African Americans and Voluntary HIV Counseling and Testing
A Fact Sheet for National HIV Testing Day Organizers
African Americans are the single most affected group by HIV/AIDS. In fact they have been disproportionately affected since the beginning of the epidemic.1 In 2003, African Americans represented 13% of the population; however, they were 40% of the total AIDS cases and half of all newly diagnosed HIV/AIDS cases. The numbers of women and youth with AIDS in this group have been on the rise. African American women accounted for 67% of new AIDS cases among all women in 2003, and African American teens ages 13-19 were 65% of all cases among teens in 2002.1,2
Factors to Consider When Promoting and Providing HIV Prevention and Treatment
There are a number of relevant structural factors associated with social access and equality. For instance, studies have found a direct correlation between higher AIDS incidence and lower income and nearly one in four African Americans lives in poverty.3 Limited and late access to quality health care are also related. African Americans with HIV/AIDS are more likely to be publicly insured or uninsured than are Caucasians, with 59% relying on Medicaid and 22% being uninsured.1 A study of HIV-positive people found that 56% of late testers (those diagnosed with AIDS within one year of their HIV diagnosis) were African American. Survival rates are also low for this group, with only 60% living nine years after an AIDS diagnosis.3
Denial and Stigma
Segments of the African American community have yet to successfully address relevant social issues, such as sexual orientation, HIV-related stigma and silence around sexual and drug use behaviors. For example, studies show that a significant number of African American men who have sex with men identify not as gay or bisexual but as heterosexual. 3 Some individuals don't test or return for their results for fear that a positive result will damage their self-image and their family and social relationships.4
Distrust and Fatalism
Historical and current discrimination towards African Americans in the health care arena is relevant to HIV prevention. Many have a general distrust of the medical and scientific establishments and some believe HIV to be government-made. A recent study found that among African American men, those who hold stronger conspiracy beliefs, regardless of other factors, are less likely to use condoms consistently.5
The growing community of African and Caribbean immigrants requires greater understanding of cultural and immigration issues. According to studies, immigrants face poverty, racism, stigma, extended separation from family and low self-esteem, which in turn can result in stress, depression and anxiety.6 This can increase immigrants' risk behaviors and prevent them from seeking services.
Suggestions for Effective Services and Campaign Messages
This article was provided by U.S. Centers for Disease Control and Prevention. Visit the CDC's website to find out more about their activities, publications and services.