Inequities in HIV for Black Americans

Despite developments, Black folks living in the United States continue to face gaps in HIV prevention and care.

Apr 17, 2023

pexels-karolina-grabowska-4226922 — Pexels

By Scott, Dallas Weekly, Word in Black

There has been a long-standing history of medical inequities due to race in the United States, from gynecological procedures developed using unanesthetized bodies of Black women to less pain medication being given to Black patients due to distorted assessments of pain perception. Higher infant mortality rates are still seen in today’s climate, among other disparities.

This history and current facts leave most Black Americans weary of the medical system, affecting how they interact with doctors and how care is received, which impacts their outcomes.

HIV and Prevention/Treatments

Black Americans make up about 13% of the US population; however, they comprise 42% of new HIV infections. The most significant portion of women acquiring HIV are Black cisgender (cisgender means you are or identify with the sex you were assigned at birth).

The use of Pre-exposure prophylaxis or PrEP initiation and utilization is extremely low in Black MSM or males having sex with males, even though high-risk factors are widely understood. A Center for Disease Control (CDC) study stated in 2016 that if HIV diagnosis rates persisted, one in two Black men would be diagnosed with HIV in their lifetime.

The CDC found that 62% of Black transgender women were diagnosed with HIV compared to 17% of white transgender women. The report also states that two-thirds of those diagnosed lived at or below the poverty level, and 42% experienced homelessness in the past year.

EHE: 5 Counties in Texas

Ending the HIV Endemic in the US (EHE) is an initiative that strives to end the HIV endemic in America by 2030 with the help of the Department of Health and Human Services. EHE hopes to decrease the number of infections to 9,588 per year by 2025 and 3,000 per year by 2030. The same 2019 CDC study stated that 79% of new HIV diagnoses in the US occurred due to MSM and 14% due to heterosexual contact. In contrast, only 4% was from injection drug use. Three percent were from MSM and injection drug use combined, and 1% stated “other.”

For women, 91% of new HIV diagnoses in 2019 were heterosexual women, while 8% were from injection drug use, and 1% were “other.”

The CDC describes EHE as this: [It] focuses first on 50 local areas that account for more than half of new HIV diagnoses and seven states with a substantial rural burden. The initiative infuses the 57 priority jurisdictions with additional resources, technology, and expertise to expand HIV prevention and treatment activities. If sufficient resources become available, the initiative will eventually expand to other areas.

There are five counties taking part in the initiative in Texas:

Dallas County
Harris County
Tarrant County
Travis County
Broward County

In those counties and other areas around the country, EHE is scaling up four science-based, proven techniques to reduce HIV infections.

Diagnose
Treat
Prevent
Respond

On top of that, the CDC will continue to invest in communities most affected while trying to help HIV programs recover, rebuild, and expand after being hit hard by the COVID-19 pandemic. Outreach will be expanded and strengthened in places such as syringe service programs and STD clinics. If more resources become available, they plan to expand to other areas.

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