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HIV/AIDS Among African Americans

Centers for Disease Control Fact Sheet

In the United States, the impact of HIV and AIDS in the African American community has been devastating. Through December 1999, CDC had received reports of 733,374 AIDS cases - of those, 272,881 cases occurred among African Americans. Representing only an estimated 12% of the total U.S. population, African Americans make up almost 37% of all AIDS cases reported in this country.

Researchers estimate that 240,000-325,000 African Americans - about 1 in 50 African American men and 1 in 160 African American women - are infected with HIV. Of those infected with HIV, it is estimated that almost 118,000 African Americans were living with AIDS at the end of 1998.

In 1999, more African Americans were reported with AIDS than any other racial/ethnic group

• 21,900 cases were reported among African Americans, representing nearly half (47%) of the 46,400 AIDS cases reported that year.
• Almost two-thirds (63%) of all women reported with AIDS were African American.
• African American children also represented almost two-thirds (65%) of all reported pediatric AIDS cases.
• The 1999 rate of reported AIDS cases among African Americans was 66.0 per 100,000 population, more than 2 times greater than the rate for Hispanics and 8 times greater than the rate for whites.

Data on HIV and AIDS diagnoses in 25 states with integrated reporting systems show these trends are continuing. In these states, during the period from January 1996 through June 1999, African Americans represented a high proportion (50%) of all AIDS diagnoses, but an even greater proportion (57%) of all HIV diagnoses. And among young people (ages 13 to 24), 65% of the HIV diagnoses were among African Americans.

Prevention Efforts Must Focus on High-Risk Behaviors

Adult/Adolescent Men.  Among African American men with AIDS, men who have sex with men (MSM) represent the largest proportion (37%) of reported cases since the epidemic began. The second most common exposure category for African American men is injection drug use (34%), and heterosexual exposure accounts for 8% of cumulative cases.

Adult/Adolescent Women.   Among African American women, injection drug use has accounted for 42% of all AIDS case reports since the epidemic began, with 38% due to heterosexual contact.

Interrelated Prevention Challenges in African American Communities

Looking at select seroprevalence studies among high-risk populations gives an even clearer picture of why the epidemic continues to spread in communities of color. The data suggest that three interrelated issues play a role -- the continued health disparities between economic classes, the challenges related to controlling substance abuse, and the intersection of substance abuse with the epidemic of HIV and other sexually transmitted diseases (STDs).

• Substance abuse is fueling the sexual spread of HIV in the United States, especially in minority communities with high rates of STDs. Studies of HIV prevalence among patients in drug treatment centers and STD clinics find the rates of HIV infection among African Americans to be significantly higher than those among whites. Sharing needles and trading sex for drugs are two ways that substance abuse can lead to HIV and other STD transmission, putting sex partners and children of drug users at risk as well. Comprehensive programs for drug users must provide the information, skills, and support necessary to reduce both injection-related and sexual risks. At the same time, HIV prevention and treatment, substance abuse prevention, and sexually transmitted disease treatment and prevention services must be better integrated to take advantage of the multiple opportunities for intervention.
• Prevention efforts must be improved and sustained for young gay men. In a sample of young men who have sex with men (ages 15-22) in seven urban areas, researchers found that, overall, 7% were infected with HIV (range, 2%-12%). A significantly higher percentage of African American MSM (14%) than white MSM (3%) were infected.

It is clear that the public sector alone cannot successfully combat HIV and AIDS in the African American community. Overcoming the current barriers to HIV prevention and treatment requires that local leaders acknowledge the severity of the continuing epidemic among African Americans and play an even greater role in combating HIV/AIDS in their own communities. Additionally, HIV prevention strategies known to be effective (both behavioral and biomedical) must be available and accessible for all populations at risk.