Black women remain at high risk for HIV, and represent 64% of all women living with HIV in the United States. Anyone who has sex can get HIV. Most women who have HIV (84%) got it by having sex with men.
The Good News
New HIV infections among black women are decreasing. Between 2008 and 2010, new infections decreased by 21% among black women. Despite this encouraging news, black women remain heavily impacted by HIV – and there’s much more to be done. If current trends continue, 1 in 32 black women will be infected with HIV in their lifetimes.
Why are Black Women at Higher Risk for HIV?
While black women don’t necessarily engage in riskier behaviors than women of other ethnicities, a range of complex factors places them at greater risk for HIV. Generally, black women may be at increased risk for HIV because, proportionately, there are more people living with HIV in the black community, increasing the chance of exposure with every new sexual encounter. Higher rates of sexually transmitted infections, not knowing your (or your partner’s) HIV status, stigma, fear, discrimination, negative perceptions about HIV testing, and socioeconomic issues associated with poverty, e.g. limited access to healthcare, housing, and HIV prevention education, are also contributing factors. Learn more about HIV and Women.
The Truth About Sex
Whether you’ve had one partner or several, having sex without using a condom or other protection (e.g. HIV medicines like PrEP) is still the main way that women get HIV.
When it comes to sex, some activities can put you at greater risk for getting HIV than others. Oral sex is much less risky than vaginal sex, and anal sex is much riskier for getting HIV than vaginal sex.
Reasons to Take Charge. Take the Test.
Many people know that HIV is a significant health risk. However, research suggests that many women continue to underestimate their own personal risk of getting HIV, even when they are taking part in relatively high risk behaviors. Underestimating your risk for HIV can keep you from getting tested for HIV. It can also prevent you from choosing behaviors that can help keep you from getting HIV.
Think you don’t need to worry about getting tested for HIV? Think again. Consider these 5 reasons to get tested for HIV.
- You are having sex.
If you’ve had sex without a condom or other protection, you may be at risk for HIV. The fact is, whether you’ve had one partner or several, sex is still the #1 way that women get HIV. There are many ways you can reduce your risk of HIV.
You can reduce your risk of HIV by choosing to have sex with one partner who recently tested HIV negative and agreeing to be sexually active only with each other. Limiting your number of sexual partners, reduces your risk of getting HIV, as it decreases your chances of having sex with someone who is living with HIV.
If you are sexually active, you can choose less risky sexual behaviors. Among oral, vaginal and anal sex, anal sex is the riskiest type of sex for HIV transmission, followed by vaginal sex. Oral sex is much less risky than anal or vaginal sex.
Use latex male condoms or female condoms correctly every time you have anal or vaginal sex. Condoms are the only effective form of birth control that also helps reduce the risk of transmitting HIV and most other sexually transmitted diseases (STDs).
PrEP - a new prevention option for people who are at high risk of getting HIV, could also reduce your risk of getting HIV. PrEP is meant to be used consistently, as a pill taken every day. You should consider PrEP if you are HIV-negative and in an ongoing sexual relationship with an HIV-positive partner. PrEP should also be considered if you do not regularly use condoms during sex and are having sex with someone whose HIV status you don’t know for sure, or who may be at substantial risk of getting HIV (e.g., people who inject drugs or men who have sex with other men).
- You don’t know his HIV status.
You’ve heard it before. You can’t tell someone’s HIV status by looking at them. Remember - 1 in 7 people living with HIV don’t know that they have it. People often get HIV early in a relationship because they don’t know their partner’s HIV status, and they stop using condoms (or other prevention tools) as the relationship becomes more serious.
If you don’t know your partner’s HIV status, then you have a greater chance of getting HIV. For instance, if you don’t know your partner’s HIV status, you may wrongly assume that he doesn’t have HIV. What if he was infected a long time ago and was never tested? What if he was infected with HIV recently, since his last HIV test? You never know. In either case, having sex without a condom, and/or medicines used to prevent HIV, with someone who is HIV positive or whose status you don’t know could put you at risk for getting HIV.
Even if you know your partner’s HIV status, things could change. You may not always know if your partner is having sex outside of the relationship or doing other things that could increase their chance for getting HIV.
Put your love to the test. Get tested, preferably together. Once you know your results and his, you can make decisions about how best to keep each other safe.
It is important that you and your partner have ongoing conversations about these issues to stay healthy.
- You’re pregnant – or thinking of becoming pregnant.
If you are pregnant, or planning to get pregnant, knowing your HIV status can help protect your baby from getting HIV. Because 1 in 7 people with HIV do not know their HIV status, many women who are infected with HIV may not know they are infected.
HIV testing during pregnancy is important because if a woman is living with HIV and doesn’t know it, she may accidentally transmit HIV to her baby during the pregnancy, during birth or by breastfeeding. HIV testing provides an opportunity for women living with HIV to find out if they are living with the virus. If a woman is living with HIV, treatment can improve her health and greatly lower the chance that she will pass HIV to her baby before, during, or after birth. Women with HIV who take HIV medicines (antiretroviral therapy) during pregnancy (as recommended) can reduce the risk of passing HIV to their babies to less than 1%.
- You have an STD.
Having an (sexually transmitted disease) STD greatly increases the likelihood of both getting and passing HIV. People who are HIV-negative but infected with an undiagnosed or untreated STD are at least two to five times more likely to get HIV if they are exposed to the virus during sex. It’s also important to note that if someone is both living with HIV and infected with another STD, they are more likely (than people who are living with HIV but don’t have another STD) to pass HIV to their partner during sex. You should also get tested for other STDs such as gonorrhea, syphilis, and chlamydia, and insist that your partner does too.
- If you test positive for HIV, there are treatments available that can allow you to live a long, healthy life.
Many women (and men) avoid getting tested and knowing their HIV status for fear of discovering they have HIV. However, it’s important to remember that HIV is increasingly becoming a manageable disease. Today, there are medicines available that can not only help you better manage your health, but keep you from passing HIV to your partner/s, and make it possible for you to have an HIV-negative baby. Living with HIV without treatment leaves your body vulnerable to the disease, and could negatively impact your lifespan and quality of life. If you find out you are living with HIV, you can get on treatment which can improve your health, prolong your life, and greatly lower your chance of passing HIV to others. The sooner you get and stay on treatment, the better.
Getting tested for HIV is the only way to know your HIV status for sure. Whether you test positive or negative, knowing your HIV status can give you peace of mind.
What should I do if I’m scared to talk to my partner about HIV testing and safe sex?
Don’t be scared. Just remember, nearly everyone who is having sex will have this conversation at some point. Try to approach the situation with confidence. Chances are if you’re calm and bring it up without judgment, he will be open to the discussion. For all you know, he could be just as scared to bring it up as you are. Just remember, nearly everyone who is having sex will have this conversation at some point, and many other women before you have already done it.
What if he gets mad when I bring up HIV testing and/or safer sex?
Some women may be afraid that their partner will verbally, physically, or sexually abuse them if they try to talk about HIV testing, condom use, or other HIV prevention strategies. Women who have experienced abuse or violence in the past may also be more likely than those without a history of violence to engage in sexual behaviors that can put them at increased risk for HIV, such as exchanging sex for drugs or having multiple partners.
If you suspect that your relationship is unhealthy and unsafe, try talking to a trusted friend, family member, or counselor. Consider calling the National Domestic Violence Hotline at 800-799-SAFE (7233) for help and support.