The HIV infection rate among black women living in certain parts of the United States is 5 times higher than estimated for black women nationally and similar to rates found in some sub-Saharan African countries. The finding comes from the Women’s HIV Seroincidence Study (ISIS), conducted by researchers in the HIV Prevention Trials Network and funded by the National Institute of Allergy and Infectious Diseases.
Approximately 25% of HIV infections in the United States occur in women. Black women are disproportionately affected: two-thirds of new infections among US women occur in black women, although black women comprise only 14% of the US female population. The researchers noted that despite these high numbers, past efforts have failed to identify specific populations of US women with sufficient HIV incidence to conduct effective HIV prevention.
Using detailed ethnographic mapping, the researchers identified venues, such as laundromats, liquor stores, bars, and dance clubs, frequented by at-risk women within communities defined by high HIV prevalence and poverty rates; 2099 women from these locations between the ages of 18 and 44 years (88% black) without a prior positive HIV test result were enrolled in the study. HIV testing revealed that 32 women (1.5%) were infected with HIV at enrollment. During the 6 to 12 months of follow-up, 4 women (0.24%) acquired HIV infection, a rate 5 times higher than the estimated rate of infection of 0.05% for black women nationally and similar to percentages seen in the Congo (0.28%) and Kenya (0.53%).
ISIS study chair Sally Hodder, MD, of the University of Medicine and Dentistry of New Jersey–New Jersey Medical School, said the findings could help focus future HIV prevention efforts. “We have known that black women in the US are disproportionately impacted by HIV; however, the magnitude of this disparity in areas hardest hit by the HIV epidemic underscores the gravity of the problem,” she said in a release. “Despite prevention efforts in the last 30 years, the reality is that we still have ongoing HIV transmission in the US that requires focusing prevention efforts.”
Preliminary findings from ISIS were reported earlier this month at the Conference on Retroviruses and Opportunistic Infections. The full study is expected to be published later this year.