex and later refused help to manage the disease.
Danvers says Maria lacks what many middle class American women take for granted like the ability to read and write at a high school level. Or she adds, "the knowledge that it is okay to question your medical providers? the right to know that your opinions, suggestions and self-diagnosis count, the ability to understand what is being prescribed, why it is being prescribed and what to expect from this medical treatment."
Tameeka is another case, a single African American woman who got AIDS from IV drug abuse. When Danvers visited her small apartment she discovered all Tameeka's medicines had been dumped into a clear glass salad bowl in the center of the kitchen table. "I asked her why the medications were in this bowl all mixed," she says. "She told me that her doctor had told her that she needed to take all her medications by the end of the month, and that he wanted her to bring the empty bottles to him at their monthly visits."
When Danvers asked her to demonstrate how she took her medicine, "Tameeka walked over to the salad bowl, took a fistful of random medications and almost took them," Danvers says. Danvers - who had come to the apartment to complete an AIDS survey - left after helping Tameeka put the pills in the right bottles, create a schedule to take the medicine and make an emergency appointment to see the doctor.
Danvers says Tameeka and Maria are among the growing number of minority women with AIDS who are young, poor and have limited access to affordable health care. She says these women are often unaware that they are at high risk of HIV infection because their male partners have injected drugs, have had unprotected sex with multiple partners or had sex with other men. Danvers says new health strategies must target this vulnerable group.
"We need support services like case managers, peer educators, social workers, mental health providers, medication adherence counselors, support groups, educational forum."? and other people, Danvers adds, "who can provide the knowledge that people like Maria and Tameeka are missing." Danvers hopes by telling these stories - and by sharing her own diagnosis - she can play her part in helping to prevent the spread of AIDS.