Challenges Black Americans Face
CHALLENGES
African Americans face a number of challenges that contribute to the higher rates of HIV infection. The greater number of people living with HIV (prevalence) in African American communities and the fact that African Americans tend to have sex with partners of the same race/ethnicity means that they face a greater risk of HIV infection with each new sexual encounter.
HIGHER RATES OF SEXUALLY TRANSMITTED INFECTIONS
African American communities continue to experience higher rates of other sexually transmitted infections (STIs) compared with other racial/ethnic communities in the United States. Having an STI can significantly increase the chance of getting or transmitting HIV by 5 times.
LACK OF AWARENESS
Lack of awareness of HIV status can affect HIV rates in communities. Almost 73,600 HIV-infected people in the African American community in 2011 were unaware of their HIV status. Diagnosis late in the course of HIV infection is common, which results in missed opportunities to get early medical care and prevent transmission to others.
Social Determinants of Health and Structural Factors
The term social determinants of health (SDH) refers to the overlapping social structures and economic systems (e.g., social environment, physical environment, health services, and structural and societal factors) that are responsible for most health inequities. Addressing the SDH that adversely affect health outcomes may advance efforts in reducing disparities in HIV diagnosis rates between populations. Addressing the SDH also helps to quantify health differences between populations or geographic areas and can provide insight for identifying populations or areas that may benefit from HIV testing, prevention, and treatment initiatives.
SOCIOECONOMIC ISSUES WITH POVERTY
The poverty rate is higher among African Americans than other racial/ethnic groups. The socio economic issues associated with poverty—including limited access to high-quality health care, housing, and HIV prevention education—directly and indirectly increase the risk for HIV infection, and affect the health of people living with and at risk for HIV. These factors may explain why African Americans have worse outcomes on the HIV continuum of care, including lower rates of linkage to care, retention in care, being prescribed HIV treatment, and viral suppression. New data from 2010 indicate that 75% of HIV-infected African Americans aged 13 or older are linked to care, 48% are retained in care, 46% are prescribed antiretroviral therapy, and only 35% are virally suppressed.
Stigma, fear, discrimination, homophobia, and negative perceptions
Stigma, fear, discrimination, homophobia, and negative perceptions about HIV testing can also place too many African Americans at higher risk. Many at risk for HIV fear discrimination and rejection more than infection and may choose not to seek testing.
Continue to Support the National HIV/AIDS Strategy (NHAS) and Expand Investments in Prevention, Care, and Research.
The Budget expands access to HIV/AIDS prevention and treatment activities and supports the goals of the National HIV/AIDS Strategy to
reduce HIV incidence;
increase access to care and optimize health outcomes for people living with HIV;
and reduce HIV-related health disparities.
By providing resources for Affordable Care Act implementation, the Budget will support increased health care coverage for thousands of people living with HIV/AIDS and expand access to HIV testing for millions of Americans.
The Budget makes smarter investments by prioritizing HIV/AIDS resources within high-burden communities and among high-risk groups, including gay men, black Americans and Latino Americans.
Compared to 2012, the Budget increases domestic discretionary Health and Human Services (HHS) HIV/AIDS funding by $73 million and Veterans Affairs (VA) HIV/AIDS funding by $155 million.
Overall, total U.S. Government-wide spending on HIV/AIDS increases from $27.8 billion in FY 2012 to $29.7 billion in the FY 2014 Budget.
Increase Funding for HIV/AIDS Prevention and Service Integration.
The Budget includes $833 million, an increase of $10 million for the Centers for Disease Control and Prevention (CDC) to continue implementing the goals of the National HIV/AIDS Strategy by preventing HIV/AIDS among high-risk communities using evidence-based interventions.
The Budget redirects $40 million from less effective activities to support a new $40 million Community High-Impact Prevention initiative to improve systems that link persons recently diagnosed with HIV to care.