AIDS Q&A 2012: Are Blacks Still Suffering The Most?

    A red AIDS Awareness ribbon pin against a white backgroundThe HIV/AIDS epidemic in the African American community made its “debut” in the early 1980’s and is entering its third decade as one of this country’s most critical and challenging health issue. Among African Americans, HIV/AIDS has produced especially grave outcomes.

    According to the National Center for Health Statistics 2006 Report, HIV/AIDS is one of the top 10 leading causes of death for African Americans; and in the same year African Americans accounted for more than half (54 percent) of estimated new HIV infections in the United States. About 72% of new HIV infections occur in men who have sex with men, and 57% occur among African Americans.

    The Centers for Disease Control and Prevention (CDC) estimates that a quarter of those living with HIV, more than 250,000 do not know they are infected.

    To help answer your questions and dispel myths about a disease that continues to pervade the Black community, BlackDoctor.org recently invited noted HIV/AIDS expert Dr. Keith Crawford to host an hour-long Q&A session on Facebook. The event was an overwhelming success!

    Here is a complete list of the questions and answers from this dynamic, engaging conversation:

    1. How often should I be tested for HIV?

    Dr. Crawford: I would recommend annually if you are sexually active and practicing safe sex. You should integrate HIV screening with your routine annual medical checkups that monitor for heart disease, diabetes, kidney function, mental health, etc. Be sure to ask for it.

    Unfortunately, many of our medical providers are still in the Stone Age and do not offer HIV testing to their patients.

    2. Is it safe for two people with HIV to have sex?

    Dr. Crawford: Not necessarily. It MAY possibly be OK if both persons are on medicines controlling their HIV and taking their medicines properly. Otherwise, the medicines that work for you may not be effective against the other person’s virus so they could infect you with a different virus that’s difficult to treat.

    3. If I have sexual contact with a person with HIV, does that mean I automatically get the disease too?

    Dr. Crawford: No. There are a lot of factors that determine whether someone with HIV infects someone else. Some of these include:

    • How much HIV is in the infected person’s blood and also their semen/vaginal fluids? 
One of the strongest predictors of infection is how much virus is in the infected person’s reproductive tract, which is usually related to how much is in the blood. With effective treatment, this amount of virus is dramatically reduced in the blood and reproductive tract, reducing the chance of infecting someone else.
    • For men, are they circumcised? Circumcision has been demonstrated to reduce the risk of HIV transmission as well as other STD’s.
    • Does the infected person have an STD? Does the uninfected person have an STD?
Sexually Transmitted Diseases can increase the amount of HIV in the semen or vaginal fluids. STD’s cause inflammation making it easier for HIV and other infections to pass.
    • What type of sex are you having (see question# 6 above)
    • What “strain” of HIV does the person have? Across the world, there are different “subtypes” of the HIV virus and some of these types are more easily transmitted sexually that others.

    These are some of the key factors involved.

    4. Do you know of any programs that help HIV positive people obtain free medication or services?

    Dr. Crawford: Yes. The Ryan White Care Act funds clinics throughout the US to provide free HIV medical care for individuals who don’t have medical insurance. Ask your local public health department or visit www.hab.hrsa.gov. Along with these programs, the AIDS Drug Assistance Program (ADAP) operates in all states providing HIV medicines for eligible patients.

    5. Are there new strands of HiV that medication no longer works for? If so, what is being done about it?

    Dr. Crawford: Whether or not HIV medicines work depends on the individual. Before starting therapy, your medical provider should do a test (called a resistance test) which tells him or her which medications are effective against their virus. Medications may not work for person particular if the person was prescribed the medicine but did not take the medicine as their provider instructed them too. Missing doses of medicine allows the virus to “escape” from the protection the medicine provides. If a person has no medication resistance, any or all the HIV medicines can potentially work.

    6. Is there a specific kind of sex that gives more exposure to the disease (i.e., vaginal, anal, or oral)?

    Dr. Crawford: Yes. Definitely anal sex increases the risk of infection over vaginal sex, particularly for the receptive/passive partner. Use a condom either way. Oral sex has a lower risk, but that also depends on whether the person has sores or abrasions in the mouth.

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