HIV and family are not typically mentioned in the same breath, but one prevention expert is hoping to change that.
Chisina Kapungu, a Chicago clinical psychologist, hopes to curb the alarming spread of HIV in the African-American community with a family-based HIV prevention program. Her primary solution: increasing communication between African-American mothers and their daughters.
Kapungu, who recently received a $795,000 grant from the National Institute for Mental Health for her work, said she aims to reduce HIV infections by convincing black girls to wait longer before having sex.
She is collaborating with two Chicago churches and several community-based educators for the program. Her first trial, which is slated for March 2011, will involve 72 pairs of girls in their early teens with their mothers or primary female caregivers.
According to the Centers for Disease Control and Prevention, blacks accounted for 51 percent of the roughly 4200 new U.S. HIV diagnoses in 2007-the most current year for the statistics-but represent 13 percent of the population. Some 64 percent of women living with HIV are black, and the HIV incidence rate for black women is nearly 15 times the rate for white women.
Kapungu, an assistant professor of obstetrics and gynecology at the University of Illinois at Chicago, notes how the early onset of puberty among black girls contributes to putting them at great risk of infection. Kapungu, whose heritage is from Zimbabwe, recalls members of her own family dying from the disease.
“That’s really the crux of how this started,” she said. “In 1998, when Zimbabwe was hit with the highest HIV rates in the world, I really wanted to investigate why that was. I went to Zimbabwe even though I didn’t have a job to consult with Population Services International to implement voluntary HIV counseling and testing sites. I realized that’s what I wanted to do. Being an African-American woman, it’s hitting this population [here] as well.
“I also think that, for something that’s preventable, it’s unfortunate,” Kapungu adds. “If you just give people skills and education and opportunities, then you can decrease the prevalence of HIV in these communities. For me, it’s a personal journey.”
Black youth, and women especially, she noted, develop into puberty earlier than white youth.
“You may have an African-American adolescent who started menstruating as early as age nine compared to a white adolescent who starts a few years later. When you start developing earlier, you increase the risk of engaging in sex earlier and having multiple partners,” Kapungu said. “And so then you become more at risk. That’s a huge reason.”
Biologically, women are more susceptible to the disease because of how HIV is transmitted between the sexes, Kapungu explained. The lining of the vagina provides a large area that comes into contact with the virus, she said-there are also issues of sexual abuse, among other multiple reasons why black women are at greatest risk. But some people still consider HIV a “gay disease,” Kapungu said.
“Or they’re thinking by looking at Magic Johnson that all of a sudden he’s been cured. It’s again that misinformation,” she said.
Kapungu was inspired to launch her program after noticing little available literature on faith-based, HIV prevention programs. She conducted focus groups and health fairs across Chicago. She also spoke at churches, noting that such issues aren’t typically discussed in the pulpit or within the community. As to how her program differs from others, Kapungu insists that hers is not abstinence-only.
“It’s a program that is going to educate mothers and daughters about HIV transmission and prevention…The main objectives are to decrease sexual possibility situations and delay of sexual intercourse,” she said.
“Teenagers are having sex, and I can’t be blind to that. You see it from the number of teenage pregnancies. I do believe there’s an appropriate time to have sex, so it’s challenging,” Kapungu admits. “I think you just really have to provide your child with skills to make the best decisions.”
The church, she added, will be the venue for developing the program, with input from key community stakeholders.
“It’s a resource that isn’t used and that needs to be if we really want to have an impact on the African-American community. It’s been shown in obesity that we can have an impact within churches, and I’m hoping it can be shown in HIV prevention as well.”
Kapungu chose to focus on mother-daughter pairs because, “mothers are a major source of socialization, particularly for girls. I’m hoping that…they can begin to talk because it’s very difficult to discuss these sensitive issues.
“Research has shown that parents actually think that they’re talking to children about sex, but when you ask the children they’ll tell you they never had that conversation,” Kapungu said. “There’s a huge discrepancy, and I really want to decrease that. I want to teach parents how to talk to their children about sex and find ways to communicate to kids that resonate. “