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By the Numbers: Black HIV Testing and Infection

Part of Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

June 2009

MAP of the Black AIDS Epidemic in America

Black communities in the Northeast and Southeast -- particularly in Florida, Maryland and New York -- had the highest rates of HIV infection between 2002 and 2006. Overall, the prevalence of HIV among Blacks is nearly eight times that among whites.*

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America
Click image to enlarge.

* CDC, HIV Prevalence Estimates -- United States, 2006, MMWR, 57(39);1073-1076.


Black HIV Infection in America

The State of Awareness

Percent of men saying they have seen, heard or read "a lot" about the problem of AIDS in the United States during the last year.

Blacks200462 percent
 200933 percent
Latinos200445 percent
 200923 percent
Whites200428 percent
 20099 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Know Someone With AIDS

More Black Americans than any other racial/ethnic group report knowing someone close who has AIDS, has died from AIDS or who is HIV-positive.

 Percentage
BLW
Close friend or family member382019
Acquaintance, co-worker or someone else201724
Don't know anyone426256

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Race of Newly Infected

An estimated 56,300 people were newly infected in 2006, the most recent year for which data is available. The racial breakdown among them was:

Black45 percent
White35 percent
Latino17 percent
Other Ethnicities3 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Race of All HIV-Positive

An estimated 1.1 million people are HIV positive in the United States. The racial breakdown among them is:

Black46.1 percent
White34.6 percent
Latino17.5 percent
Other Ethnicities1.8 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Rate of Infection

Black Americans were infected at a rate seven times that of whites in 2006 -- and Black women were infected at a rate almost 15 times that of whites. The number of people infected per 100,000, by race, was:

Among Blacks83.7
Among Latinos29.3
Among Native Americans14.6
Among Whites11.5
Among Asian/Pacific Islander10.3

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Infection Over Time

Black Americans' share of new infections has grown steadily over time. By the late 1980s, Blacks began accounting for the largest share of new infections.

Estimated new human immunodeficiency virus (HIV) infections, by race/ethnicity, extended back-calculation model, 50 U.S. states and the District of Columbia, 1977-2006:

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

How STDs Help HIV

A person with an STD is two to five times more likely to contract HIV when exposed to it, and HIV-positive people who have an STD are more infectious.* In 2006, Blacks had the highest rates of all STDs.

Infection rate among Black women vs. white women for:

Chlamydia7x higher
Gonorrhea14x higher
Syphilis16x higher

Infection rate among Black men vs. white men for:

Chlamydia11x higher
Gonorrhea25x higher
Syphilis5x higher

Sources: CDC, Sexually Transmitted Disease Surveillance, 2006. November 2007.

*CDC, The Role of STD Detection and Treatment in HIV Prevention -- CDC Fact Sheet, accessed on December 17, 2008, at www.cdc.gov/std/hiv/STDFact-STD&HIV.htm#MoreInfo.54(24);597-601.

Among Women

An estimated 14,410 Black, white and Latina women were newly infected in 2006. The racial breakdown among them was:

Black61 percent
White23 percent
Latina16 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Source: CDC, Subpopulation Estimates from the HIV Incidence Surveillance System -- United States, 2006, 57(36);985-989. Data not available for any other ethnicity.

Among Men

An estimated 39,820 Black, white and Latino men were newly infected in 2006. The racial breakdown among them was:

Black46 percent
White36 percent
Latino18 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

How Black Men Get Infected

Male-to-male sexual contact was the primary risk factor for 72 percent of all men infected in 2006. Among Black men who tested positive, risk factors included:

Male-to-male sex63 percent
Heterosexual sex20 percent
Injection drug use12 percent
IDU and male-to-male sex4 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

How Black Women Get Infected

Black women got infected at a rate 18 times that of whites in 2006. Risk factors included:

Sex with men80 percent
Injection drug use20 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Among Gay and Bisexual Men

Gay and bisexual men accounted for more than half of all new infections in 2006. The racial breakdown among them was:

Black46 percent
White35 percent
Latino19 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Undiagnosed Gay and Bisexual Men

A five-city study published in 2005 found 46 percent of Black gay and bisexual men to be HIV-positive; well over half of them did not know it. The percentage of undiagnosed infections was:

Among Blacks67 percent
Among Latinos48 percent
Among Multiracial50 percent
Among White18 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Where Newly HIV-Positive Live

The South is the modern epidemic's geographic frontline, in part because of its sizable Black population. The regional breakdown for new infections in 2006 was:

South46.7 percent
Northeast25.4 percent
West16.1 percent
Midwest11.6 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America


Black HIV Testing and Transmission in America

Race of Americans Tested

One in ten Americans said in 2006 that they got tested for HIV in the previous year, but Blacks tested at higher rates than any other racial or ethnic group. The share of people who reported getting tested was:

Among Blacks21.7 percent
Among Latinos12.6 percent
Among Whites8 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Lifetime Testing Rate

In 2009, more than half of all Black Americans over the age of 18 report having been tested for HIV at some point in their lifetimes. That's a significantly higher testing rate than any other racial or ethnic group.

Blacks52 percent
Latinos38 percent
Whites34 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Source: CDC, Early Release of Selected Estimates Based on Data From the 2007 National Health Interview Study, June 2008.

Views on Testing and Stigma

Most Black Americans in 2009 say they think testing would not lead to stigma.

Would make no difference in how people think of you69 percent
People would think more of you19 percent
People would think less of you7 percent
Don't know/refused4 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Impetus of HIV Test

Most Black Americans who take an HIV test say they specifically ask for it.

Asked to be tested54 percent
Doctor/nurse told me it was being done25 percent
Impression it was routine part of exam20 percent
Don't know/other1 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Timing of HIV Test Decision

Most Black Americans who take an HIV test say they decide to do it as part of another health visit.

As part of another health visit72 percent
Went specifically to be tested27 percent
Don't know2 percent

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Reasons for HIV Test

Most Black Americans who take an HIV test say "it just seemed like a good idea." Percentage of reasons stated by Blacks who report being tested, by men and women:

 Percentage
 MenWomen
Seemed like good idea8475
Do it every year4346
Doctor suggested2921
Possibly infected2616
Partner suggested124

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Health Care Provider Suggested HIV Testing

Among those reporting, Blacks and Latinos more often say they are counseled by health professionals to have an HIV test than whites. Percentages by race and age:

 Percentage
 18-2930-4950+
Blacks283624
Latinos293419
Whites181610

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

Got HIV Test in Last 12 Months

Among those reporting, Blacks more often say they got an HIV test in the last 12 months than other racial/ethnic groups. Percentages by race and age:

 Percentage
 18-290-4950-64
Blacks474326
Latinos422122
Whites27157

Passing the Test: The Challenges and Opportunities of HIV Testing in Black America

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This article was provided by Black AIDS Institute. Visit Black AIDS Institute's website to find out more about their activities and publications.
 

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