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African American women, falling out of care

Rod McCullom | 4/29/2013, 6:47 p.m. | Updated on 4/29/2013, 6:47 p.m.
Reports of an almost 20-month-old Mississippi infant who was cured of HIV dominated news coverage during early March. But much ...

“Black women have the highest unintended-pregnancy rate of any demographic,” the Guttmacher Institute reported. Women whose pregnancies are unintended often delay prenatal care, affecting the health of both the mom and the fetus – and increasing the risk of mother-to-child transmission if the mother turns out to be HIV positive.

Blacks are also more likely to be “late testers” and to be diagnosed with HIV far into its progression, as was the Mississippi mother. Less than two-thirds of HIV-positive people in the United States begin care for their infection within a year after diagnosis, according to the CDC. Black men and women are also more likely to “drop out of care” after an HIV diagnosis. Again – just like the Mississippi mother.

“Many people have blamed the mother for her child being placed in that position. We need to ask, ‘What could we have done differently to ensure the mother had prenatal care?’” Gaddist said. “We don’t know if the mother had access to care. Access doesn’t necessarily mean ‘if’ care was available. Access means, ‘Did she have a ride to her appointment?’ Since the mother lived in a rural area, the answer could be no.”

Blacks account for 50 percent of HIV infections in rural counties, according to the Rural Center for AIDS/STD Prevention. “That makes it more likely that the mother could be lost to care,” Parker said. “There are fewer hospital and clinics, as well as poverty and transportation challenges.”

“There is also the stigma of being HIV positive and attempting to access care – especially in a small town,” Parker continued. “Many positive women feel uncomfortable going to these clinics or hospitals. They may have to worry about gossip and could become victims of domestic violence.”