National Black HIV/AIDS Awareness Day

Dr. Dana Hines
February 13, 2017

Although they make up only 12 percent of the US population, African-Americans accounted for 44 percent of all newly diagnosed cases of HIV in the United States, according to the Centers for Disease Control. African-Americans have the highest proportion of new HIV and AIDS diagnoses compared to all races and ethnicities.

Today, National Black HIV/AIDS Awareness Day (NBHAAD), is a national initiative aimed at increasing HIV prevention, testing, treatment, and linkage to care among blacks living in the United States and African Diaspora (NBHAAD). Each year, public health agencies, community based organizations, churches, and other community entities gather in African-American communities across the country to discuss the burgeoning epidemic in our communities, raise awareness about innovative strategies for prevention such as pre-exposure prophylaxis (PREP); and to promote HIV education and testing.

These efforts have never been more important, as unintended consequences of the current push toward stripping federal funding from sanctuary cities will further threaten access to health care, HIV prevention and treatment.

African-American men are especially vulnerable to this epidemic; in 2014, African American men accounted for more than half (73 percent, 14,305) of all newly diagnosed cases of HIV; and of that number, more than half (57 percent, 11,201) were among African-American men who have sex with men.

African-American women also bear a moderate portion of new HIV disease burden and accounted for more than one-quarter (26 percent, 5,128) of all newly diagnosed cases of HIV in 2014. Gender and racial minorities such as African-American transgender women, are also more likely to test HIV positive when compared to transgender Hispanic/Latina and white transgender women.

But why are the numbers so high? Are African-Americans engaging in riskier sex? And what can we do about it? The first step is to restructure our way of thinking of HIV as a disease that happens because someone was sexually irresponsible, to thinking of the social conditions, social contexts, and policies that drive the epidemic.

Issues including poverty, lack of insurance, unstable housing, un/underemployment, racial discrimination, and high rates of incarceration without post-release programs that support re-entry into the community and assistance with securing employment, are structural drivers of the HIV epidemic among African-Americans. These conditions restrict access to preventive treatment such as PREP, which costs about $1,300 per month without insurance; and to continuous HIV care.

Recent executive orders from the current administration to strip federal grant funding from cities designated as sanctuary cities pose additional structural risks, not only to African Americans, but to all people in those cities who are living with HIV. Sanctuary cities are those cities who offer refuge to immigrants fleeing violence, religious persecution, and other atrocities in their home country and who refuse to cooperate with the current Administration’s efforts to ban refugees and immigrants from certain Muslim-majority countries from entering the US.

Among the list of designated sanctuary cities is the District of Columbia, which ranks fifth among cities with the highest rates of new HIV infection — primarily African-Americans, and where the lifetime risk of contracting HIV is 1-in-13. If the administration’s efforts prove successful in defunding sanctuary cities, then DC could lose billions of dollars in federal funding, according to reports in The Washington Post and aidsmap.com.

So as we commemorate National Black HIV/AIDS Awareness Day and mobilize our efforts in working towards and AIDS-Free Generation and advocating for policies that support health parity, may we be reminded of a quote from Sir Williams Dean, former Governor General of Australia, “The ultimate test of our worth as individuals and countries is how we treat the most vulnerable and disadvantaged.”

 

Dr. Dana Hines is an Assistant Professor at GW Nursing.  Her research interests include social determinants of health, health disparities, and strategies to improve access to care among sexual and gender minorities, namely transgender women, living with or at risk for HIV.