A South Philadelphia woman embraces her role as the new face of HIV.
Six years ago Mildred Lewis packed her bags and left home with her young daughter. Fleeing an abusive relationship, Lewis was determined to escape to a place where her fiance and her violent past couldn't find her.
But Lewis was soon trapped again. Sitting in a doctor's office, wringing her hands, Lewis learned she was HIV positive.
The doctor told her to come back next week for medication, then coolly sent her on her way. But Lewis wasn't coming back.
"I was so angry that I was on the verge of suicide," says Lewis, 41. "[My fiance] was an attractive man, and he was always out there messing around with other women. I believe he knew he had HIV and never said anything."
After leaving the doctor's office, Lewis stood crying on a SEPTA platform, waiting for the chance to step in front of a moving train. But the train was late, and Lewis decided to go home. She would later try again to take her life.
"The last time I tried to kill myself, I remember being drunk, and I was going to take some Tylenol," says Lewis. "But my spirit picked up the Bible, and it talked about how God knew me before I was in the womb. God already knew I was going to go through some problems, but he was going to turn it around. Everything bad that happened, he was going to turn around for good. That was the time I was able to lift my head up and move forward."
In the early 1980s HIV was considered primarily a gay white man's disease. But today blacks account for half of the new HIV infections in the United States, and many are becoming infected through heterosexual sex. Within those numbers, black women are becoming infected at a faster rate than any other group, accounting for nearly 64 percent of the HIV cases reported among women in the United States, and making Lewis the new face of HIV/AIDS.
"For the first time, half of the people living with AIDS are women," says Gary Bell, executive director of Blacks Educating Blacks About Sexual Health Issues (BEBASHI), a nonprofit organization that provides HIV counseling. "But across the board there's a lack of education, a lack of urgency, and that's a scary phenomenon. It is widely thought that one-third of the people who are HIV positive don't even know it. If we don't pay attention to HIV prevention, we're going to accelerate this epidemic."
AIDS has become the leading cause of death among black women 25 to 34 years old and among black men 35 to 44 years old. Here in Philadelphia, blacks account for 65 percent of reported AIDS cases.
According to the Centers for Disease Control, blacks contend with multiple risk factors for HIV infection. For black women, the data suggest that the leading cause of HIV infection is sexual contact with men. Yet for various and complex reasons, many women don't protect themselves against the possibility of their partners' risky behavior, including cheating with other women and having sex with men--aka living on the "down low."
"Men who are not admitting to having sex with men are of course having sex with women," says Karen Fitchette-Gordon, executive director of the Philadelphia Black Women's Health Project, which runs an HIV program in West Philadelphia. "So they're bringing those things to women and not being open about it, and women are not empowered enough to ask. They're not empowered to demand to know a person's HIV status before they sleep with them. They don't feel empowered enough to make them wear a condom. We're not empowered that way. We're not taught to be. We need to be, but we also need to make men become more responsible for their behavior."
Another risk factor is denial. From protecting their privacy to fear of a cultural backlash, some blacks refuse to talk about HIV risks like homosexuality, bisexuality and drug use, which leads to a lack of information about HIV and AIDS in the black community.
"You can say, 'My brother has cancer' or 'My mother has diabetes,' but you don't hear [black] people talking about AIDS," says Bell. "We don't have those conversations because there's such a stigma. AIDS isn't something people want to talk about, so people don't realize how widespread and prevalent it is.
"People need to put their own health and welfare above everything else. To do that they have to stare this HIV thing in the face."
For a long time Lewis couldn't face her HIV. She refused to get retested or get medication. Instead she buried her fears in crack cocaine and alcohol addiction.
Confronted by her sister, Lewis eventually acknowledged that she needed help.
"We just cried together," says Lewis, recalling the day she told her sister she was HIV positive. "She was so hurt that I'd been carrying it around for so many months. She told me, 'I'm going to be there, and the family is going to be there as well.'"