ABSTRACT

As we approach a time in the history of HIV disease when optimism often outweighs cynicism and hope replaces hopelessness, we are still confronted with the staggering statistics pointing to an increase in the incidence of H I V infection in women. Sadly, this has been the reality since the late 1980s. This is coupled with an increase in the death rate of women with HIV, while their male counterparts are experiencing a longer life expectancy and improved quality of life. The mass media and others on the periphery of the epidemic appear perplexed by this phenomenon; however, a review of the course of the disease and this country's response wil l elucidate the many reasons, including denial, fear, and distrust, for the current state of affairs. Concomitant problems of sexism (leading to the traditional exclusion of women from medical research studies and drug trials), racism, and homophobia, which are indelibly woven into the very fabric of the United States, also contribute to the different effects of H I V disease for women and men. These very issues wil l continue to cause a disparity, one fatal to women, in the availability of care, treatment, and social support, if not confronted directly through services and programs designed by and for women. I have had the distinct experience of working in the field of HIV/AIDS since 1984, the defining experience of being African American and female for forty years, and the exhilarating experience of being lesbian for who really knows how long. It is through these lenses of experience that I present this chapter.