HIV or Human Immunodeficiency Virus is type of virus that causes progressive decline of the immune system and consequently leading to AIDS or Acquired Immunodeficiency Syndrome (Douek et al., 2009). In the United States, there is a markedly increase in the number of HIV/AIDS diagnosis, particularly in African Americans between the ages of 13 and 24. The Centers for Disease Control and Prevention (CDC) reported that in the year 2004, there were 40,049 cumulative cases of AIDS within this age bracket alone. Furthermore, since the dawn of the AIDS epidemic, it is estimated that around 10,129 individuals have since died, all belonging to the adolescent and young adult group. These numbers have since increased, with no indication of slowing down, more so eradicating the disease. In fact, in 1999, the number of adolescents and young adults diagnosed with AIDs rose to 3.9%, and by 2004, the numbers have reached 4.2%. African-Americans currently represent 12% of the total population in the United States, however, they account for 44% of newly diagnosed HIV infections (CDC, 2012). In 2011, 49% of African-Americans accounted for newly-diagnosed cases of AIDS, which is an advanced form an HIV infection. Geographically, New York has the most number of HIV cases while Florida takes the second spot with 46,248 black adolescents diagnosed with HIV (CDC, 2010).
The increasing trend in the number of African-Americans with HIV cannot be attributed to a single factor. Rather, it stems from a combination of issues that afflict black adolescents and young adults. Risk factors that predispose individuals in acquiring the HIV infection comprise of risky behaviors such as engaging in unprotected sex, multiple sexual partners, sharing of contaminated needles, and history of a sexually transmitted disease. Below is further discussion of these risk factors for African-American homosexuals.
Sexual Intercourse, unprotected sex and multiple sex partners
Sexual intercourse remains as the most common vehicle in contacting HIV, particularly for adolescents and young adults. According to recent data on HIV, a majority of HIV positive male adolescents and young adults become infected through sexual intercourse with men. Since there is a high prevalence of HIV within this population, younger African-American males are at increased risk, particularly when they become partners of older men. This is because older men have had more sexual encounters, thus having greater exposure and risk of acquiring the HIV virus.
It is equally important to note that the transmission of HIV increases through the presence of sexually transmitted diseases such as Chlamydia, gonorrhea, etc. Teenagers account for 25% of the number of cases of sexually transmitted of STI’s annually in the United States, thereby proving that they become more exposed to the risk of contracting HIV. As discussed earlier, this is particularly important because the risk of transmitting the HIV virus rises dramatically if either individual is currently infected with a sexually transmitted infection. The risk of contracting HIV is up to 3 to 5 times greater in the presence of STIs such as Chlamydia or Gonorrhea due to the pus and mucus production. Similarly, the risk of getting HIV is 9 times greater in cases where one partner has Syphilis or Genital Herpes. In comparison to Caucasians, African-Americans are 8 times more likely to have Chlamydia and 18 times more likely to have Gonorrhea, thus accounting for the larger numbers of African-Americans who have HIV/AIDS.
Use of injections or drugs
The use of injections only account for a small number of males infected with HIV. It is however, the second most likely reason for the transmission of HIV in African-Americans. Risk occurs when individuals share needles and one is positive for HIV. Similarly, sex workers who are drug users are not likely to use condoms for protection and thus, may acquire the disease and pass it on unknowingly. Some drugs can also lower inhibitions, thus increasing the likelihood of these individuals to engage in risky behaviors. In 2008, the use of injections/drugs accounted for eighteen percent of the total AIDS cases among African –Americans. In fact, blacks are more likely to have AIDS compared to any other racial group in the United States and they often do not survive long after they are diagnosed with AIDS (Valle & Levy, 2008)
Characteristic of the stage of adolescence is a sense of invincibility and that bad things cannot happen to them. Adolescents and even some people in the young adult bracket tend to engage in risky behavior and actions due to their failure to realize their own mortality. Oftentimes, individuals in this age group delay HIV testing or avoid confronting the issue altogether, choosing to live in denial. Individuals who do get tested and subsequently get a positive result either delay or totally refuse to have any treatment. This refusal to access basic health services and medical attention can lead to increasing HIV transmissions. Health care providers often report that adolescents and young adults who tested positive for HIV often remain in a state of denial which may last for months and even years. The diagnosis of HIV is hard for them, and it takes a while for these individuals to accept medical treatment. Therefore, it is important that health care workers ensure privacy and total confidentiality during these visits. There is also a need to explain their current condition in a clear and understandable manner so as they can fully understand the situation that they are in. Individuals should be encouraged to participate in treatment programs and undergo counseling for additional psychological support.
Similarly, the HIV/AIDS epidemic has disproportionately affected adolescents and young adults of African-American descent. In fact, African-Americans aged from 13 years to 19 years old account for 66% of the total reported cases of AIDS in 2003. Poverty, lack of knowledge, and lack of access to health care services are just some reasons that contributed to the HIV crisis among African-Americans (CDC, 2011). African-Americans tend to be hospitalized and are more likely to die from causes related to HIV more than any other racial group. In fact, Fullilove (2006), states that the United States must look beyond medical solutions to the HIV crisis and should focus on improving policies that will address the health disparities that African-Americans experience.
The social stigma brought about by the disease has also contributed to African-Americans delaying testing for HIV. In fact, black gays and bisexuals are least likely to be aware of their HIV status. 71% within this population do not even know that they have HIV and these people can pass the infection unknowingly to others through indiscriminate sexual practices. Furthermore, black homosexuals tend to hide their sexual orientation and don’t identify themselves as gay to other people. These tendencies and behavior can deter black homosexuals from seeking healthcare advice and interfere with their ability to access HIV testing facilities and other such services (Malebranche et al., 2004).
CDC (2010). National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Atlas.
CDC (2011, November). Fact Sheet: HIV among African Americans
CDC (2012, June). HIV Surveillance Supplemental Report 2012. Vol. 17, No. 3 (Part A);
Fullilove, R. (2006). African-Americans, Health Disparities and HIV/AIDS. National Minority Aids Council
Douek D.C. et al. (2009). Emerging Concepts in the Immunopathogenesis of AIDS. Annu. Rev. Med.60: 471–84.
Malebranche, D.J. et al. (2004). Race and sexual identity: Perceptions about medical culture and healthcare among black men who have sex with men. Journal of the National Medical Association, 96, 97-101.
Valle M, and Levy J, (2008, January) Finding meaning: African American injection drug users’ interpretations of testing HIV-positive. Aids Care 20(1):130-8.