New data released last week on the 14th annual National Black HIV/AIDS Awareness Day underscores the need to ramp up testing and prevention efforts across Black communities—and to link those who are HIV-positive to quality care and keep them in treatment.
African-Americans represent only 14% of the United States’ population but account for nearly half—some 44%—of all new infections, report the Centers for Disease Control and Prevention. African-Americans also account for about half of the estimated 1.1 million people living with HIV/AIDS in the United States
But only about a third of Black Americans who are positive have achieved “viral suppression," according to new research published in Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.
Viral suppression means it “is under control at a level that helps keep people healthy and reduces the risk of transmission,” Donna Hubbard McCree, PhD told EBONY.com. Dr. McCree is the Associate Director for Health Equity of the CDC’s Division of HIV/AIDS Prevention. “That’s why it’s important on days like today that we keep the conversation out there.”
“Part of that conversation must be discussing things such as pre-marital sex and men who have sex with men. Unfortunately that is uncomfortable for many people,” Kimberly A. Parker, Ph.D., assistant professor of health studies at Texas Woman's University told EBONY.com.
Only 75 percent of all Blacks who were diagnosed with HIV/AIDS in 2010 were linked to care, according to the new research. About half remained in care and were prescribed antiretroviral therapy. Only 35 percent of HIV positive Black Americans achieved viral suppression.
“About one third of African Americans have never been tested,” Dr. McCree told EBONY.com. “It’s important to know your status, get linked to care and stay on care. Everyone from 13 to 64 years old should be regularly tested.”
Black women have been impacted much more by the epidemic than any other demographic of women. African-American women account for more than 60 percent of all infections among women.
Some good news: Recent data show that new infections among Black women are declining for the first time in over a decade. “New HIV infections among Black women [decreased by] 21 percent between 2008 and 2010,” CDC reported in December 2012.
“That is very promising. Of course we need several more years to confirm the trend has continued,” added Dr. McCree. “The data doesn’t tell us ‘why’ but we are hopeful that some of the educational messages and interventions targeted to African American women are taking hold—in addition to testing, treatment and prevention information.”
“The ‘stigma’ of being Black and HIV positive remains a significant barrier to treatment,” Texas Woman’s University Dr. Kimberly Parker added. “Many women are worried that their families, husbands, boyfriends and jobs will treat them differently if they someone discovers their HIV status.”
While there has been a marked decrease in new infections among Black women, Black gay and bisexual men have not been so lucky. New infections have been particularly “alarming” among young Black gay and bisexual men aged 13 to 19, according to CDC. New infections increased by almost half between 2006 and 2009.
The crisis is so severe in some American cities that "one in two Black men who have sex with other men is HIV positive," according to a report released by the Black AIDS Institute at AIDS 2012 in Washington.
Researchers are unsure why new infections are soaring among Black gay/bi men. Most data show that Black gay men do not practice more unsafe sex than White gay men. Many experts say a “perfect storm” of economic barriers, decreased access to health insurance, incarceration rates, increased risk for STIs, homophobia, stigma, racism and other factors “fuel” the epidemic among Black gay and bisexual men.
“But it is important to remember that Black men are not monolithic,” Terrance E. Moore told EBONY.con. Moore is the Director of Health Policy at the National Alliance of State & Territorial AIDS Directors. New interventions must be “tailored” and “targeted” to specific populations, said Moore.
“Let’s say you are a Black gay man living in a community of lower socioeconomic status. You could be very concerned that someone is going to see you walk into an HIV testing facility. You may not access that test which is the first line of defense,” said Moore. “What is the best way to reach these young men? It’s extraordinarily important to recognize that [people] access health care based on how good we feel about ourselves.”
Rod McCullom has written and produced for ABC News, NBC, The Atlantic, the Los Angeles Times, EBONY and others. He recently reported from Barcelona for EBONY.com as an AIDS Vaccine 2013 International Media Fellow.