Poor, black and female

By Gumisai Mutume

WASHINGTON - Wendy says she suffered from uterine bleeding every day for three years, because doctors were reluctant to complete surgery on her once they learnt of her HIV status.

"When they found out I was HIV positive, no one wanted to treat me," says Wendy, who now spends her time raising HIV awareness among poor, predominantly Black and Hispanic communities in Gary, Indiana.

"If I had been a gay, White man, would I have been easily brushed aside? I've had to fight for treatment which I think I wouldn't have had to, were I a man," says Wendy. She was diagnosed HIV positive in 1995, and she says she has been fighting for fair medical treatment ever since.

Wendy, who is in her 40s, represents the marginalised face of HIV in The United States. "When a lot of African American women get to find out what they have, it is probably too late to save them from ordinary illnesses that can be cured," says Wendy. "I have seen more African American women die of HIV than any other group."

In the United States, AIDS has evolved into a disease of the poor. It is now the leading cause of death among African-Americans between the ages of 25 and 44, even though it no longer makes the list of the federal government's 15 leading causes of death in the broader population.

A recent report by the Centre for Disease Control (CDC) reveals that even though African Americans represent 13 percent of the US population, more than half of all new HIV infections occur among them. They are 10 times more likely than whites to be diagnosed with AIDS and 10 times more likely to die from it.

The report estimates that 1 African American man in 50 is infected with HIV and 1 in every 160 Black women. In comparison, the prevalence among White men is 1 in 250 and 1 in 3,000 among White women, in a country where an estimated 900,000 people are infected with HIV.

"It is becoming more prevalent in marginalized communities, among people who are generally outside the system when it comes to getting information," says David Satcher, the US Surgeon General. "People who, when they get information, get it late."

Since the first Acquired Immune Deficiency Syndrome cases were reported in June 1981, the virus has caused the death of 400,000 Americans. Worldwide 22 million deaths have been reported and global infection is currently estimated at 36 million people.

Helene Gayle of CDC says that in the United States,"prevention strategies have to evolve to address the new challenges, and the needs of new population groups increasingly at risk without ignoring those who were first infected".

The major defining characteristic of HIV/AIDS in America now is neither race nor sex, but social class, says Gayle. Those in the upper levels are able to afford to manage the disease, while the poor, who often lacking health insurance, do not.