National Women and Girls HIV AIDS Awareness Day is a reminder that the HIV epidemic is not over, especially for Black women. The numbers remain deeply uneven, and the women closest to the work say progress depends on trust and community investment that actually reaches Black women.
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The Disparities Are Deep
Black women continue to carry a disproportionate share of new HIV diagnoses in the United States. According to the CDC, in 2023, they made up 13 percent of the female population but accounted for 50 percent of new HIV diagnoses among women. Their diagnosis rate was 11 times higher than that of white women. These gaps reflect long standing inequities in access to prevention, testing, and care.
Three leaders working across communications, clinical practice, and community advocacy shared what they are seeing and what it will take to change the trajectory for Black women and girls.
Prevention Is Not Reaching Black Women
Bithiah Lafontant, Head of Enterprise Communications at ViiV Healthcare, says the disparities remain impossible to ignore. For her, the first step is shifting how the healthcare system communicates with Black women.
“To turn the tide, it is crucial that we focus on combating HIV stigma, promoting open and honest conversations, and most importantly, increasing awareness and action around the options that are available for HIV prevention and treatment nationwide.”
She believes providers must take a more active role.
“Healthcare providers need to be proactively starting conversations about HIV with Black women so that they are aware of the issue and are empowered to make decisions about how to best protect their health.”
ViiV describes its work as community first, and Lafontant explains that this approach is more than a slogan.
“ViiV Healthcare puts communities at the center of everything we do, prioritizing those most impacted by HIV.”
That includes clinical trials that reflect the communities most affected and partnerships that meet women where they are. One example is Risk to Reasons, a program designed specifically for Black women.
“Instead of focusing on risk, we explore reasons to embrace HIV prevention, which may include gaining power and control, normalizing self-care, and being free from shame. Risk to Reasons is a key component of ViiV’s philanthropic investments dedicated to Black women’s needs and voices in HIV prevention. This program has reached more than one million people with reasons for HIV prevention, trained more than 3,500 providers and continues to change the HIV narrative for Black women through storytelling, convening safe spaces, arts and culture.”
How Evolving HIV Care Supports Women
For many women, daily pills do not fit the realities of caregiving, work, and financial pressure. Lafontant says meeting women where they are requires flexibility.
“Meeting women where they are means building trust and creating pathways to health that fit their needs and realities.”
Dr. Zandraetta Tims Cook, Medical Director at Faebris Infectious Disease Medical Practice, sees this every day in her Atlanta clinic.
“Long-acting injectable options like Cabenuva for HIV treatment, and Apretude for HIV prevention are important because they offer another option outside of a daily oral pill.”
She notes that privacy and stigma also shape women’s choices.
“The discreet nature of an injection can also help to address privacy concerns that might be important for women in various life situations.”
For many women, power lies in choice.
“Having options empowers women with the choice of an effective method of prevention or treatment that integrates into their unique lives.”
Medical Mistrust Still Shapes Care
Dr. Tims Cook says many women still do not see themselves reflected in HIV prevention efforts.
“Women represent 19 percent of all new HIV diagnoses in the U.S., yet among all PrEP users, a staggering 92 percent were men and only 8 percent were women.”
She notes that this disconnect is especially sharp for Black women.
“These imbalances underscore inequities and a narrow perception of populations impacted by HIV.”
For her, the work begins with rebuilding trust in clinical spaces.
“For Black women, who have historically been underserved in medical settings, we must rebuild trust.”
That trust is shaped by the environment women walk into.
“This always starts by creating a safe, non-judgmental environment where women feel truly heard and respected.”
And she believes providers must take the lead in making HIV conversations routine.
“The most critical shift in clinical practice needed today is normalizing HIV testing and prevention conversations.”
African Immigrant Women Face Even Higher Barriers
Chioma Nnaji, Senior Program Director at the Multicultural AIDS Coalition, says one of the biggest misunderstandings is treating Black women as a single group.
“A Black woman born and raised in the U.S. has a very different experience than an African immigrant woman who recently arrived from a refugee camp. Ignoring these differences creates harm.”
She points to the data that often gets overlooked.
“HIV diagnosis rates among African immigrants in the U.S. are six times higher than the general population, and African immigrant women are over five times more likely to be diagnosed with HIV than U.S. born Black women.”
These disparities are shaped by immigration status, language, culture, and access to care.
The Stories That Shape Her Work
Nnaji has spent years listening to women who were never given the space to understand their own bodies.
She often starts by asking women how many openings the vulva has.
“Many women are surprised to learn the answer is three, the urinary opening, the vagina and the anus.”
She often begins with anatomy before moving into conversations about communication, relationships, and autonomy.
“Women were taught to feel ashamed of their bodies, and pleasure was framed as something that existed only for men. So, when we start talking about HIV prevention, testing or PrEP, we often begin with the basics, such as body anatomy. From there, the conversation expands to communication in relationships and women feeling comfortable naming what they want and need for their own health.”
Stigma Continues to Silence Women
Stigma remains one of the most powerful barriers to testing and care. Nnaji says this fear is still deeply rooted in many of the communities she serves.
“HIV in many African immigrant communities is still perceived as a death sentence.”
She explains that this fear often leads to delayed diagnoses, which inspired the creation of ASHE, a peer-led group for African immigrant women living with HIV.
“ASHE has evolved into a powerful source of healing, advocacy and leadership for African immigrant women living with HIV.”
What Action Looks Like Right Now
Nnaji says real progress depends on supporting the people already doing the work.
“We need to invest more deeply in community-based organizations that already have relationships with African immigrant communities.”
She points to the importance of approaches shaped by culture, not just language.
“Institutions need to support culturally specific programs, not just translation of materials, but approaches that reflect how communities actually talk about health, relationships and family.”
And she stresses that women should be shaping the programs meant for them.
“When women help design programs, outreach and messaging, the work becomes more relevant and much more effective.”
What Actually Works for Black Women and Girls
Nnaji emphasizes that the strategies that consistently reach women grow from community leadership.
“Peer led strategies and Community Health Workers remain some of the most effective ways to reach women and connect them to prevention and care.”
But she worries that the support these models rely on is slipping.
“The real question is whether we are willing to keep investing in the people and relationships that make this work possible.”
Real shifts are happening because women are insisting on care that reflects their lives. The work isn’t theirs alone, but women keep pushing the change in the direction it needs to go.
Resources:
HIV Diagnoses, Deaths, and Prevalence: 2025 Update | HIV Data | CDC
The Global specialist company in HIV Care | ViiV Healthcare
Faebris – Building the Stepping Stones to Care, Comfort & Empathy in Atlanta.
HIV Testing/Services | Multicultural AIDS Coalition | United States
