New HIV infections and HIV/AIDS-related deaths disproportionately affect African American women (1, 2), despite advances in HIV treatment and declines in HIV infections among other risk groups. Women of color are especially affected by HIV infection and AIDS. African American women make up only 12% of the female population in the United States, yet they account for 66% of new HIV infections (6). In 2004, HIV infection was the leading cause of death for African American women aged 25–34 years and the 3rd leading cause of death for African American women aged 35–44 years (3). In 2005, the rate of AIDS diagnoses for African American women was 20 times the rate for White women (6). HIV/AIDS-related conditions are now the leading cause of death for African American women aged 25-34 years (7).

Recent CDC data show that the main risk factors for most HIV/AIDS diagnoses among African Americans females are high-risk heterosexual contact (80%) followed by injection drug use (18%); and as with all racial and ethnic groups, African Americans at higher risk for HIV are those who are unaware of their partner’s risk factors, have other sexually transmitted diseases (STDs), and have unprotected anal and vaginal intercourse (6, 8). Injection drug use is a risk factor for African American women, but it is less of a risk factor for them than for White and Hispanic women. In 2004, an estimated 17% of African American women with AIDS reported that they used injection drugs compared with 31% of White women with AIDS and 21% of Hispanic women with AIDS (9).

The reasons for increased AIDS incidence and deaths among African American women are complex (1, 10). Among the reasons for increased incidence are: There are disproportionately high HIV infection rates among African American women, large numbers of African American women at risk for AIDS, and African American women might benefit less from antiretroviral therapy than other groups because they have greater difficulties with access to care and adherence to treatment than other women (1, 2, 11, 12).

Race and ethnicity, alone, are not risk factors for HIV infection. Poverty and other social and structural influences are associated with higher HIV/AIDS incidence among African Americans (13). African American women at high risk for HIV often sustain the brunt of racism, discrimination, poverty, and sexual abuse. These social determinants may be influencing factors which can contribute to their decreased ability to protect themselves against this devastating disease.

These compelling data demonstrate the need to convene diverse stakeholders in order to discuss, identify, and develop comprehensive strategies to reach African American women most in need.

In March 2007, CDC’s Division of HIV/AIDS Prevention announced an action plan to respond to the major health crisis of HIV/AIDS among African Americans. This action plan, titled A Heightened National Response to the HIV/AIDS Crisis among African Americans, focuses on four main areas: 1) expanding the reach for prevention services, 2) increasing opportunities for diagnosing and treating HIV, 3) developing new, effective prevention interventions, and 4) mobilizing broader community action (14). The HIV/AIDS and African American Women Consultation convened by the CDC and held in Atlanta, Georgia on June 20-21, 2007, was guided by these four main areas. The consultation gave participants the opportunity to share their collective knowledge and skills. Participants included stakeholders from academia, state and local health departments, community-based service providers, and others with expertise regarding African American women’s historic, cultural, economic and health issues and in serving African American women (for a list of participants, see Appendix A). Most importantly, the consultation generated ideas and thoughts for prevention strategies to better meet the needs of underserved African American women affected by HIV/AIDS.

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