Thirty years after the HIV/AIDS epidemic was officially recognized by the United States medical establishment, the impact the disease has had on the African American community is profound.
In fact, the Centers for Disease Control (CDC) has described the situation as a crisis. Consider these facts:
1) Although Blacks represent only about 14 percent of the U.S. population, they account for almost half the people living with AIDS in the nation–46 percent, or an estimated 545,000 people.
2) Since the beginning of the epidemic, more than 250,000 Blacks with AIDS have died. (More than 575,000 Americans in general have died because of the disease.)
3) According to the Black AIDS Institute, if Black America were its own country, it would rank 16th in the world in the number of people with HIV–ahead of Ethiopia, Botswana and Haiti.
4) Data released by the CDC in August 2011 showed an alarming 48 percent increase in new HIV infections among young Black men ages 13-29 who have sex with men. The figures are based on research between 2006 and 2009 and represent the most recent numbers available.
5) One in five people living with AIDS do not know they are infected.
Plainly speaking, African Americans are significantly more likely to get infected with HIV than other racial groups, and as usual there is a complex combination of social, economic and cultural factors at the root of the disparity.
One of the reasons for the higher infection rate is that African Americans tend to have sex with other Blacks, which decreases the pool of non-infected partners.
There is also lack of access to healthcare; and discomfort talking about HIV, HIV testing, treatment and support.
According to the Black AIDS Institute report, “AIDS: 30 Years Is Enuf!,” other factors are late diagnosis; discontinuity of care and a high prevalence of conditions that interfere with adherence to treatment regimens.
“This new data is the first time we have been able to look at multi-year trends, and what we see is that the rate (of HIV infection) remains relatively stable but at a high rate, and the population most at risk is young Black gay and bisexual men ages 13-29. They were the only group where you saw an significant increase. Black women were also 15 times more likely than Whites and three to four times more likely than Hispanic women to be infected,” said Donna McCree, Ph.D., associate director of Health Equity for the Division of HIV/AIDS Prevention with the CDC.
Despite the disheartening news about the increase in infections among young Black men, McCree said there have been improvement over the years. She pointed out the mother-child infection rate, which was 1,060 per year at the beginning of the epidemic, is now down to 150.
“There has also been a decrease in the number of new infections, but we still have more work to do,” added the CDC director.
Additionally, under President Barack Obama, the federal government launched its first comprehensive, target-driven National HIV/AIDS Strategy (see AIDS.gov). The strategy has a threefold goal: 1) reducing the number of people who become infected with HIV; 2) increasing access to care and improving health outcomes for people living with HIV; and 3) reducing HIV-related health disparities.
People infected with the HIV virus are living longer, thanks to a class of drugs called antiretrovirals. But the health disparities Black and minorities face impact access to these life-saving medicines.
Phil Wilson, CEO and founder of the Black AIDS Institute and a victim of HIV, wrote in “AIDS: 30 Years Is Enuf!,” that one of the challenges in the African American community is that the response to the epidemic has been insufficient.
“Only during the third decade of AIDS was the epidemic considered to pose a ‘state of emergency’ in Black America. By this point, Black people were more than seven times more likely than Whites to become infected.”
According to the “AIDS: 30 Years is Enuf!” report, African Americans are the most likely to be tested, but also disproportionately represented among those who test positive.
But McCree pointed out that the stigma around HIV and some of the behaviors that put folks at risk for contracting the disease keeps more people from getting tested or keeps those who do get tested from going back to get the results and treatment.
“The key to breaking the stigma in the community is to make sure that families talk about HIV/AIDS,” said McCree, who noted that CDC is partnering with national, regional and local organizations to implement the National HIV/AIDS Strategy, which in part will target more resources at the areas where there is a higher need such as the African American community.
One key effort is the 11-year-old National Black HIV/AIDS Awareness Day, which is a testing and treatment community mobilization to increase awareness of HIV/AIDS prevention among African Americans.
There are other efforts to make a difference, including the International AIDS Conference, which is returning to the U.S. for the first time in 20 years.
As a prelude to this meeting, D.C.-based Community Education Group (CEG) and the Urban Coalition for HIV/AIDS Prevention Services (UCHAPS) will hold a series of mobilizing events in 15 U.S. cities.
Called the Road to AIDS 2012, the tour, according to A. Toni Young, CEG chief executive officer, is a way for people (ordinary community residents, healthcare workers, elected officials and others) to hear information firsthand. In this case, representatives from the Obama administration will be at each meeting to talk about the National HIV/AIDS Strategy, as well as how the Affordable Care Act will benefit those living with the disease.
“The Affordable Care Act will allow for clinics and medical service providers to be reimbursed for HIV/AIDS testing,” explained Young, who added that once Obama’s healthcare program is fully operational, it will also help those on the AIDS Drug Assistance Program waiting list obtain financial help to purchase their medicines sooner.
Young also believes that the Affordable Care Act will play a part in continuing to reshape the HIV/AIDS medical provider landscape. The CEO said what has happened over the years is that as funding streams have changed, some organizations did not change. Young believes the new healthcare reform is going to accelerate the change process.
“. . . If you, as an (HIV/AIDS) organization, are not panicked, there’s something wrong,” added Young who said that in order to survive, those groups with HIV/AIDS as their primary or singular focus are going to have to revamp. She said this includes considering branching out to provide more health services or stepping up your HIV/AIDS activities to be more practical and hands-on.
