African-Americans and HIV/AIDS in the United States African-Americans’ share of the U.S. AIDS burden has never been more disproportionate to their representation in the total population. Surveillance
Blacks accounted for one-third of all men estimated to be living with AIDS in the United States at the end of 2004. An estimated 29.2 percent of Black men with AIDS had acquired the disease through injection drug use (IDU), and 18.1 percent had become infected through heterosexual contact—a much higher proportion than that for all men (21.1 percent IDU and 11.2 percent heterosexual contact). Men who have sex with men (MSM) was less likely to have been the reported HIV exposure category for Black men (43.7 percent) than for all men (58.3 percent) and, especially, for White men (75.2 percent).6 Women At the end of 2004, 60.3 percent
of all women estimated to be living with AIDS were Black. Heterosexual
contact was the HIV exposure category for 65.2 percent of those cases.6 The AIDS rate among adult Black women was 48.2, approximately 23
times that of White women (2.1).4 Children One-half of all children under age 13 who were estimated to be living with AIDS at the end of 2004 were Black.4 Since the onset of the epidemic, perinatal (mother-to-child) transmission has been the exposure category in 91.4 percent of cases in children.7 CRITICAL ISSUES Blacks are more likely to be uninsured than their White counterparts (19.7 percent versus 11.3 percent).8 Blacks have the highest poverty rate of all ethnic and racial groups.8 A study on infection patterns and risk behavior among young urban MSM found that HIV infection rates were high among Blacks (14 percent, compared with 3 percent for Whites).9 A correlation has been found
between perceived discrimination in HIV treatment and the status
of mental and physical health, medication adherence, and health care
satisfaction. In a study of AIDS patient care, 71 percent of participants
reported having experienced race-based discrimination in a health
care setting, and 66 percent reported African-Americans constitute 40 percent of the incarcerated population. Men who are incarcerated are at greater risk for HIV infection, thereby increasing the risk of transmission into other populations upon their release.11 Behavioral health risks associated with incarceration (and, thus, a greater incidence of HIV infection) include unprotected sexual contact, tattooing, and drug use.12 African-American men over age 50 are another group at increasingly high risk for HIV infection; they are a subpopulation often overlooked in preventive measures.11 Although it is more important than ever to ensure access to treatment for African-Americans, they are less likely than Whites to participate in clinical drug trials as a result of continued distrust of the health care system.13 African-Americans and the Ryan White CARE Act In 2004, more than one-half (52 percent) of all Ryan White Comprehensive AIDS Resources Emergency (CARE) Act clients were African-American. The proportion was much higher in some care settings. To increase access to quality care for minorities and respond to the need for additional minority providers of state-of-the-art HIV/AIDS care in underserved communities, the CARE Act funds the National Minority AIDS Education and Training Center program to expand clinical expertise in minority communities. More information is available at www.nmaetc.org. The Health Resources and Services Administration has supported a range of activities that address the epidemic among African-Americans. Highlights include the African-American Children’s Initiative, funded through the CARE Act Title IV program for Women, Infants, Children, Youth, and Families; community consultations and collaborations with community organizations such as the National Minority AIDS Council; and publication of study findings related to the search for increasingly effective means for reaching underserved populations. Capacity-building and planning grants have been targeted to underserved communities to expand the number of service settings available to vulnerable minority populations. |
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References
|
U.S. Department
of Health and Human Services - Health Resources and Services Administration
- HIV/AIDS Bureau
5600 Fishers Lane - Room 7-05 - Rockville, MD 20857 - 301-443-1993 - www.hab.hrsa.gov |