HIV and family are not typically mentioned in the same breath, but one prevention expert is hoping to change that.

Clinical psychologist Chisina Kapungu hopes to curb the alarming spread of HIV in the African-American community with a family-based HIV prevention program. Her primary solution: imcreasing 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 African-American girls to wait longer before becoming sexually active.

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 African-American girls in their early teens and their mothers or primary female caregivers.

According to the Centers for Disease Control and Prevention, blacks accounted for 51 percent of the 42,655 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, discusses how the early onset of puberty among African-American girls contributes to putting them at great risk of infection. She also describes the roles of sexual education and communication in her faith-based program and how these tools - and not just abstinence - may be key to protecting the next generation.

Q: How did your commitment to reducing HIV infections begin? 

A: I had a lot of members of my family die from HIV in Zimbabwe. That’s really the crux of how this started. 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. 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.

Q: Why are African-American women at a disproportionately high risk of infection? 

A: African-American youth, they 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. And so then you become more at risk. That’s a huge reason.

Biologically, women in themselves are more susceptible to the disease just because of how HIV is transmitted from men to women. The lining of the vagina provides a large area that comes into contact with the virus. And you have issues of sexual abuse. There are multiple reasons why African-American women are at greatest risk.

Q: Do you think vigilance levels are lower because HIV/AIDS is now seen as something chronic rather than a death sentence? 

A: In this country in particular we associate HIV with Africa or with developing nations. I think that in some communities, especially impoverished ones, you have so many other things to worry about—poverty, finances, violence, family—you’re not necessarily concerned with HIV. You think, ‘That’s not going to be me.’ It’s not a concern.

And stigma plays a big part. Still, unfortunately, people are thinking that HIV is a gay disease. Or they’re thinking by looking at Magic Johnson that all of a sudden he’s been cured. It’s again that misinformation.

Q: What inspired your HIV prevention program? 

A: I noticed that there wasn’t a lot of literature on faith-based HIV prevention programs. And after conducting focus groups and health fairs across Chicago, health providers invited me to come to their churches to talk about these issues, which aren’t naturally discussed on the pulpit or within the community. Everyone kept saying that the church would be the best venue to engage families and talk about sensitive issues like communication, HIV, abstinence and condom use.

Q: How is your HIV prevention program different from other ones? 

A: My program is not an abstinence-only program. It’s a program that is going to educate mothers and daughters about HIV transmission and prevention, discuss sexual possibility situations, and provide skills to reinforce factors that have been associated with delay in sexual debut: sexual communication, negative peer influence and parental monitoring. The main objectives are to decrease sexual possibility situations and delay of sexual intercourse.

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. I think you just really have to provide your child with skills to make the best decisions.

Q: How does the church factor into your program? 

A: The church is the venue, and the program will be developed with key stakeholders in the church. 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.

But I’m going to have people within the community to facilitate the groups. One of the results of the focus groups was that parishioners didn’t want people within the church actually facilitating the groups. People don’t want to be judged for anything they felt or said.

Q: Why are you working with mother-daughter pairs in this program? 

A: Mothers are a major source of socialization, particularly for girls. I’m hoping that by grouping them in parent-adolescent dyads, 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. 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.