National Black HIV/AIDS Awareness Day, observed across the United States each year on February 7, is a time to look back at strides the African American population has made in lessening the disproportional impact of the virus, and a time to look ahead to continuing prevention and education efforts.
According to the US Centers for Disease Control and Prevention (CDC)
, HIV diagnoses decreased 12% overall among African Americans from 2010 to 2016 in the United States. Diagnoses among gay and bisexual black men aged 13 to 24 fell by 5%, and the rates among women and heterosexual men also decreased over the same time period, 25% and 26%, respectively.
But the disproportionality remains. African Americans comprised approximately 13% of the US population in 2017, yet accounted for 43% of all HIV diagnoses. Black men who engage in sex with other men make up the most affected subpopulation, with 9807 new HIV diagnoses in 2017.
The problem is there is no magic bullet that will close the impact gap. It is multifactorial, encompassing socioeconomics, discrimination, fear, homophobia, and stigma.
“This is nothing new—we have seen these inequities for a few decades now,” David J. Malebranche, MD, MPH, associate professor of medicine at Morehouse School of Medicine, told Contagion®
in an interview. “Particularly in the Southeast, you have issues of poverty, homelessness, archaic policies and politicians, and lack of political awareness and resources that contribute on larger structural levels. Additionally, persistent issues of racism, sexism, sexual prejudice against LGBTQ folk, discrimination against transgender and gender nonconforming people in society all create a foundation of marginalization among certain groups. When you drop HIV in the mix, it is hard to eradicate when these larger issues persist.”
To combat the inequalities and engrained societal attitudes, health care providers and clinicians should do 4 things, Dr. Malebranche explained.
“First, be more humanistic and stop treating patients as diseases personified,” he said. “Second, stop letting their implicit and overt racial, sexual, and other biases get in the way of their clinical decision-making. Third, be as empathetic and aggressive with the care of their patients as they would if themselves or a member of their family were walking in their patients' shoes. And fourth, stop simply blaming patients when they don't show up to clinic or are non-adherent with medications, and instead look inward to see what they can be doing better to help engage patients in the health care process.”
This year’s National Black HIV/AIDS Awareness Day theme is “Together for Love: Stop the Stigma
,” which urges everyone to “get educated, get tested, get treated, and get involved.”
“HIV stigma in communities can further cause delays in testing and treatment, and can delay life-saving prevention and treatment options such as pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), or antiretroviral therapy (ART) to those needing it when perpetuated by medical systems and personnel,” Dr. Malebranche said.
From a government perspective, the CDC is investing in increased prevention and surveillance efforts in populations and geographic areas of greatest need. The agency recommends everyone between the ages of 13 and 64 get tested for HIV at least once, with those considered high risk getting tested annually.
For those diagnosed with HIV, the most important thing is to get in care and stay on treatment.
“On [National Black HIV/AIDS Awareness Day], help us make progress to reduce HIV among African Americans by fighting stigma and promoting HIV testing, prevention, and treatment,” the CDC urges. “Eventually we can get to no new HIV infections if we work together.”
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