The estimated lifetime risk for a diagnosis of HIV infection is a key measure of the disparities that exist for this disease in the United States. CDC estimates that were published in 2010 indicate that 1 in 52 Hispanics/Latinos and 1 in 22 blacks/African Americans will receive an HIV diagnoses during their lifetimes, compared with an estimated 1 in 170 whites.
This health inequity exists. Our work is to find out why, who, and what can be done to change these numbers.
Many factors contribute to higher HIV rates in certain populations. Race and ethnicity are not directly linked to the higher rates. Rather, overlapping social structures and environmental systems continue to place certain groups at a higher risk. For example, poverty, homophobia, stigma, discrimination, and language barriers are factors that influence whether a person will seek and is able to obtain HIV prevention information and quality health services.
These social and environmental factors—often called social determinants of health—are the roadblocks to protecting and improving health not just for persons of color but for all people in the United States. The month-long observance of National Minority Health Month highlights the need for more open conversations, better social and physical environments, increased access to quality health services, and an enhanced understanding of the complex barriers to good health.
CDC and partners have many programs at work to reach those who lack access to prevention and care services, who experience stifling homophobia and stigma, or other factors that reduce the quality of health care they receive.
The Care and Prevention in the United States (CAPUS) Demonstration Project addresses social, economic, clinical and structural factors influencing HIV health outcomes (see earlier blog on CAPUS). Another strategy, High Impact Prevention, launched in 2012, targets areas with the highest rates of HIV with funding allocations to provide HIV testing and comprehensive prevention and care services. A third, the Expanded Testing Initiative (ETI) supports state and local health department efforts to provide routine HIV testing in health care and community settings.
There is also, The Act Against AIDS Leadership Initiative (AAALI), a component of CDC’s Act Against AIDS Initiative, which includes partnerships with 19 organizations that have demonstrated effective leadership, reach, credibility, influence, and a history of service to the African American and/or Latino communities. These organizations are integrating HIV awareness, prevention, testing, and stigma reduction into existing outreach and their day-to-day program activities. CDC also has national campaigns underway that deliver important messages about HIV infection for African Americans. Take Charge. Take the Test. encourages African American women to get tested for HIV. Testing Makes Us Stronger is aimed at increasing HIV testing among black gay and bisexual men. And Let’s Stop HIV Together, the newest AAA campaign, fights stigma and raises general awareness.
These programs and initiatives are removing barriers to HIV prevention. People are gaining knowledge about HIV and getting tested. Those with the disease are being linked to care and treatment services, and those not infected but at high risk are being provided prevention services.
We make progress with each person who learns about HIV on the radio or at faith gatherings, each person who is tested right in their community, each person who takes part in an HIV prevention program at a local organization, and each person who sees an HIV health care provider for the first time. These connections between prevention, testing, care and treatment are improving health one person, one block, one community at a time, while also raising the level of health for all in the United States.
I hope you will take time to look around at your community, your neighbor, friend, colleague, family and ask yourself how you can contribute to better health for each of them as well as yourself.
Disparities and inequities can be overcome with our help. A small step from each of us can go a long way to blazing a clear path to better health protection and disease prevention for the entire American population.