HIV/AIDS Culture and Black Women: Baltimore vs. National Rates

This paper examines whether culture found in Baltimore, Maryland influences the rate at which Black women contract HIV, as compared to the same demographic across the United States. It compares different aspects of society in both geographical areas as a method of determining whether the culture in Baltimore can be changed in a positive manner to improve outcomes for affected women.

A study of the comparative traits between these two contexts should identify any significant discrepancies between the two cultures and how Black women may be helped by addressing cultural factors in Baltimore. The World Health Organization (WHO) has noted that "women around the world are more susceptible to HIV/AIDS for three main reasons" (More, 1994, p. 62). Those reasons include the fact that there are more female mucosal surfaces exposed during sexual intercourse; women tend to have intercourse with older men, "who are more likely to have had numerous partners and are therefore more likely to have been exposed to the virus" (More, p. 62); and since men are often the controlling figure in many sexual encounters, a woman's desire to use protection may not be considered.

What this paper focuses on is the culture that may influence the incidence of HIV/AIDS acquisition in both the city of Baltimore and across the United States. By focusing on the culture in which AIDS is acquired, data may reveal discrepancies and shed light on possible solutions to the problem.

The data used in this paper was drawn from current and past journal articles concerning HIV and, specifically, women who contract HIV in the United States — with particular attention to Baltimore, Maryland. Recent statistics from that area are alarming. A 2009 report on AIDS/HIV sufferers in Baltimore ranked the city fifth nationally in percentage of incidences, at a rate of 29.6 cases per thousand residents. Even more alarming was the fact that of the almost 1,600 new cases reported in Baltimore for HIV/AIDS in 2007, 37% were female and 87% of the total were of African-American descent.

This high percentage compares unfavorably to a national study by the Centers for Disease Control and Prevention (CDC), which showed a much lower overall percentage of Black females reported as infected by either HIV or AIDS. That study did show, however, that "compared to their white counterparts, African-American women were seven times more likely to be infected with HIV" (Brown, 2003). The same study showed that during 2001, "African-American women accounted for almost sixty-four percent of the HIV-1 cases reported among women" (Brown, 2003) — a figure that, while very high, was still lower than the rate among African-American males. The reported rate of HIV/AIDS infection for African-Americans in Baltimore for 2007 was 86.7% of all total HIV cases and 89.6% of all AIDS cases in the city.

The culture in Baltimore among the African-American community could be a strong contributing factor to those statistics. One recent study suggested that "HIV/AIDS risk among African-American women is best understood by emphasizing HIV/AIDS-related risk behaviours within the larger context of the African-American community" (Ferguson, Quinn, Eng, & Sandelowski, 2006, p. 323). Cornelius Baker, executive director of the National Association of People with AIDS, stated at an AIDS conference that "in communities across the nation, young African-Americans are being infected at alarming rates" (Elder, 1999).

The question that remains is why the Black community has a substantially higher rate of incidence than the white or Latino communities — and specifically why Baltimore shows an even higher rate than the national average. Unlike qualitative studies, statistical or quantitative studies provide direct numbers that can be interpreted objectively. The numbers presented here show evidence that Black individuals suffer a much higher rate of infection than do white or Latino individuals, and that Black women suffer a markedly higher rate when compared to their white counterparts. They represent a significant proportion of the overall rate of incidence in both Baltimore and the United States as a whole.

The answer to the question of whether culture affects the incidence of HIV/AIDS infection appears numerically clear: statistics show that in Baltimore and across the nation, the African-American community is being infected at a much higher rate than the Latino or white community. The question then turns to what the solution might be.

The studies examined in this paper all seem to point to the African-American cultural context as one that does relatively little to inhibit risky sexual behavior among young African-American men and women. The specific acts or cultural dynamics that allow such behavior are not sufficiently explored in the current literature to fully enlighten educators and other interested parties. Though the studies provide significant statistics, they do not thoroughly address the qualitative thinking or ideas behind the numbers.