Oct. 29--Too often, it is when women show up for prenatal exams that they discover they are HIV positive, or sick with full-blown AIDS. Even more common, the women are black or Hispanic, and in long-term relationships they believed were monogamous.
Their risk factor for contracting the virus that causes AIDS? Being an adult and being a woman of color.
Last year in North Carolina, 80 percent of HIV cases diagnosed in women were among blacks, Hispanics and Native Americans. While men, particularly African-American men, still account for the largest number of HIV/AIDS cases, an often hidden epidemic is taking place among women.
"We are losing the war against AIDS," said Dr. Steve Cline, deputy state health director. "We're losing it not just as a nation, but also losing it as a region. The South is disproportionately hit."
Cline addressed advocates, care providers and HIV patients Tuesday to help launch a Web page designed to reach Southern women infected with HIV/AIDS. It features video testimony of 30 women, including several from the Triangle, who have been diagnosed with HIV or are working to combat the disease.
The Web effort -- called the Southern AIDS Living Quilt (www.livingquilt.org) -- is the latest line of attack mounted by the Southern AIDS Coalition, which was started six years ago by public health leaders in 17 states.
The group wrote a manifesto in 2002 to federal officials who fund AIDS programs, demanding a new approach for a new epidemic. Initially concentrated among urban gays and intravenous drug users, the virus began making an onslaught in rural areas in the 1990s.
By 2007, the South had more people living with HIV than any other region in the nation.
But even after more federal tax dollars began flowing to AIDS programs in the Southern states, the epidemic has raged on -- especially among black and Hispanic women. The rate of HIV infection among black women is 15 times higher than for white women, and it is four times higher for Hispanic women than whites.
"That is absolutely unacceptable," said Evelyn Foust, director of the state's communicable disease branch.
Among the challenges in North Carolina is the state's rural history, along with pockets of poverty that make it hard to get health care. In addition, the state's culture, steeped in traditional Christian doctrine, often makes it difficult to discuss sex openly.
"I'm a Southerner," Cline said, noting that he was born and raised in North Carolina, "and how we live our lives and what we talk about doesn't always work for us."
The issue is especially difficult for women, who may not feel they can demand that longtime boyfriends or husbands wear condoms, which protect against transmission of the HIV virus. Many have no idea their sex partners are not monogamous.
For Hispanic women, the issue is even more freighted, especially if they are Catholic and heed prohibitions against contraception. Women here illegally also fear that an HIV diagnosis will trigger deportation.
"Latino women are finding out they are HIV positive through prenatal care," said Yvonne Torres, HIV/STD program manger for Wake Human Services. "Some of the men who come here arrive earlier than their wives and have unprotected sex with women they don't know. That's how women get infected."
Foust said the state has more work to do to erase the stigma of HIV/AIDS and make testing routine. While a new state policy has cleared the way for testing women during routine pelvic exams, the testing is not uniformly done throughout the state. She said the new Web site is an effort to build knowledge, erase the stigma and encourage women to seek help.
Linda Holland-Blackwell of Raleigh is one of those who offered testimonials on the Living Quilt. Diagnosed with full-blown AIDS in 2000, Blackwell said she thought she had been issued a death sentence. With support from her family, her church and community AIDS organizations, she said she has begun to reach out to others who have the disease.
"Don't be afraid to be tested," she said. "And know you aren't alone."
savery@newsobserver.com or 919-829-4882
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