National Black HIV/AIDS Awareness Day, observed each year on February 7, serves as a reminder that despite some progress, racial disparities in HIV infection persist in the United States. Decades into the epidemic, the black community shoulders the heaviest burden domestically, accounting for nearly half of all new HIV diagnoses each year, despite representing only 13 percent of the population.
While prevention efforts have helped to reduce the annual number of new HIV diagnoses among African Americans over the last decade, progress has not been uniform across the black community.
“The impacts of HIV within the African-American community remain mixed,” said Greg Millett, amfAR Vice President and Director of Public Policy. “While HIV diagnoses have generally declined for African Americans, not all groups have reflected this trend.”
According to the U.S. Centers for Disease Control and Prevention, 60 percent of African Americans who received an HIV diagnosis in 2017 were gay or bisexual men, and more than 40% of those men were aged 25 to 34. Additionally, black transgender women are more likely to be living with HIV than transgender women of other races/ethnicities. A 2009 National Institutes of Health study showed that more than half of black transgender women were HIV-positive.
Approximately 14 percent of African Americans living with HIV do not know they are positive. A late diagnosis of HIV infection is common in African-American communities and often results in missed opportunities to get early medical care and prevent transmission to others.
Underlying factors such as discrimination, stigma, poverty, and lack of access to healthcare contribute to the disproportionate burden of HIV among African Americans. This is most notably the case in the American South, where about half of the nation’s new HIV diagnoses occur, with black Americans disproportionately impacted in every risk group. In general, African Americans are less likely than whites to have private health insurance. Lack of insurance can increase risk for HIV transmission and lead to poor health outcomes for HIV-positive people who are not in care.
In 2019, President Trump launched an initiative to end HIV in the U.S. by 2030. In the first phase of the initiative, 50 counties and seven states accounting for more than 50 percent of new HIV infections in the U.S. annually have been targeted by federal funding and programs. amfAR recently launched the Ending the HIV Epidemic database (EHE), which maps and graphs who various policies can impact the success of the initiative.
One of the takeaways from the database is that a higher proportion of African Americans in the seven EHE states (about 12 percent) do not have health insurance compared to African Americans nationally (about ten percent). This is problematic considering that 64 percent of new HIV diagnoses in the seven states are among African Americans as compared to 45 percent nationally.
“African Americans at risk of acquiring HIV, or who are HIV-positive, need access to healthcare,” said Millett. “We must reduce barriers such as stigma, discrimination, and poverty in order to increase access to care, and ultimately to leave nobody behind as we work toward ending AIDS.”
For more information about the barriers to achieving the goals of EHE, visit https://ehe.amfar.org
For more information about HIV/AIDS and African Americans, visit https://www.cdc.gov/hiv/group/racialethnic/africanamericans/index.html