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What Really Fuels the HIV/AIDS Epidemic in Black America?

February 6, 2012

What Really Fuels the HIV/AIDS Epidemic in Black America?

For the past 15 years, we have been bombarded with images and media attention that have blamed the "down-low brotha" -- the closeted gay man who sleeps with both men and women -- for the HIV epidemic in black America. Meanwhile, numerous studies have debunked those claims. Yes, there are closeted gay black men, but the reality is that so much more is at play when it comes to why African Americans account for only 14 percent of the U.S. population but make up almost half of all newly diagnosed HIV cases each year.

Take a look at what HIV advocates from across the country say is really worsening the epidemic in the African-American community.

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Ingrid Floyd


Ingrid Floyd, Executive Director, Iris House, New York

Poverty fuels the HIV epidemic due to its impact on all aspects of life, including income, housing, education, nutrition, access to health care -- and the list goes on. In the African-American communities where poverty rates are even higher, there exists a greater gap in all of these areas that fuels the inability to negotiate, feel empowered, get educated on HIV and get tested.

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Allen Kwabena Frimpong

Injection Drug Use

Allen Kwabena Frimpong, Capacity Building Advisor, Harm Reduction Coalition, New York

According to the CDC, the number of new HIV infections among the sub-populations most affected are lowest among black males and females who inject drugs. Two factors that contribute to these relatively low numbers are: One, our white counterparts use drugs more than we do -- despite the fact that we disproportionately carry the health, social and economic costs associated with the harms from drug use and punitive drug policies.

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Deon Haywood

Gender Inequality

Deon Haywood, Executive Director, Women With a Vision, New Orleans

As long as we have economically repressive policies in this country, we're going to have women at risk for HIV. As we often say, HIV can affect anybody, but it's particularly hard on women who are poor.

Policies that target African-American women on welfare -- like Temporary Assistance for Needy Families, which in some states requires a negative drug test to qualify for assistance -- put women at an economic disadvantage that can leave them vulnerable to violence, and to HIV, through possibly unprotected "survival sex" and whatever other activities they need to engage in so that they and their families can survive.

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Bethsheba Johnson, G.N.P.-B.C., A.A.H.I.V.S.

Low Health Literacy

Bethsheba Johnson, G.N.P.-B.C., A.A.H.I.V.S., Associate Medical Director, St. Hope Foundation, Houston

Health literacy is the ability to use written materials to function in health care settings and to maintain one's health and the skills needed to advocate for and request needed clarification. However, a shocking number of Americans, especially those of color, are lacking these skills. Previous research suggests that a low level of health literacy is an underlying factor that explains racial disparities in the prevalence and incidence of HIV/AIDS.

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Kenyon Farrow


Kenyon Farrow, Communications Manager, Housing Works, New York

Homophobia is a major factor that's driving HIV rates in black communities. We're told we're worthless by the churches we attend. Black LGBT youth are not getting a comprehensive sex education in schools that includes sexuality across the spectrum, so it's irrelevant to them. Twenty-five to 40 percent of homeless youth are LGBT, and a disproportionate number are black. Is it any wonder that new infections among men who have sex with men (MSM) are highest among black MSM ages 13 to 29?

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Claire Simon

Untreated and Undiagnosed STDs

Claire Simon, Communications Manager, Co-Founder/Co-Director, Young Women of Color HIV/AIDS Coalition, New York

Undiagnosed and untreated sexually transmitted diseases (STDs) are known to increase the chances of one being infected with HIV because they suppress your immune system, making you more vulnerable to seroconverting. The CDC estimates that there are approximately 19 million new STD infections each year -- almost half of them among young people 15 to 24 years of age. In a 2008 report, the CDC found that one in two African-American girls has had at least one STD.

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Hilary Beard

Lack of Access to Quality Health Care

Hilary Beard, Author of Health First! The Black Woman's Wellness Guide, Philadelphia

Black people are disproportionately uninsured, and when you don't have insurance, it means there is no co-pay; you have to pay for that appointment out of your own pocket. And if you cannot afford insurance or don't have a job that offers any, it's a serious financial strain. You might be inclined to skip appointments, put them off and not get the necessary tests that you need, not take your meds because you cannot afford them, or split your pills in half or take them every other day. This can set into motion a whole chain of events.

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Tracie Gardner

Mass Incarceration

Tracie Gardner, Founder and Director, Women's Initiative to Stop HIV NY, New York

When looking at the incidence of many STDs, particularly HIV, they are concentrated in poor, segregated neighborhoods that are characterized by high rates of incarceration. Inner-city populations of African Americans and Latinos account for almost two-thirds of the 2.2 million Americans in prison nationwide, and two disturbing trends are increasingly present in these communities.

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Kellee Terrell

Lack of Comprehensive Sex Education

Kellee Terrell, News Editor,, New York

Thanks to former Presidents George Bush and Bill Clinton, since 1997, our federal government has invested almost 1.5 billion in abstinence-only education, while numerous studies have shown that these programs are completely ineffective in delaying sex. And in the end, what this means is that our youths have not received the crucial information that they need to protect them and ward off unwanted pregnancies and STDs, including HIV.

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David Malebranche, M.D.

Late Testing

David Malebranche, M.D., Associate Professor, Emory University School of Medicine, Atlanta

Late HIV testing among black Americans is a contributor to the current HIV racial disparity in America. Many believe that a lack of testing is the cause, but in fact, black Americans have the highest HIV testing rates among any racial/ethnic group in the country. The issue is not "if" we get HIV testing or not, but rather "when" this testing takes place.

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Rae Lewis-Thornton


Rae Lewis-Thornton, Activist, Blogger at Diva Living With AIDS, Chicago

The stigma around HIV created an enormous amount of shame for people living with HIV and their family. This stigma is embedded in American culture. In the 21st century it's become politically incorrect to talk negatively about HIV and people living with HIV openly, but the whispers float in our society just like the air we breathe. I can understand at one level the black community saying, "Not Me!" I mean who wants to admit that HIV is rampant in their community. Shoot, I kept my infection a secret for seven years because I was afraid that people would judge me. Still today, I get nasty tweets about my dating and sex life, but I tackle it head on.

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