excavated. that'll do it for this edition of al jazeera america. remember, news at the top of every hour. thanks for watching. >> hi, i'm lisa fletcher, and you are in the "stream." black women are testing positive for hiv at an alarming rate. what is leading to the increase in infections that has some now looking at the prison system. ♪ my co-host, wajahat ali is here, bringing in all of your live feedback for the show.

it has been about 20 years since the start of the aids crisis in the u.s., and it has sort of faded out of the headlines, so we don't hear about it as much, and then we hear stats like this and it is alarming. >> yeah. our jaws dropped when we were doing this research. it's infuriating and sobering, and this is still an issue. >> wake them up a little. every ten minutes in someone in

the u.s. is effected with hiv. more than a million americans are living with the virus, and while the disease doesn't discriminate, the overwhelming majority of infection are in men who have sex with men. but hidden in the numbers is a disturbing find. aides is the number one killer of black women age 25 to 34. while making up roughly 13% of the nation's female population, they account for nearly 65% of all hiv infections among women. with the majority contracting the disease during sex. >> i was like, oh, my god, this guy has given me -- i knew it at that moment. i wasn't promiscuous, i was in a monogamous relationship. >> health officials say there are a lot of things that factor into this. but they are also looking at another potential source, prison.

the cdc says every year one out of seven people who pass through the correctional system have hiv, and the majority of the men in the system are black. and once they return to the communities, there's the question about the likelihood that they could pass their disease on to their female partners. joining us now to help us answer some questions is a cdc trained epidemiologist who has worked with hiv patients and on this issue around the globe. the director of the ribbon consulting group, she is hiv positive. ceo of fremont communications and advocates for children and women of color. and the cofounder of the red pump project where she uses technology to raise awareness about aids. welcome everyone to the "stream." doctor you have studied this

issue a lot is there a connection between inmates with hiv to then what happens in communities, particularly communities of color? >> the short answer is probably, but we don't know to what extent. it's a really provocative question, is the prison population perpetuating the hiv epidemic in the black community, but the reality is we don't have enough information to know if that's true or not, and if it is true, to what extent. so our goals are really to understood -- understand where people are contracting hiv and figure out what we need to do to stop the spread of hiv. so it's a question that comes up all the time, we hear it a lot, but we just don't know the answer yet >> lisa are there any patterns that have been identified in terms of why there is such a

high rate of hiv within the black female population? >> which lisa in >> oh, i'm so sorry, you, lisa. we have three lisas on the show tonight, viewers. >> yes. could you repeat your question -- >> sure, i was wondering if there are any patterns that have been identified. you have written on this. this is a big focus of yours, any patterns identified that help put a few more pieces into the puzzle? >> well, one of the patterns actually coming out of the prison system is them not being tested when they rife and when they leave, and so we don't -- as dr. fitzpatrick said we don't have the data. however, there was a law enacted around federal prisons, and those folks are getting tested, so we really need to look at and

address some of the local jails and state prisons and see where that cycle is leading us. but black women are -- there numbers -- and we should identify the fact that the numbers have decreased, except that they are still very high, and so it is still unacceptable levels, but there has been a slight decrease in the last two years or so, but that when you look at black women and you look at many are in the lower socioeconomic position in life, where they don't have access to care, and, you know, it's a lot of the social determinants that lead them to being at higher risk for getting hiv and aids. >> lisa our community has been tweeting in about the reasons why this is effecting african america women.

it is 65% among black women. that's staggering. and markey says . . . linda you have lived with this for more than 20 years, what are some of the reasons that aren't shown in main stream media and headline news that are really effecting african american women which causes an alarming number, this alarming rise if you will? >> there is definitely a large number of disproportion at it black women living with hiv. and i think what some of your -- your followers say in a

tweet, it is poverty, housing, homelessness, the cost of insurance and medication, but there are a lot of services to help with the cost of medication if someone is living with hiv, but many women when we contact it to incarceration, many women whether they know their partner is hiv infected or not, women are taking care of their households and multiple households. so them getting the care they need earlier definitely can help prevent the spread of hiv. one of the tweets said they are men on the down low. there are definitely men on the down low, but there are a lot of men are heterosexual, and we can't track them. we don't know who they are. as a women who has been married

since her diagnosis, i have been diagnosed for 23 year, i have been married for 8 years. whether people are engaging in situational sex voluntarily or involuntarily, there are things that can happen to decrease the risk of hiv coming into our communities. and there are men who are not in the jails who don't have the information, who they are not programmed in resources targeted and then identified as heterosexual men who these women are in relationships with. >> doctor you have worked on this issue around the world, how is it in urban areas like detroit, new york, newark, and right here in d.c., that the rate of hiv in the black population can compete with the rate of aids and hiv in africa?

>> we hear that a lot. d.c. has the rate of hiv that rivals that in africa, and i think in some ways it's a little unfair to the epidemic in africa. because the epidemic in africa is on a scale that we can't even fathom here in the u.s., but having said that, all of the things we talked about so far are contributing to the rates of hiv. i think one thing we do know is that black women tend to have partners who are also black men. so if you have a higher rate of hiv infection in black men, and black women are only in sexual networks, or primarily in sexual networks with black men, then you are likely to have a much higher rate. >> sure. >> while we're at the beginning of the show, though, i feel like i need to chime in on this down low issue.

>> tell people what that means. >> it's a very derogatory term that we really need to move away from. the down low is this notion that someone is in the closet. there is research data to show that men who don't inform their sexual partners of their male-to-male relationships, actually practice safer behavior. so i think it's not proper to stay focused on the, quote unquote, men on the down low. and it stigmatizes behavior. what are people doing to put themselves at risk? they are having unprotected sex with people who are hiv positive, people who don't know their status or are not talking about their status. so i think we have to move away

from the labels on people. >> true. and sometimes people shift their behavior based on fear of stigmas, which is what i want to talk about when we come back. the fear of what others might thing can keep you from getting help. why confronting hiv is harder in black communities. >> tv is no longer one way, with "the stream" second screen app. get excuse if app content, receive graphs, quizzes, and quest information. interact with other app users in real time. you can be our third co-host, vote, tweet, record video comments and we'll feature them on air. use our app and drive the community's discussions on live tv. download >> al jazeera america presents extrodanary

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>> every sunday night, al jazeera america brings you conversations you won't find anywhere else... >> your'e listening because you wanna see what happen... >> get your damn education... >> talk to al jazeera only on al jazeera america >> oh my... ♪ >> oftentimes with the stigma of living with hiv there's the guilt that i did something wrong. i'm a very bad person, or the

shame that i have something that no one else has. >> welcome back, we're discussing the impact hiv has on xhup tease of color and looking at factors that place black women at higher risk than almost every other group. we were talking about fear of shame and disgrace really plays a huge role in people getting help they need. >> yeah, and mikey says . . . and we got a great video comment from pat tick. >> still ma is also a huge come

known when you look at hiv. and when we reduce stigma, we do that by education, and that allows normalization of hiv testing and people to feel more comfortable with talking about their hiv status and being more open about it. people living with hiv in stigmatized communities hide, and we shouldn't be that way. >> stigma still persists lisa. >> oh, it does. and linda you have been living with hiv since 1990. where is the still ma of hiv different in the black communities compared to others? >> i don't think if i can tell you why. but stigma is very high in the black community, and very much connected to the early onset of this disease, and in 1980s, connect to the homophobia.

in the african american community, i think the fact -- just as she said earlier, i did something wrong. i'm bad. i'm ugly. i'm dirty. i'm hiv. i'm the bug. and who wants to be what community don't want to be present? so stigma is real, and people address it very differently. some address the stigma very much in front and confront it and understand i'm not hiv. hiv is embarrassed that i contracted it, in a monogamous relationship with someone i assumed i was in love with. in 1990 when i was diagnosed the messaging wasn't there for women of any color of any race. today is the messaging there? yeah, but i would still say that even some of our messaging is very stigmatizing and

judgmental, and many times very negative to black men. even as doctor fitzpatrick stated, how we have to take the blame off of the concept of down low, and really talk about the behavior that individuals are practicing, so, again, we don't want to talk about sex. sex is taboo in the black community. having conversation as adults with family, we're not having those conversations with our children. it shouldn't be the school or the churches or television that educate our children. it should be us the parent. but those conversations are also fuelling this sigma, what happens around the dining room able to -- oh, i forgot, many of us don't sit at the dining room table anymore -- to have education time. this address stigma, what we allow. and even people working with hiv feel that sometimes we allow people to say things that is

very stigmatizing around us, and we don't take the leadership to say no, that's not true. a of clinicians who work in kneeled, they don't even go home and have this conversation, this is the work i do, but not necessarily what i practice or teach. >> can i make a point here? >> sure, go ahead. >> the -- when you think about i, the last time we really had conversations about hiv was when people were dying from hiv. >> yeah. >> dying left and right. and white gay men were dying of hiv. and that was over 20 years ago. so if the community's perception was formed back when people were dying of hiv. and you didn't see a lot of people dying of hiv, and if you

did they are skeletal people. when patients come in and they are sick and you ask them why are you just now coming in? they talk about the stigma. they are not hearing the messages of hope around hiv and the treatment availability. so the stigma is there because we stopped talking about hiv a long time ago. >> i think for young people, you know, i'm part of the generation that has never lived without hiv existing, without aids being a thing, this epidemic just being around us. >> uh-huh. >> and for us it comes with cause apathy, for example, kick starter campaigns and nonprofits about everything. we kind of have information overload, so some of the information we get-goes through one ear and out the other.

for us it's a more a matter of we have never lived in a time when aids was a death sentence. i'm 29 and aids is 30, but from the time i was nine and up, watching philadelphia -- around me philadelphia wasn't happening. i grew up on the fact that medication can allow you to live a very long and fruitful life. so the messaging has to be different for young people that it is not the flu, but it's also not a death sentence, so there's a middle ground that we need to acknowledge and actually take more serious. and our stigma might look different from yours as people who are middle age or even higher, the 34 and up bracket because we are the generation that talks about sex in social media, however, we're not talking about it in productive ways, to let our peers know,

hey, try to do the condom. >> that's an excellent point, and that is how do you grab the at tension and change the messages to adapt to the times about the impact of hiv not just on women but in all communities. we're going to talk about a project that could be a step in back. >> no doubt about it, innovation changes our lives. opening doors ... opening possibilities. taking the impossible from lab ... to life. on techknow, our scientists bring you a sneak-peak of the future, and take you behind the scenes at our evolving world. techknow - ideas, invention, life. on al jazeera america

your global news leader aids is the leading cause of death for black women ages 25 to 34. but there are things you can do to help. >> prevention is power. >> get educated.

>> get tested. >> get treated. >> it is estimated that 1 in 32 black women will be diagnosed with hiv at some point in their lifetime. are we seeing any really promising advances in treatment right now? >> oh, absolutely. the treatment for hiv has been revolutionized over the last several years. in fact people remember a time when a person with hiv had to take a handful of pills sometimes up to 30 pills a day. >> yeah. >> and now you can treat the infection with as few as one or two pills aday, it's incredible, and the side effects are few and far between, and this is the message people need to understand about hiv. it is a treatable disease. and we need to think about incorporating diagnosis and treatment into the regular prevention and treatment

system. >> in preparing for the show waj and i were amaced to discover that there is a prophylactic treatment if you think you have been exposed. it is somewhat like a morning after pill for hiv. >> yes. for people who are hiv negative. this is called preexposure prophylactic. so before you are exposed, you can take this medication. but it has to be taken consistently and indefinitely if you are placing yourself at risk for pexposure. and there is post prophylactic for people who know they were exposed to hiv it is essential they contact a healthcare facility

within 72 hours so they can access the medication. >> tell us about how you are using social media to raise awareness. >> my organization the red pump project turned five this year. we asked bloggers to add this red shoe badge on their blog, and dedicate their website to talking about hiv and aids. so we take the very serious disease and conversation out of townhalls and bring it into social media and into twitter, and we use red shoes to get people's attention, and while we have their attention, we talk about hiv and the issues surrounding it, and the stigma, and what we try to do is normalize the conversation so it takes some of the shame and secrecy out of it. let's just talk about it, why not?

>> speaking about talking, our community has really responded about new messages . . . linda i'm going to go to you with this, give us a new forward. >> think kim said it. any woman can contract this disease. she has to protect herself. there are a number of ways. hiv truly is 100% preventable, not just in hearing the message but making action nch the gentlemen has said action, utilizing safe sex practices, but talk to a health-care provider, not just through social media or reading a book. the next time you go to the

doctor, if someone don't talk to you about hiv, you talk to them about hiv. that's whether you are married, single, straight, gay, whatever you are. if you have ever had sex, and again when we talk about black women it's not just younger black women. i was talking to a woman correctly, she said i'm 65 years old, i'm in a new relationship. who buys the condoms? that. >> lisa, we have about 25 seconds left. >> i just want to add real quick that we also need to talk about after 30 years about how it is transmitted and the riskier ways of having sex. not even way you have sex is most at risk for having hiv. and we'll be discussing hiv disclosure among women with congressional member barbara lee and dr. fitzpatrick march 19th

on google hangout. >> great conversation. see you next time. ♪ >> condemnation and sanctions as crimea moves to break away from the ukraine. >> hello, this is al jazeera, live from doha. also ahead - accused of using child soldiers. the international criminal court so due to deliver a verdict against a former congolese leader. >> urgent help or risks of falling apart in crimea. >> how this