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AFRICAN-AMERICANS AND HIV
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| SURVEILLANCE |
- In
2006, Blacks or African-Americans accounted
for just 12.4 percent of the U.S. population
but 48.8 percent of estimated new AIDS
cases.1,2
- The
AIDS rate among adults and adolescents
(the number of people living with AIDS
per 100,000 individuals) was 60.3 for
Blacks, compared with 14.9 for the total
U.S. population.3
- Black
men and women account for an ever-growing
number of U.S. deaths attributed to AIDS.
Since the onset of the epidemic, an estimated
38.6 percent of deaths from AIDS have
been among Blacks, and the proportion
is increasing. In 2006, 50.8 percent of
the estimated total AIDS mortality was
among Blacks.4
- In
2005, AIDS was the third leading cause
of death among African-American women
ages 25–34 and the third leading
cause of death among African-American
men ages 35–44.5
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Blacks
accounted for more than one-third of all
males estimated to be living with AIDS in
the United States at the end of 2006. An
estimated 26.6 percent of Black men living
with AIDS had acquired the disease through
injection drug use (IDU) and 19.0 percent
had become infected through high-risk heterosexual
contact—a much higher proportion than
among all males (18.9 percent IDU and 11.7
percent high-risk heterosexual contact).
Male-to-male sexual contact was less likely
to have been the reported HIV transmission
category for Black men (45.2 percent) than
for all men (59.9 percent) and, especially,
for White men (75.2 percent).6
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| WOMEN
AND CHILDREN |
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At
the end of 2006, 61.9 percent of all women
estimated to be living with AIDS were Black.
High-risk heterosexual contact was the HIV
transmission category for 67.6 percent of
those cases.6 The AIDS rate among adult
Black women is 40.4, more than 21 times
that of White women (1.9).3
At
the end of 2006, 78.9 percent of all children
under age 13 estimated to be living with
AIDS were Black.3 Since the onset
of the epidemic, mother-to-child has been
the transmission category in 92 percent
of cases.7
People
living with HIV disease are, on average,
poorer than the general population, and
Ryan White HIV/AIDS Program clients are
poorer still. For them, the Ryan White HIV/AIDS
Program is the payor of last resort because
they are uninsured or have inadequate insurance
and cannot cover the costs of care on their
own, and because no other source of payment
for services, public or private, is available.
Most Ryan White clients are from a racial
or ethnic minority group. In 2006, more
than 70% of clients served by the Ryan White
HIV/AIDS Program were people of color. In
2006, 66% of clients were male and 33% were
female.
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| CRITICAL
ISSUES |
| Blacks
are more likely to be uninsured than Whites
(20.5 percent versus 10.8 percent).8
Blacks are also three times more likely to
live in poverty than Whites.8 Health
care disparities related to race, ethnicity,
and socioeconomic status remain prevalent
in the U.S. health care system: Blacks had
poorer quality and worse access to care than
Whites.9
Men
who are incarcerated are at greater risk
for HIV infection, thereby increasing the
risk of transmission into other populations.1
If current incarceration rates persist,
roughly 1 in 3 Black males will enter State
or Federal prison during their lifetime.10
Prevalence of imprisonment is higher among
Blacks (men and women) than among any other
racial or ethnic group.10,11
Behavioral health risks associated with
incarceration (and, thus, a greater incidence
of HIV infection) include unprotected sexual
contact, tattooing, and drug use.12
“Because
African American women are less likely than
other women to date men outside their racial/ethnic
group, high rates of HIV infection among
African American men has important
implications for African American women’s
HIV risk.”13
A
study conducted between June 2004 and April
2005 in five U.S. cities found 46 percent
of Black men who have sex with men (MSM)
were HIV positive and 67 percent of these
men were unaware of their status.14
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| HRSA'S
RESPONSE |
| In
2006, one-half (48 percent) of all Ryan White
HIV/AIDS Program clients were African-American.
The proportion was much higher in some care
settings. To increase access to quality care
for minorities and to respond to the need
for additional minority providers of state-of-the-art
care in underserved communities, the Ryan
White HIV/AIDS Program funds the National
Minority AIDS Education and Training Center
to expand clinical expertise in minority communities
(see www.nmaetc.org). The National Minority
AIDS Initiative has been codified into law
and is now Part F of the Ryan White HIV/AIDS
Program (see www.hab.hrsa.gov/treatmentmodernization/minority.htm).
The
Health Resources and Services Administration
(HRSA) supports many other activities
that address the epidemic among African-Americans.
Highlights include the Special Projects
of National Significance (SPNS) Program
on Outreach, Care, and Prevention to Engage
HIV Seropositive Young MSM of Color; collaboration
with community organizations such as the
National Minority AIDS Council; and
publications on the search for increasingly
effective means for reaching the underserved.
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| END
NOTES: |
1
|
U.S. Census Bureau. 2006
American community survey data profile
highlights. 2006. Accessed June
10, 2008. |
| 2 |
Centers for Disease Control and Prevention
(CDC). HIV/AIDS Surveillance
Report. 2006;18:13. Table 3. |
| 3 |
CDC. HIV/AIDS Surveillance Report.
2006;18:15. Table 5a. |
| 4 |
CDC. HIV/AIDS Surveillance Report.
2006;18:17. Table 7. |
| 5 |
U.S. Department of Health and Human
Services (HHS). Office of Minority Health.
HIV/AIDS data/statistics. n.d. Accessed
June 10, 2008 at: www.omhrc.gov/templates/browse.aspx?lvl=3&lvlid=7. |
| 6 |
CDC. HIV/AIDS Surveillance Report.
2006;18:23. Table 11. |
| 7 |
CDC. HIV/AIDS Surveillance Report.
2006;18:37. Table 17. |
| 8 |
U.S. Census Bureau. Income, Poverty,
and Health Insurance in the United States:
2006. Washington, DC; U.S. Government
Printing Office 2007:22. Available at:
www.census.gov/prod/2007pubs/p60-233.pdf
(PDF – 3108KB). Accessed June
10, 2008. |
| 9 |
HHS.
Agency for Healthcare Research and Quality
(AHRQ). National Healthcare Disparities
Report. Rockville, MD: AHRQ; 2007.
Available at: www.ahrq.gov/qual/nhdr06/highlights/nhdr06high.htm#intro.
Accessed June 10, 2008. |
| 10 |
Bureau
of Justice Statistics (BJS). Criminal
offenders statistics. n.d. Available
at: www.ojp.usdoj.gov/bjs/crimoff.htm#recidivism.
Accessed June 10, 2008. |
| 11 |
BJS.
Prisoners in 2005. November
2006. Available at: www.ojp.usdoj.gov/bjs/pub/pdf/p05.pdf
(PDF – 376KB). Accessed June
10, 2008. |
| 12 |
Blankenship
KM, Smoyer AB, Bray SJ, Mattocks K.
Black-white disparities in HIV/AIDS:
the role of drug policy and the corrections
system. Health Care Poor Underserved.
2005;16(4 suppl B):140-56. |
| 13
|
National
Alliance of State & Territorial
AIDS Directors (NASTAD). The landscape
of HIV/AIDS among African American women
in the United States. African
American Women’s Issue Brief No.
1. Washington, DC: Author; 2008. |
| 14 |
NASTAD. Findings from targeted interviews
on HIV prevention activities directed
toward Black men who have sex with men
(MSM). Black MSM Issue Brief No.
3. Washington, DC: Author; 2008. |
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