NBNA BRIEFING PAPER ON HIV/AIDS

In the United States, the impact of HIV and AIDS in the African American community has been devastating. According to the Centers for Disease Control and Prevention, in 2000, Blacks and Hispanics account for a disproportionate share of AIDS cases.

Over half of the AIDS cases reported in the U.S. were among Blacks and Hispanics.

In 2000, 66% of the 41,960 adult and adolescent AIDS cases reported were among Blacks and Hispanics.

Over three-quarters of the women and children reported with AIDS were Black or Hispanic.

In 2000, African Americans comprised 12% percent of the U.S. population, but made up 47% of the AIDS cases as compared to whites who comprise 71% percent of the population and make up 32% of the AIDS cases. Hispanics make up 19% of the AIDS cases and 13% of the population.

Researchers estimate that of the 240,000 - 325,000 African Americans infected by HIV, 1 in 50 African American men are infected with HIV; 1 in 160 African American women are infected with HIV; and, 118,000 African Americans are living with AIDS.

Prevention efforts must focus on high risk behaviors. Among African American men with AIDS, men who have sex with men 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 of 34% and heterosexual exposure accounts for 8 percent.

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

Young disadvantaged women, particularly African-American women, are being infected with HIV at younger ages and at higher rates than their male counterparts, according to a CDC study published in the September 1998, issue of the Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology (JAIDS). The study presents data from 1990 through 1996 on the rates of HIV infection among entrants to the U.S. Job Corps program, a federally funded job training program for disadvantaged out-of-school youth from all 50 states and U.S. territories. While not representative of all youth, these data provide a snapshot of the continuing toll of HIV among the many young people in the United States who are economically and educationally disadvantaged.

The results indicate that of the over 350,000 16- to 21-year-olds tested, more than 2 per 1,000 were HIV-infected, with rates among young African-American women exceeding 5 per 1,000. Young African-American women had the highest HIV infection rate of any group.

Women at Greater Risk at Early Ages

One of the most alarming findings was the elevated risk among young women, compared to young men. During the seven-year study period, HIV prevalence was 50% higher for women in the study than for men (3 per 1,000 versus 2 per 1,000) as a result of dramatically higher rates of infection among young women 16-18 years of age. With increased age, the differences in prevalence diminished, and at 19, 20, and 21, there were no significant differences between women and men. These findings point to the critical need to reach young women early and provide them the skills and information needed to protect themselves from infection. Many of these young women are likely infected by men older than themselves. Prevention programs for disadvantaged young women should include a focus on building the self-esteem and skills necessary to delay sexual intercourse and to negotiate condom use.

HIV prevention programs work and save money. At the beginning of the HIV epidemic, 150,000 people were infected with HIV annually. Now the rate of new HIV cases is around 40,000. The cost of caring for a person living with HIV is $125,000 to $157,000 over their lifetime.

Recommendations:

NBNA advocates for increased funding for HIV/AIDS at the Centers for Disease Control and Prevention, specifically targeted at high risk groups.

NBNA advocates for increased funding for Ryan White CARE Act programs by 15 percent over FY 2002.

The NBNA Briefing Paper on HIV/AIDS was presented during the National Black Nurses Day on Capitol Hill on February 7, 2002.

2/6/2002