People in the African American community account for a higher proportion of new HIV diagnoses in the United States than any other racial or ethnic group. While some of the rampant infections have leveled off over the past couple of years, the danger of infection still exists and it's important to realize that HIV has the ability to affect all people within the community.
So why does HIV strike the African American community so disproportionately? The Centers for Disease Control and Prevention (CDC) theorizes the following:
-Awareness of HIV status and late diagnosis.
Individuals that are unaware of their HIV status or are diagnosed late or later while having the disease can unknowingly spread the disease among the community. A 2010 study conducted by the CDC found that almost 85,000 people infected with HIV in the African American community were unaware of their HIV status.
-Prevalence within the community.
Starting out with a high percentage of community members with HIV increases the probability of infection to others. People of the same race/ethnicity, in this case African American, tend to have sex with the same race and ethnicity so that increases the risk of infection with a new sex partner.
-Socioeconomic contributing factors.
Lower socioeconomic status, which is prevalent in some African American communities, can have a negative effect on education and access to adequate healthcare. Lack of insurance and ability to pay for care and treatment can impede everything from initial diagnosis through long term continuing care.
-Discrimination and stigma.
While stigma and fear of HIV and the diagnosis of being HIV positive may not be any more prevalent than in other races and ethnicities, it still exists and is no less either. Also, members of the African American community are no stranger to discrimination of all types. This is a major challenge to early diagnosis, acknowledgement and treatment.
According to a 2011 CDC Surveillance Report, injected drug use counts for more HIV infections among African Americans than any other ethnic group. It's also the third most likely route to HIV transmission. Injected drug use can directly transmit through the sharing of needles and secondarily or indirectly be transmitted through being sexually involved with an IV drug user.
The U.S. Health Resources and Services Administration (HRSA) which administers the Ryan White Care Act, is well aware of the problem in the African American community.
The Ryan White HIV/AIDS Program was established with the passage of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act of 1990. The Program is not an entitlement, but the payer of last resort for people who otherwise would not be able to afford treatment, care, and support services for themselves or their families. Almost one-half of all Ryan White HIV/AIDS Program clients were African American in 2007 and 2008.
There are many parts to the act. As an example, "Part B" includes the AIDS Drug Assistance Program (ADAP) which is a medical lifeline for people who can't afford their lifesaving meds. "Part F," however, includes the Minority AIDS Initiative (MAI), established in 1998 during a meeting between Federal officials and African American service providers and community leaders about the continued disproportionate impact of HIV in black communities. During the meeting, they demanded the government take further action to increase the response to HIV among African Americans and heavily impacted minorities overall.
The MAI supports the expansion of HIV services within minority and minority-serving providers and community-based organizations managing and treating HIV at the grassroots level.
MAI funds have played an integral role in expanding HIV service delivery in African American communities, enabling providers already serving hard to reach African Americans an opportunity to address issues such as HIV stigma that have prevented many of them from addressing HIV disease.
In addition to the MAI, "Part F" also includes the Special Projects of National Significance, which supports the development of innovative HIV care that otherwise would not be funded or evaluated. Initiatives have addressed how to engage various vulnerable subpopulations of African Americans into HIV care, including black gay youth, people in jail settings, women of color and Caribbean groups.
So what can you do for your part to help the problem? If you are African American and HIV-positive or at risk, what you need to do to help protect yourself or others from contracting the HIV virus isn't different from other races or ethnicities. Things like practicing safe sex with your partner, using PrEP, not using a dirty or shared needle if you are a drug user, getting tested and knowing your partner's status are all essential.
What is different though, because you live in a community that has such a high incidence of HIV, is the level of awareness that you need to have.
For starters, your awareness needs to begin with you. If you are HIV-positive, let your partner(s) know. If you haven't been tested and think you might be at risk - no question - get tested. If you have a partner, get tested with him or her. Doing that gives you peace of mind of your partner's status too.
Educate not only yourself but close friends and family members who might not be as careful and knowledgeable as you and may also be at a higher risk.
Getting tested and being educated can help stop the spread of HIV to you and can also mean you not spreading it to others.
African Americans are able to access the help and resources available to anyone with HIV, like the Ryan White Care Act (see https://hab.hrsa.gov/), but if you would like to seek out programs, services and information that is more specifically geared toward the African American community, here are some ideas of where to start:
-Begin with the Centers for Disease Control and Prevention (CDC) website at www.CDC.gov. For HIV in general go to www.cdc.gov/hiv/. For information specific to the African American community, go to www.cdc.gov/hiv/risk/racialethnic/aa/index.html. There you'll have access to podcasts, factsheets, funding information, statistics and much more.
-The Black AIDS Institute. 1833 West 8th Street #200; Los Angeles, CA 90057-4920; 213-353-3610; www.blackaids.org
-National Black Leadership Commission on AIDS. 215 W. 125th Street; Suite 2; New York, NY 10027; 212-614-0023; www.nblca.org
-National Minority AIDS Council. 1000 Vermont Ave., NW; Suite 200; Washington, DC 20005; 202-870-0918; www.nmac.org
-Contact your local AIDS Service Organization (ASO). ASOs will have local and community based information to point you in the right direction.
-Contact your State or local HIV hotline. Try other sources for information first (if a non-emergency) but sometimes hotlines will have local information and sources specific to the African American community.
-The Balm in Gilead. 620 Moorefield Park Dr.; Suite 150; Midlothian, VA 23236; 804-644-2256; www.balmingilead.org
-The Black Church and HIV (NAACP). 410-580-5777; www.theblackchurchandhiv.org
Copyright 2017, Positive Health Publications, Inc.
This magazine is intended to enhance your relationship with your doctor - not replace it! Medical treatments and products should always be discussed with a licensed physician who has experience treating HIV and AIDS!