Dr. Kimberly Smith, an infectious disease specialist at Chicago's Rush Medical Center, has been on the front lines of the HIV epidemic for more than a decade. Over the years, she has seen a dramatic increase in the number of women and African-Americans who've contracted HIV.
There's not a simple explanation for why more women are becoming infected, but Dr. Smith says she can pinpoint three important causes. "The first is lack of perception of risk," she says. "The second is lack of power in relationships, and then the third is the role that substance use plays."
Many women in monogamous relationships don't think they are at risk, Dr. Smith says, but their partners could be putting them in danger without them knowing it. If your significant other is having sex with other men or women, abusing drugs or has been to prison, your chances of contracting HIV are greatly increased.
A woman who is dependent on a man, emotionally or financially, may not have the power to withhold sex or demand that the man wear a condom, Dr. Smith says. Condom use is critical to preventing the spread of HIV.
Dr. Smith says we can't ignore the role drugs play in the fight against AIDS. "Substance use plays a role as well. ... Not only intravenous drug use, but also importantly crack cocaine," she says. "When individuals are addicted to crack cocaine ... they do very desperate things in order to get access to the drugs."