Friday, February 6, 2009

HIV and health disparity

Early in my career I worked with an HIV/AIDS prevention organization. I have to say we thought we would be in better shape by 2009. At least we hoped we would. Tomorrow is National Black HIV/AIDS Awareness Day. Here are some things we (should) know. In 2006, the last year for which the CDC provides data:

* 45 percent of all new HIV infections were in Black Americans
* Nearly half of all Americans living with HIV were Black
* Only 12 percent of the US population was Black
* Black women got infected with HIV at 15 times the rate of white women

OUCH. In mid-2007 I talked with someone on the front lines of the crisis. Eric Bing MD, PhD, MPH is the co-director of the Center for HIV Identification, Prevention, and Treatment Services in Los Angeles. Dr Bing also serves on the Board of Directors for AIDS Project Los Angeles. Below is an excerpt from our Q & A:

According to the CDC, there are about 40,000 new infections in the US each year

– that sounds right.

The rate of new infections among African American women is startling. Of women with HIV, 64 percent are African American, whereas they are only 13 percent of the general population.

How would you explain that?

Most black women with HIV are getting infected from having sex with men who are HIV positive, as opposed to injection drug use. Transmitting from a man to woman is more efficient than from a woman to a man. So even if there were fewer men who were HIV positive, you would still have a lot of women getting infected.

But there are a lot of men who are HIV positive. Particularly those men who black women want: black men. When you have a disease within a group that interacts it’s easier to transmit within that group.

So what causes high HIV infection rates among black men?

It’s very similar to the reasons that white men get infected. You often don’t hear about it because people want to find all the other reasons...For the majority of black men who have HIV it’s related to having sex with other men. The second most frequent cause is injection drug use and the third is heterosexual sex.

What will help ease the burden of HIV/AIDS?

Vaccine development has proven to be extremely difficult, in part because of how quickly the virus can mutate. The only good prevention strategy for the near future is prevention of high risk behaviors.

Alas, it looks like there won't be a magic bullet anytime soon. We just have to buckle down and develop prevention information campaigns and behavior motivation efforts that can reach people at risk.

1 comment:

Nicolette said...

Oh, that's very sad.

I recently heard a figure computed on the space down the DC mall from where Rev. Martin Luther King gave his "I have a Dream" speech to the spot where President Obama took his oath of office. If you divide that distance by the elapsed chronological time, the social progress rate comes out to be 7 inches per year.