The HIV/AIDS epidemic continues to be a major health crisis facing the African-American community.

· Although African Americans make up only about 12 percent of the U.S. population, they accounted for half of the new HIV infections reported in the United States in 2001.

· Numerous studies suggest that many new infections occur among young African Americans.

A Closer Look at a Serious Health Crisis

In the early 1980s, HIV/AIDS was considered primarily a gay white male disease in the United States. Today, however, the epidemic has expanded and the disease is also a major health problem in the African-American community, where men and women of every age and sexual orientation are affected.

Black Men
· African-American men account for 43 percent of HIV cases reported among men in 2001.

· 32 percent of African-American men who have sex with men were found to be infected with HIV in a recent multi-city study of men ages 23 to 29 years, compared to 14 percent of Latinos and 7 percent of whites in the study.

· While information on recent HIV infection is limited, data reported to CDC through 2001 suggest that the leading cause of HIV infection among African-American men is sexual contact with other men, followed by injection drug use and heterosexual contact.

Black Women
· African-American women accounted for nearly 64 percent of HIV cases reported among women in 2001.

· The rate of HIV infection among African-American women, ages 20 to 44, in 25 states with HIV reporting before 1994, was 80.1 per 100,000 population from 1994 to 1998 - four times higher than the rates among Latinos of the same age, and more than 16 times higher than the rates among white women.

· While information on recent HIV infection is limited, available data suggest that the leading cause of HIV infection among African- American women is heterosexual contact, followed by injection drug use.

Black Youth
· A CDC study of Job Corps entrants, ages 16 to 21, found that, compared to their white counterparts, African-American women were seven times more likely to be infected with HIV, and African-American men were four times more likely to be infected.

· 14 percent of young African-American men who have sex with men were infected with HIV, nearly four times the rate of their white counterparts, in a five-year study of almost 3,500 gay and bisexual men ages 15 to 22 in seven U.S. cities between 1994 and 1998.

Cumulative Toll: Disease and Death
In addition to experiencing historically higher rates of HIV infection, African Americans continue to face challenges in accessing health care, prevention services, and treatment.

· African Americans have accounted for more than 320,000, or 38 percent, of the more than 833,000 estimated AIDS cases diagnosed since the beginning of the epidemic. By the end of December 2001, more than 168,000 African Americans had died from AIDS.

· In 2001, African Americans accounted for about 21,000, or 50 percent, of the more than 41,000 estimated new AIDS cases diagnosed among adults. AIDS (HIV disease) is the leading cause of death among African-American women ages 25 to 34 and African-American men ages 35 to 44. AIDS (HIV disease) is among the top three causes of death for African-American men ages 25 to 54 and African-American women ages 35 to 44.

· From 1996 to 1998, overall AIDS incidence (the number of people with HIV who progress to AIDS each year) declined rapidly, falling 38 percent among whites but only 23 percent among African Americans. AIDS deaths during those years showed a similar pattern, declining 58 percent among whites and only 44 percent among African Americans. Since 1998, the falling rates of AIDS cases have stalled among African Americans. In 2001, the AIDS rate among African Americans was nine times the rates reported among whites.

· A recent CDC study of 9,113 patients in 11 U.S. cities found that HIV-infected African Americans were less likely than infected whites to receive the life-enhancing antiretroviral therapies for HIV. In 1 2001, the AIDS rate among African Americans was nine times the rate reported among whites.

African Americans Contend with Multiple HIV Risk Factors
Race and ethnicity are not, themselves, risk factors for HIV infection. However, African Americans are more likely to face challenges associated with risk for HIV infection, including:

· Poverty. Nearly one in four African Americans lives in poverty. Although poverty itself is not a risk factor, studies have found a direct relationship between higher AIDS incidence and lower income. A variety of socioeconomic problems associated with poverty directly or indirectly increase HIV risks, including limited access to quality health care and higher levels of unemployment.

· Denial and Discrimination. Although a growing number of African Americans are responding to the HIV/AIDS crisis in their community, others have been slow to join the effort. One reason is that some African-Americans are reluctant to acknowledge sensitive issues, such as homosexuality and drug use, which are associated with HIV infection. The cost of denial can be great. For example, studies show that a significant number of African-American men who have sex with men identify themselves as heterosexual. As a result, they may not relate to prevention messages crafted for gay men. Without frank and open discussion of HIV risks, many African Americans will not get the information and support they need to protect them and their partners from HIV.

· Partners at Risk. African-American women are most likely to be infected with HIV as a result of sex with men. They may not be aware of their male partners' possible risks for HIV infection (such as unprotected sex with multiple partners, bisexuality or injection drug use). Women who suspect that their partners are at risk for HIV infection may be reluctant to try to negotiate condom use for various and complex reasons. For example, some women may not insist on condom use out of fear that the man will physically abuse them or withdraw financial support.

· Substance Abuse. Injection drug use is the second leading cause of HIV infection for both African-American men and women. But sharing needles is not the only HIV risk related to substance abuse. Both casual and chronic substance abusers are more likely to engage in high-risk behaviors, such as unprotected sex, when they are under the influence of drugs or alcohol.

· Sexually Transmitted Disease Connection. For many of the reasons noted above, African Americans also have the highest STD rates in the nation. Compared to whites, African Americans are 27 times more likely to have gonorrhea and 16 times more likely to have syphilis. In part because of physical changes caused by STD infection, including genital lesions that can serve as a portal of entry for HIV, the presence of certain STDs can increase by three- to five-fold the chances of contracting HIV. Similarly, since co-infection with HIV and another STD can cause increased HIV shedding, a person who is co-infected has a greater chance of spreading HIV to others.

Source from: http://www.cdc.gov/hiv/pubs/Facts/afam.htm