WASHINGTON – Chenita Smithwick finds more and more women walking into her Baltimore office every day.
Like her, most are African American.
Like her, most are HIV positive.
Statistics from the Maryland Department of Health and Mental Hygiene agree with Smithwick, a case manager for an AIDS awareness group in Baltimore. Women accounted for 39 percent of the new HIV cases in Maryland last year, up from 35 percent in 1994. Of those cases, 84.2 percent were African-American women.
AIDS is now the leading cause of death among black women in the state ages 18-44, according to the state.
The largest number of infections among women in Maryland came through heterosexual contact, followed by injection drug use, said Liza Solomon, director of the Maryland AIDS Administration. She said the state is taking steps to fight the epidemic among women through continuing HIV prevention and clinical programs.
“We’re certainly concerned about an increase in AIDS cases among women,” Solomon said.
It is not just a Maryland phenomenon: Nationally, 30 percent of the 40,000 new HIV infections in 1998 were among women, the Centers for Disease Control and Prevention estimates.
At Sisters Together and Reaching, the grass-roots organization where Smithwick works, “There has been a 20 to 30 percent rise in the number of women who have come to us … over the past two or three years,” said Debra Hickman, director of the group.
Hickman said women have issues in the fight against HIV and AIDS that men do not face. While the AIDS Administration said that heterosexual contact with an HIV-positive person accounted for 42.3 percent of the new infections among women, for example, Hickman said women often have no choice over protection.
“A woman may not feel safe enough to tell her partner that he needs to use a condom for fear of physical violence,” Hickman said.
While some groups and government agencies make female condoms available, she said, it is nothing like male condoms “which are available by the handful.” Hickman and others say AIDS awareness programs even today do not target women adequately. The disease is still perceived as “a gay man’s disease,” which leads to women taking fewer precautions during heterosexual sex, said Jeffrey Grebelle, program administrator for the AIDS Action group in Baltimore.
Grebelle said intravenous drug use was also a major reason for the rise and spread of HIV among women. Over the last year, 40.1 percent of the new HIV infections among women were due to injection drug use, according to the AIDS Administration.
But mothers who wanted to get off drugs often do not get into rehabilitation programs, Hickman said, because of worries about who would look after their children.
Advocates say awareness is the key to the AIDS epidemic — the more women know about the disease, the more likely they are to guard themselves against it. Awareness is also important because there is advanced medication available to HIV and AIDS patients that can help them prolong their lives, Smithwick said.
“We’re not dying today — we’re living longer,” she said.
Smithwick was 29 and a “dope shooter” when she found out she had the virus. She thought her life had ended. Fourteen years later, “I live happy” and with none of the illnesses associated with HIV, she said.
She stresses the lack of HIV awareness among women while recalling her own experience — she was on drugs for 20 years but had no idea she was at risk until a yeast infection sent her to a doctor, who advised her to take an HIV test.
“When I tested positive, I was told I had two and a half years to live. I didn’t have a clue other than that I was dying,” she said. “When you don’t know anything, you don’t know what to think.”
Smithwick has since educated herself about the disease and its treatment and said she now leads a full life. “I have colds and flus like everybody else, but that’s it.”
Her husband — who she married after being diagnosed — is free of the disease. “I own a house, a car … If you want to live, you can do it.”
But Smithwick said that, unlike her, many women have no time to invest in caring for their health. “Women have to look after their homes, kids … where does that leave them with time to take care of themselves?”
She advises those who come to her to “educate yourself about yourself and the disease.”
But meanwhile, the numbers of HIV-infected women keep growing. Smithwick, who has seen the disease spread over the years to younger and older women, said it saddens her to see it claiming so many of her “baby sisters.”
“I have kids coming to me — girls between 12 and 19 — who say they never thought they’d get it,” she said.