Why We Should Care: HIV in the United States
December 1, 2001
Eight-hundred-thousand to 900,000 people in the US are currently living with HIV or AIDS. Of these, an estimated 300,000 are unaware that they are infected. Since the beginning of the pandemic, approximately 775,000 people have been reported to have AIDS, and 450,000 people have died from AIDS. Even though in the US we have been successful in reducing the mortality rate of HIV, we have yet to reduce the number of new infections. New HIV infections were estimated at 40,000 per year in the early 1990s and have remained largely at this same level throughout the last decade.
Of great concern at present is the onset of "safe sex fatigue." People may be taking fewer precautions to protect themselves from infection for several reasons: the belief that antiretroviral drugs make AIDS a manageable, chronic disease; the attitude that infection with HIV is inevitable; increasing weariness toward maintaining risk-reducing behaviors; and the generational phenomena that younger people did not experience the devastating early days of the pandemic.
Evidence suggests that HIV and AIDS have disproportionately affected women, people of color, and youth in the US.
Women: The number of new HIV infections and AIDS cases is increasing among women in the US. Of all HIV-positive women, 41% reported that they were exposed through heterosexual contact and 20% reported infection through injection drug use. Although the number of AIDS deaths among women declined 35% between 1993 and 1998, the number of AIDS deaths among men declined 64%. Studies indicate that women are less likely to receive or seek treatment when compared to men because of health care, social, and financial barriers.
Minorities: HIV and AIDS have disproportionately affected minority populations, especially African Americans and Hispanics. As of 1999, while African Americans accounted for 37% of all AIDS cases, they represented only 12% of the US population. Furthermore, African American and Hispanic women represented 81% of all AIDS cases among American women, yet they accounted for only 25% of the female population in the US. Social and economic conditions, such as language barriers, poverty, substance abuse, and access to health care, contribute to the increasing risk of HIV among minority communities. Religious beliefs and mistrust of the medical community may also inhibit people from seeking health care.
Men Who Have Sex with Men: As of December 2000, 46% of all reported US AIDS cases were transmitted through male-male sex. Young African American men who have sex with men (MSM) are at higher risk of contracting HIV compared to other ethnicities. A recent CDC study of 23-29 year old MSM showed that the new infection rate among African American MSM is 14.7%, compared to 3.5% among Hispanic MSM and 2.5% among white MSM.
The percentage of individuals in the study that were already HIV-positive varied according to ethnicity as well. Among study participants, 32% of African American, 14% of Hispanic, and 7% of white MSM were HIV-positive.
Cultural and religious biases that fuel homophobia may act as significant barriers to treating and preventing HIV transmission among MSM.
Proportion of Newly-Reported US AIDS Cases by Race/Ethnicity, 1985-1999
This article was provided by American Association for World Health. It is a part of the publication I Care ... Do You? Youth and AIDS in the 21st Century.