HIV; Health Disparity; Females; Positive Deviance


Community Health and Preventive Medicine | Immune System Diseases | Infectious Disease | Other Public Health | Public Health | Virus Diseases | Women's Health



In the United States, human immunodeficiency virus (HIV) continues to be among the top 10 leading causes of mortality for black women between the ages of 20 and 54¹, but does not rank among the top 10 leading causes of death for white women amongst all age groups². This study describes the HIV mortality difference between black and white women and formulate hypotheses that may reduce or eliminate disparities.


Information was accessed through public data, the US Census, and the US Compressed Mortality File.


In these descriptive data from 1987 through 2015, including reliable HIV mortality rates of both black and white females aged 25 to 64, the HIV mortality difference in black women is 8.2 times greater than that of their white counterparts. The mortality rate of black: white females is 8.7, a number comparable to that of 1997(13.39) a year after the introduction of highly active antiretroviral therapy (HAART). Although the data indicates a decline in the age adjusted mortality rate in HIV among black females, the current rate for black females is at a greater level than that for white female at any point of the epidemic.


These descriptive data demonstrate a large HIV mortality difference between black and white women. The data also demonstrate a small number of communities with low HIV mortality differences among black/African American women. Their characteristics may provide clinical and public health insights to reduce these higher mortality differences in the black female population of the United States. Analytic epidemiologic studies are necessary to test these hypotheses.