Of all the afflictions that have scourged mankind in the 21st Century, HIV/AIDS is arguably the most terrible. This is because it results in the premature death of the infected and has no known cure to date. While all races are equally predisposed to being infected by the HIV virus, it has been noted that the African American community has an especially high number of new infections.
HIV/AIDS has become one of the leading causes of mortality among African American males and the death rate from AIDS is disproportionately higher for this population than for white Americans (Gordon 162). The Center for Disease Control and Prevention asserts that “by race/ethnicity, African Americans face the most severe burden of HIV in the United States”. This begs the question why this ethnic group demonstrates a disproportionate prevalence for the killer disease.
This paper argues that certain lifestyle choices as well as economic realities are responsible for the disproportionate overrepresentation of African Americans in HIV/AIDS infections. The paper shall utilize authoritative sources and statistics to explain why HIV/Aids crises are high in the African-American community.
The African American Community and HIV/AIDS
According to the 2000 U.S. census, African Americans make up about 13% of the entire US population (US Census Bureau). This number consists of both the native born African Americans as well as the ones who have migrated from Africa, the Caribbean islands and other locations. As of the end of 2007, statistics from the Center for Disease Control and Prevention showed that African Americans accounted for 46% of people living with HIV/AIDS in the US (CDC).
This minority group also accounted for almost 50% of the new HIV infections. While Laurencin, Christensen and Taylor suggest that the rising number of blacks living with HIV/AIDS may not be an indication of higher infection rates but rather the increase in longevity of infected individuals due to advances in treatments, African American infection rates still fail to show significant drop that other ethnic groups demonstrate (36).
Within the black community, men are particularly prone to HIV/AIDS with statistics indicating that in 2006, African American Males made up 65% of the new infections among the black community.
Causes of High HIV/AIDS Prevalence in African Americans
One of the activities which have been blamed for a rise of HIV infection and transmission among the black community in America is substance abuse and especially Intravenous drug use (IDU).
Research has demonstrated that drug use is responsible for HIV prevalence with new data suggesting that intravenous drug use accounts for approximately 25% of the new HIV infections among African Americans (Lowinson and Ruiz 1097). This is mostly as a result of the disproportionate overrepresentation of African Americans among intravenous drug users.
An explanation for this overrepresentation by African Americans in drug use is provided by Lowinson and Ruiz who note that “many ethnic minorities view drug abuse as an adaptive response to oppressive societal conditions” (1097). Substance abuse results in an increase in risk behavior such as unprotected sexual encounters as well as needle sharing.
Ward reports that the greatest impact of the HIV and AIDS epidemic has being among men who have sex with men (MSM) (430). Research conducted by the CDC on the prevalence of HIV among MSM revealed that not only were HIV incidents among young black MSM higher but that new infections were also high.
Stigma and homophobia in the African American community have been blamed for the rise in HIV/AIDS infection rates amongst this group. Stigma has resulted in the black MSM population being highly secretive, a phenomena termed as “down low” by the media.
This leads to a situation whereby those who engage in male to male sexual contact do it in secret while maintaining a heterosexual face to the society. Wright suggests that this attitude has led to a scenario whereby black men lead homosexual lives but are unwilling to be labeled as “gay” and therefore do not take in prevention messages addressed to the gay community since they do not regard themselves as part of it.
Another factor that has resulted in the resulted in the heightening of the HIV crises in African Americans is that this group continues to have a markedly higher rate of other STDs.
Laurencin, Christensen and Taylor document that the highest rates of sexually transmitted diseases such as gonorrhea and syphilis are found among the black population (37). HIV/AIDS has been known to have some relationship with other sexually transmitted diseases. A person who is suffering from certain STDs has a greater likelihood of being infected by the HIV/AIDS virus as compared to a person who has no STDs.
In addition to this, the CDC reveals that a person who has other STDs in addition to HIV infection poses a greater risk to others since the chances for infecting them with HIV is multiplied. The reason for this is that some STDs such as gonorrhea result in inflammation which increased one’s susceptibility and infectiousness.
Lack of awareness of one’s HIV status has been blamed for the prevalence of HIV and AIDS in much of sub-Saharan Africa. This scenario has been the same amongst African Americans where unawareness levels remain high. Laurencin, Christensen and Taylor declare that the high level of unawareness of one’s HIV status among African Americans is a public health concern (40).
A survey in 2004 found out that a third of African Americans had never been tested for HIV/AIDS. In addition to this, black MSM exhibited an even higher unawareness level with up to two thirds of them never having been tested for HIV infection (Laurencin, Christensen and Taylor 40).
There has been a notable relationship between incarceration and the prevalence of HIV/AIDS infections. A report by the CDC reveals that the infection rage is 5 times as high for prison inmates than for the rest of the population.
All this is under the backdrop of an increase in the number of inmates as well as a disproportionate representation of the African American community in our prison system. According to McTighe and Jervis, black men are imprisoned at almost six times the rate of white men and constitute approximately 35% of the total prison population (1).
One of the reasons for the high number of incarcerated African Americans is the national drug policy. Mauer and King document that the “war on drugs” which was officially started in the 1980s resulted in an unprecedented growth of the prison population in the United States with drug arrests more than tripling within the last three decades (2).
HIV transmission has been linked to the socio-economic status of people. This is because a person’s socio-economic status influences their lifestyle as well as their ability to protect their health. Ward notes that poverty and unemployment afflict the African American population higher than the white population.
In addition to this, there is a lack of access to the much needed health care (433). This is a fact that is corroborated by Laurencin, Christensen and Taylor who note that as of 1999, one in four African Americans were living in poverty. Some of the consequences of poverty have been homelessness, increased drug use, incarceration and risky sexual behavior. All these are responsible for an increase in the transmission of HIV/AIDS.
The Center for Disease Control and Prevention has been at the forefront of the fight against HIV/AIDS in the black community. CDC has established HIV prevention and interventions programs which have been specifically structured to meet the needs of the African Americans.
In addition to this, intense research on how to reduce HIV risk in African Americans has been undertaken with the aim of coming up with customized biomedical interventions for this minority group. The CDC has also liaised with local African American leaders in its “Act Against AIDS” campaigns which are aimed at increasing the awareness of HIV among the members of the community.
The latest initiative by the CDC has been the expanded HIV testing program which is expected to run until 2012. This program is aimed at encouraging testing among African Americans since knowledge of one’s HIV status has been known to result in either behavioral change or seeking of treatment at an early stage in case one is already positive.
As has been demonstrated through this paper, prison plays a huge role in the prevalence of HIV/AIDS among African Americans. Part of the reason for this is the lack of HIV education and testing among the inmates.
As such, an emphasis on the importance of testing and education on HIV/AIDS can be great tools in the fight against the spread of the disease in the prison population. Taussig et al. suggests more inmate-led HIV prevention programs which will not only gain more cooperation from the inmates but also engender the much needed inmate trust for such programs to be effective.
Another proposed solution to the high risk of transmission among male inmates in penitentiaries has been the introduction of separate housing facilities for HIV-infected inmates. Taussig suggested that housing HIV infected inmates separately could have the double advantage of enabling the provision of focused medical care to the group as well as mitigating the spread of the virus to the general prison population.
African Americans are disproportionately overrepresented in HIV/AIDS cases and despite race and ethnicity not in themselves being risk factors for HIV/AIDS. This paper has argued that certain lifestyle choices as well as economic realities are the reasons for this phenomenon.
There is recognition in government policy that a problem exists regarding HIV/AIDS infection in the African American Community. As such, greater attention has been paid to this minority group so as to effectively deal with the HIV epidemic. This paper has highlighted that there has been some well formulated prevention efforts targeting African Americans in particular. The CDC has been the major contributor in these efforts with some positive results.
By implementing the various solutions suggested in this paper together with the extended prevention programs offered by the CDC, it can be hoped that the HIV/AIDS crises that currently faces the African American community will be mitigated therefore leading to a healthier and more prosperous United States.
Centers for Disease Control and Prevention (CDC). HIV Among African Americans. 9 Sept 2010. Web. 15 Nov. 2010. http://www.cdc.gov/hiv/topics/aa/
Gordon, Jacob. The Black Male in White America. Nova Publishers, 2004. Print.
Laurencin, Cato Christensen, Donna and Taylor, Erica. “HIV/AIDS and the African-American Community: A State of Emergency.” Journal of the National Medical Association. Vol. 100, No. 1, January 2008.
Lowinson, Joyce and Ruiz, Pedro. Substance Abuse: a Comprehensive Textbook. Lippincott Williams & Wilkins, 2005.
Mauer, Marc and King, Ryan. A 25-Year Quagmire: The War on Drugs and its Impact on American Society. Washington, D.C: The Sentencing Project, 2007.
McTighe, Laura and Jervis, Coco. Confronting HIV and mass Imprisonment: Two Intersecting Epidemics. 2008. Web 15 Nov. 2010. http://www.champnetwork.org
Taussig, J et al. “HIV Transmission Among Male Inmates in a State Prison System -Georgia, 1992–2005.” Morbidity and Mortality Weekly Report. Vol. 55, 2006.
US Census Bureau. Population Estimates: Entire Data Set. 2000. Web 15 Nov. 2010. www.census.gov/popest/datasets.html.
Ward, John. “First Report of AIDS.” MMWR Vol.50, No. 21. June 1, 2001. Print.
Wright, Kai. “The Great Down-Low Debate.” The Village Voice, 6-12 June 2001, p. 1-7.