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Barriers to Prevention |
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Barriers to Prevention
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Before creating a solution, it is first necessary to identify and understand the existing obstacles that complicate the prevention of AIDS in African American women. To start with, there is a distrust of both the government and medical institutions. This distrust traces back to the Tuskegee experiment, which is associated with racism in medicine and the misuse of the African American population by the government [5]. Mistrust of the government is also shown in Bogart’s study, in which a telephone survey was conducted to examine AIDS conspiracy beliefs. In this experiment, Bogart found that a great number of those surveyed believe the government is withholding both information and a cure for AIDS [6]. This lack of trust makes it difficult for African Americans to rely on the government or on institutions of medicine to help control this epidemic.
Another concern is the conspiracy belief involved with condom use. Condoms are not full-proof, but aside from abstinence, condoms are the most effective way for one to protect oneself from the infection of HIV/AIDS [7]. An extreme, but existent, belief is that “doctors put HIV into condoms” [6]. To discover and understand the view African American women possess regarding condoms, Ariane Bedimo utilized a focus group methodology. The group consisted of HIV-infected African Americans attending an HIV ambulatory care clinic in New Orleans, and ranged from ages 16-45 years old. From the discussion, it was agreed that condoms are generally not used during oral or anal sex, primarily because there is no risk of pregnancy [8]. One adolescent also revealed that she knew a friend who “had anal sex so that she could remain a virgin” (8). This may explain why an increased number of heterosexual women are performing anal sex, a problem previously described. The women in the group that admitted to never using condoms revealed that it was because of their partners’ refusal to wear one. Most of the women agreed that if the partner refuses it is very difficult or even impossible for the pair to use a condom (8). This study proves that even though women are aware of the importance of condoms and prefer to use them, the women are unable to because of the male’s refusal.
There is also an issue with stigma directed towards HIV-positive African American women. Gregory Herek conducted telephone surveys throughout the 1990’s which ultimately revealed the incorrect beliefs that HIV/AIDS can be transmitted by casual contact. About half of those surveyed believed one can contract AIDS by sharing a drink and 41% believed one can contract it from use of a public toilet (9). These misconceptions affect the way one treats or interacts with people who have AIDS. For instance, 19% of respondents said if a co-worker had AIDS they would avoid him, 15% want their children to avoid children at school who have AIDS and 45% said they would shop at a different grocery store if the owner has AIDS (9). The stigma towards those who are HIV-positive creates a sense of shame in those who have AIDS and ultimately forces them to hide their condition. If disgrace and embarrassment are associated with AIDS, then one will be less likely to want to get tested, be treated or even talk about HIV/AIDS. An even bigger problem, however, is the physical violence associated with women who have AIDS. Sally Zierler discovered in her study that 20% of the interviewed women reported physical abuse since they learned they were HIV-positive (10). Zierler also determined that women living with a male were three times more likely to experience violence after their HIV diagnosis (10). Therefore, not only are African American women ashamed of having AIDS, but their physical well-being is at risk. Together, these factors create barriers to prevention; however, it is essential for the Public Health Officials to break down these walls. |