Philadelphia: More AIDS Cases With Female Faces

In Philadelphia, HIV/AIDS is increasingly a disease of women, especially black and Hispanic women. Many newly diagnosed patients are heterosexual minority women who are not promiscuous, not injecting drugs, and -- because of cultural biases -- not likely to question their partner's sexual orientation or insist on condoms.

In 2001, new AIDS patients who got the disease through heterosexual sex (329 cases) for the first time outnumbered those who got it through male homosexual sex (207 cases) or infected needles (308 cases). In fact, heterosexual sex was the only transmission method that saw an increase in AIDS cases in 2001. About 30 percent of the 865 new AIDS cases in the city in 2001 were women, compared with 12 percent in 1990. In Philadelphia, blacks and Hispanics account for 75 percent of AIDS cases, but only 50 percent of the population.

"In most Latino and African-American communities ... religion still says that homosexuality is a sin," said Ednita M. Wright, assistant dean of students at Cornell University and coauthor of "African-American Women and HIV/AIDS: Critical Responses." "And it reflects on me as a woman: Not only is my man cheating on me, but he's cheating with a man." The stigma runs so deep that some African-American bisexual men identify themselves as heterosexual, with the tacit approval of their female partners. Studies also find that Latinas are unlikely to insist on "safe sex" because of cultural factors, notably machismo and Catholic opposition to birth control.

"Traditionally, heterosexuals did not see themselves at high risk, so they might not be tested" for HIV, said Kathleen Brady, HIV epidemiologist in the Philadelphia's Department of Public Health. This year, city prevention workers in a federal pilot project will try "to reach high-risk heterosexuals to define who they are and where to find them," said Brady.

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