National Black HIV/AIDS Awareness Day

February 7th was National Black HIV/AIDS Awareness Day. In order to raise awareness about the disproportionate burden HIV/AIDS has on the Black community, we are dedicating this post to discussing some possible causes for the disparity.  

The Health Disparities

Black Americans are disproportionately affected by HIV/AIDS. In 2010, Black individuals made up 44% of all new HIV infections. This is despite the fact that the U.S. population is only 12% Black. In addition to HIV, one half of all newly diagnosed AIDS cases were to Black individuals. Note that AIDS is the most advanced form of HIV. Among those Black Americans diagnosed with HIV, Black Americans are less likely to be treated for HIV and are more likely to die as a result.

HIV/AIDS is spread within social circles, therefore creating clusters of incidence in some communities. Since HIV is primarily spread by sex or sharing needles with someone who is infected with HIV, it is essential that those already infected with HIV are aware of their condition. When an individuals knows they are infected with HIV he/she can be prescribed antiretrovirals. Antiretrovirals suppresses the HIV infection and reduce the spread of the disease.  In 2010, one-in-six Blacks living with HIV did not know of their diagnosis. Like all races/ethnicities, Black individuals tend to have sex with partners who are also Black.  After an HIV diagnosis, one-in-three Blacks get medical care and viral suppression. So to recap – Black Americans have both higher rates of HIV and are less likely to be treated.

Possible Contributing Factors

1.     Poverty. A quarter of African American families live in poverty. Low-income individuals might drop out of school at early ages, have difficulty seeking employment, and engage in risky behaviors such as drug use. Without steady employment, health insurance is challenging to obtain, especially in states that opted out of expanding Medicaid under the Affordable Care Act. Since HIV education is typically done in high school, dropping out of school at an early age may also prevent an individual from receiving HIV prevention education. Poverty can also force individuals to use sex as a way to earn money, thus increasing the chance of HIV spreading throughout sexual partners. A fatalistic view of life is also correlated with poverty. In a 2006 study that surveyed LA gang members, one-in-four felt it didn’t matter if they got HIV because they would die young anyway. Poor individuals tend to live in poor neighborhoods that lack adequate transportation and/or medical facilities.

2.     Imprisonment. Many people entering prison already have HIV. The prevalence of AIDS in prisons is estimated to be three times higher than the general population.  African Americans are incarcerated at the rate six times that of White Americans and in 2001, one in six Black men had been incarcerated at one time of their life. High prison rates increase risky behaviors associated with HIV. Jail time and poverty are closely related since jail time reduces the ability for those sentenced to get work experience and creates a blemish on their criminal record for future employment opportunities. However, there is good news – incarceration rates for Blacks dropped sharply between 2000 and 2009.

3.     Stigma. The fear of discussing risky sexual behaviors, drug use, or sexual orientation may keep Black Americans from being tested for HIV and seeking treatment. Some experts suggest that this stigma is tied, in part, to the religious belief that homosexuality is a sin in church congregations with a majority Black members. Since HIV/AIDS first was seen as a disease for white, gay men, it is still associated with homosexuality. Fueling the stigma against HIV/AIDS is the misinformation related to transmission of the disease.

What can we do?

Raise awareness around HIV/AIDS. In the last several years, the federal government attempted to do this by dedicated a day to HIV/AIDS in the Black Community, dedicating additional funds, and creating new educational materials. However, this information needs to trickle down into the areas of this county that are ripe with poverty. A possible way to do this is to use community health workers to work with Black Americans where they live. For more information about what we can do to alleviate the burden of HIV/AIDS on the black community, check out this website.