Black women are dying of AIDS, and is anyone doing anything about it?

With last week commemorating the 19th Anniversary of World AIDS Day and the United Nations' AIDS-fighting agency overestimating the global impact of the epidemic by six million people, we would think we’ve seen the worst of this pandemic.

Not quite! Right here in the nation’s capitol, the HIV/AIDS epidemic rivals that of many Third World countries. Washington D.C., affectionately dubbed as “Chocolate City,” is approximately 60 percent people of African descent. And of its residents, one in 20 is thought to have HIV and 1 in 50 is thought to have AIDS. Of the 3,269 HIV cases identified between 2001 and 2006, nine of 10 were African American.

Are these statistics overwhelming?

“The Washington data is really a microcosm of what we already know: that AIDS in America today is a black disease,” said Phil Wilson, founder of the Black AIDS Institute, an HIV/AIDS think tank that focuses exclusively on AIDS among black Americans.

According to the U.S. Centers for Disease Control and Prevention, African Americans account for half of all new HIV cases, despite comprising 13 percent of the U.S. population. Equally alarming is that HIV/AIDS is the leading cause of death for African American women between the ages of 25 and 44.

At the “Women and Response to AIDS” panel at the 16th International AIDS Conference in Toronto in 2006, Sheila Johnson, founder of the Crump-Johnson Foundation in Washington D.C., pointed out that another at-risk population in the African American community is teenage girls.

Seventeen percent of the U.S. teen population is African American. In 2004, 70 percent of all teens testing HIV-positive were black. One in 10 African American teenage girls test HIV-positive in the nation’s capital, the highest percentage in the country among this age group.

When asked why such a high percentage test positive, Johnson said, “As long as girls see themselves as glorified sex objects in hip-hop videos, HIV/AIDS will increase within this population.”

Are these statistics overwhelming?! But so, too, is the failure of leadership African Americans have faced since the epidemic began. And no group of women is as affected by the failure of leadership in this country than women of African descent.

American women and their struggle against the AIDS epidemic was never so glaringly obvious than in the 2004 vice presidential debate between Dick Cheney and John Edwards. The invisibility of my group's plight has less to do with African-American women's agency to combat the epidemic than with how the government, African-American men, the Black Church, and race and gender biases inherent in the problem collude with African-American women's efforts to get help.

Gwen Ifill, an African-American female journalist with PBS' Washington Week and moderator of the vice presidential debate, brought the issue of AIDS in the U.S. front and center when she asked the men to comment on its devastating impact on African-American women.

"I want to talk to you about AIDS, and not about AIDS in China or Africa, but AIDS right here in this country, where black women between the ages of 25 and 44 are 13 times more likely to die of the disease than their counterparts. What should the government's role be in helping to end the growth of this epidemic?" Ifill asked.

Vice President Cheney responded to Ifill's question by saying, "Here in the United States, we've made significant progress. I have not heard those numbers with respect to African-American women. I was not aware that it was - that they're in epidemic there." Edwards' response wasn't any better. Edwards deflected the question by first going back to answering the previous question. Then with the remaining seconds left, he flubbed his way through.

However, three years later, at this June’s Democratic Primary Debate at Howard University that focused on African American issues ranging from health care and housing to Katrina relief, the economy and the environment, Black women stood on their feet as they applauded Sen. Hillary Clinton’s comment about the impact of HIV/AIDS on African American women. "Let me just put this in perspective: If HIV-AIDS were the leading cause of death of white women between the ages of 25 and 34 there would be an outraged outcry in this country."

When the color of the epidemic shifted from white to black, the inherent gender bias focused only on the needs of African-American men and rendered women invisible. And when gender became a new lens to track the epidemic, white women were the focus. The invisibility of African-American women in this epidemic has much to do with how the absence of a gendered race analysis makes African-American women invisible to the larger society.

What is also unnerving is that today, African American women make up 60 percent of all AIDS cases reported among women, 64 percent of new AIDS cases among women, and are three times the number of new cases reported among white women.

Many African-American women with HIV contracted it from heterosexual sex. And two ways that the virus is contracted heterosexually is through intravenous drug use and African-American men "on the down low." But men living on the DL is not a new phenomenon in the African-American community. Naming it, however, is. And it was J.L. King who became the country's poster boy by exposing the behavior in his best-seller, On the Down Low: A Journey into the Lives of "Straight" Black Men Who Sleep with Men.

"There are many women, too many women, in relationships with men who they think they know but really don't. He knew he had the disease, his mother knew he had the disease, his doctors knew, everyone seemed to know except me. And no one said a word," LaJoyce Brookshire wrote in the foreword of Browder's book, herself author of Faith Under Fire: Betrayed by a Thing Called Love. While homophobic attitudes in the larger African-American community and church contribute to their behavior, African-American men are also not taking responsibility for how their behavior is killing African-American women, and putting the entire community at risk.

The disparities within the healthcare system also contribute to the disproportionately higher number of HIV cases among African-American women, and this directly affects their quality of life and the spread of HIV. While healthcare disparities in the black community are overwhelming, so too is the failure of leadership that African Americans have faced since the epidemic began.

“The story of AIDS in America is mostly one of a failure to lead, and nowhere is this truer than in our black communities,” said Julian Bond, chairman of the NAACP, at the 2006 International AIDS Conference in Toronto.

But Phil Wilson states it plainly: “I think it’s important for us to take just a moment to realize that we are where we are today because we weren’t concerned when we thought it was somebody else’s disease.”

However, the disease has also taught us about the various faces - across race, class and gender - who wore and continue to wear the face of this disease.

When The New York Native, a now-defunct gay newspaper, in its May 18, 1981, issue first reported on a virus found in gay men then known as GRID (Gay-Related Immune Deficiency), an editorial noted that "even if the disease first became apparent in gay men, it is not just 'a gay disease.'" And HIV/AIDS, having neither an alliance to nor an affinity for queer sexualities, spread.

But where would the leadership on HIV/AIDS come from? Our African American lawmakers?

While a few of our local African-American elected officials and the Congressional Black Caucus have spoken up about the AIDS epidemic in the black community, the non-involvement by the majority of them has been scandalous. Some black officials say that their inattention to HIV/AIDS is because they are overwhelmed by the bigger and more important problems affecting inner-city urban life such as crime, gang warfare, homelessness, drugs and poverty. While some black elected officials have voted for money for AIDS programs, they have generally resisted providing the leadership needed to mobilize black and Hispanic groups to stem the spread of HIV/AIDS.

But let’s confront the elephant in the black community, by telling the truth and shaming the devil.

The biggest problem that black lawmakers have had to confront concerning the HIV/AIDS crisis in their communities is the political gag order imposed on them by their voting constituency’s homophobia and animus toward any discussion of the disease.

Would the leadership on HIV/AIDS come from the black church?

When it comes to the black church and HIV/AIDS, I am always reminded of what my mayor in Cambridge, Mass., Ken Reeves, who is both African American and gay, told The Washington Blade in March, 1998, during a two-day Harvard University HIV/AIDS conference: “African American male ministers over 40 are a tough nut to crack. If we wait for the black church on this, we’ll all be dead.”

The Black Church continues to play a part in the death of African Americans with AIDS. While its silence on the issue is appalling and unconscionable, so too is its various forms of heterosexualized rituals and pronouncements that denigrate both LGBT people and women. A study by the Pew Forum on Religion and Public Life showed that since 2000, African-American Protestants are less likely than other Protestant groups to believe that LGBT people should have equal rights. And since hot-button issues like gay adoption and marriage equality have become more prominent, support for LGBT rights among African-American Protestants has dipped as low as 40 percent.

Therefore, women with AIDS are as unwelcome in the Black Church as LGBT people. Within Black Nationalist milieus like the Black Church and the Nation of Islam, African-American women with AIDS are also viewed as race traitors. In this patriarchal straightjacket, biological essentialist views are as holy and deified as the Bible itself. And with the belief that women are to multiply and bring forth new life for the perpetuation of the race, women with AIDS lose their status in the community. Often labeled as "loose" for having contracted the virus, she is viewed as not only diseased but also dangerous because her sexual wiles continue to seduce men. A woman with AIDS is a fallen woman, not only for having contracted the disease, but also for having disregarded the policing of sexual behavior by the Black Church.

While some women have felt shamed and stigmatized by the Black Church for contracting the virus and have stayed away, many more have fought back with a righteous indignation. One of our sister warriors in Boston, Belynda Dunn, who died of AIDS in March, 2002, at the age of 49, had done so. As a tireless AIDS activist, Dunn was the founder and director of the multicultural multidisciplinary Who Touched Me Ministry, an initiative to educate black churches in stopping the spread of HIV/AIDS in their communities. She was the HIV Prevention Manager and Educator for the Boston-based AIDS Action Committee.

As a heterosexual African-American woman, Dunn was the wake-up call to the African-American community and the Black Church that HIV/AIDS is not solely a gay disease, but an equal opportunity virus. In her tireless effort to get the Black Church to see this epidemic through her as a Christian heterosexual female, Dunn became the driving force behind making the African-American community confront its homophobia and AIDSphobia.

"Belynda really lit a fire under me. That's what Belynda did with everyone. She really helped us cross ideological lines and theological lines and not get hung up on the homosexual issue. She said to the Black Church: 'Get over it,'" according to Dunn's pastor, the Rev. Martin McLee of Union United Methodist Church in Boston's South End, the only African-American church in Boston welcoming of its LGBT and HIV-positive members.

"She was known for her strength, her charisma and her vision. She had the ability to fight even when no one was listening. She was able to cut through the levels of denial. She wanted to turn this epidemic around and her vehicle to do that was the Black Church," AIDS Action's then-executive director, Larry Kessler, told a newspaper back in 2002. Ironically, she died the week when black churches in the greater Boston area held AIDS prayer services, but sadly, most black churches still turned a deaf ear to Dunn's call for action.

In African-American communities across this country, the disease still shows no sign of abating. Black cadaverous bodies have hid and still hide from the community and each other. And with its harsher judgment against women with HIV/AIDS, African-American women are less likely than any other group to seek help.

Although many of us in black communities averted our eyes, pretending we did not see them, we all saw them. We all knew them, and we all, in silence, watched them die because we have still done nothing to stem the epidemic.

In my pastoral study one day, I heard a faint knock on my door. I yelled to come in, but the person just stood there on the other side of the door from me. Thinking it was one of the kids from Sunday School horsing around, I continued with my work. Then, minutes later, again the faint knock.

Annoyed and now certain that it was one of the kids, I rose from my seat with the intention to tell the kid to stop. I swung open the door and to my surprise there stood in front of me a vaguely familiar image. Kaposi's sarcoma lesions were splattered about on this woman's face and neck. Her eyes were sunken with dark rings, and she was 40 pounds thinner. A one-time big and vibrant Afro (the community had nicknamed her Sister Angela Davis) had been transmuted into straight, willowy thin hair, and was almost gone. I greeted her as if she were a stranger. When she told me who she was, I had to fight back the tears.

Desperate to see me because she heard I did not discriminate in doing funerals for those who died with AIDS, Bernice (not her real name) felt her prayer could be answered. Bernice wanted to set up her funeral arrangements. And we did. Approximately three months from the day I heard her faint knocks on the door, Bernice died.

Before she died, Bernice helped me to set up weekly weekend workshops in the community on sexuality and spirituality for both churched and unchurched African-American women with HIV/AIDS. And Bernice was in most of them. Too weak, however, in the final weeks of her life to participate and to speak up in the workshops, Bernice just sat quietly in her wheelchair, speaking to us with her head movements. She listened to the women tell about their lives as black women, their lives as black women with black bodies no one respected, and their lives as black women with black bodies presently living with HIV/AIDS that no one wanted to touch. During each workshop, we all cried. We cried for ourselves and each other. We cried for the many black women we knew with HIV/AIDS. We cried for the many black women we knew with HIV/AIDS who did not have a support group. And we cried because for some, the workshop was one of a few times in their lives they felt safe to cry.

The feminization of this disease makes many of us AIDS activists and scholars wonder if the same amount of money, concern, communication, and moral outrage that was put into white gay men with the disease will be put into curbing its spread among black women. "What do we need to know to provide better HIV and AIDS prevention services to African-American women?" Dr. Gerri Outlaw, an African-American lesbian and chair of the Department of Social Work at the College of Health Professions at Governors State University in Illinois, asked in 2005, leading to setting up the pilot project "Women Making Meaning of HIV and AIDS in Economically Marginal African-American Communities: Implications for Community-Based Education."

Recognizing the paucity of funds and prevention strategies targeted to African-American women with HIV/AIDS, Outlaw stated she "wanted to examine community-based approaches to HIV/AIDS prevention and education for black women. Few if any services were on the west side of Chicago and women had to go to white gay areas to get services, and the treatment and prevention services were not for women, period."

The AIDS epidemic among African-American women is also symptomatic of the dialogue we need to have about our bodies and sexuality, which has been choked for centuries by a "politic of silence." In aiming to break through the "politic of silence" with her pilot project, Outlaw began interviewing mothers, daughters and grandmothers in order to access the beliefs, attitudes, experiences and perceptions of HIV/AIDS among ordinary African-American women.

"I began to talk to women about how they learned about sex in the first place. I asked what role mothers and daughters play in communication about sex. I wanted to know how much young women learned from their mothers, and I wanted to know whether others were having conversations without their daughters in light of HIV and AIDS."

But having a conservation is hard, especially for young women.

“Many of us sistas find talking about sex difficult. Our partners may get angry or defensive. They sometimes feel that we are accusing them of something or that we don't trust them. Talking is especially hard when a young woman has an older partner because the older partner tends to have more power in the relationship. Often, we look to the older partner for information about protection against pregnancy and HIV and may get wrong information. An older partner usually has more sexual experience and is more likely than the younger partner to have prior experience with illegal substances. Both of these factors increase the older partner's risk of being infected with HIV and put the younger partner, too, at risk,” an African American young woman stated, anonymously.

Working in conjunction with the “Politic of silence” is what African-American women historically created as a "culture of dissemblance" and "the politic of respectability," the silence African-American women created around their bodies and sexuality that had been exploited during slavery was viewed as a revolutionary act against the white oppressive gaze.

The "culture of dissemblance" was a proactive black feminist politic that aimed to protect the sanctity of the interior aspects of African-American women's social and sexual lives. Darlene Clark Hines, professor of history at Northwestern University and editor of Black Women in America: An Historical Encyclopedia, defines this culture as "the behavior and attitudes of black women that created the appearance of openness and disclosure but actually shielded the truth of their inner lives and selves from their oppressor."Only with secrecy could African-American women achieve the psychic and sexual space to protect their bodies and sexuality.

Evelyn Brooks Higginbotham, professor of history at Harvard University and author of Righteous Discount: The Women's Movement in the Black Baptist Church, 1880-1920, points out that the "politics of respectability" emphasized reform of personal behavior and attitudes both as a goal in itself and as a strategy for reform of the entire structural system of American race relations. Higginbotham also points out that through the discourse of respectability, the women's movement in the black Baptist Church emphasized manners and morals while simultaneously asserting traditional forms of protest, such as petitions, boycotts, and verbal appeals to justice.

African-American women are no more promiscuous than white women, however, stereotypes about African-American women's bodies and sexualitities prevent the proper prevention and education needed to stem the tide of HIV/AIDS.

The iconography of black women is predicated on four racist cultural images: the Jezebel, the Sapphire, Aunt Jemima, and Mammy. With the image of the strong black women who can endure anything and "make a way out of no way," her strength is either demonized as being emasculating of black men or impervious to the human condition. The Aunt Jemima and Mammy stereotypes are now conflated into what's called "Big Mamma" in today's present iconography of racist and sexist images of African-American women.

While the Aunt Jemima and Mammy stereotypes are prevalent images that derive from slavery, for centuries both of them have not only been threatening, comforting and nurturing to white culture but also to African-American men. The dominant culture doesn't see and hear African-American voices on this issue because our humanity is distorted and made invisible through a prism of racist and sexist stereotypes. So too is our suffering.

But the suffering can stop by breaking the silence with SISTA (Sisters Informing Sisters About Topics on AIDS), an intervention program that helps African American women reduce their risky sexual behaviors, and WILLOW (Women Involved in Life Learning from Other Women), an intervention program for women living with HIV.

BlackCommentator.com Editorial Board member, the Rev. Irene Monroe is a religion columnist, theologian, and public speaker. A native of Brooklyn, Rev. Monroe is a graduate from Wellesley College and Union Theological Seminary at Columbia University, and served as a pastor at an African-American church before coming to Harvard Divinity School for her doctorate as a Ford Fellow. Reverend Monroe’s “Let Your Light Shine Like a Rainbow 365 Days a Year - Meditations on Bible Prayers" will be out in June, 2008. As an African American feminist theologian, she speaks for a sector of society that is frequently invisible. Her website is irenemonroe.com. Click here to contact the Rev. Monroe.