Thalita Borges, Gabriela Garcia, Kimberly Germain, Hadiya Williams Health Disparities: HIV/AIDS within the African American Community as Compared to the General Population in Massachusetts Thalita Borges, Gabriela Garcia, Kimberly Germain, Hadiya Williams

What is HIV? HIV Stands for Human Immunodeficiency Virus A. A virus with no cure B. A virus that gradually attacks the immune system by destroying a type of white blood cell, CD4 Cells (T-Helper Cells) C. If left untreated, it can attack cells leaving the body unable to fight off infection and disease D. All of the above Mention two different types of HIV with a brief description

What is AIDS? Advanced HIV Infection AIDS Stands for Aquired Immune Deficiency Syndrome Advanced HIV Infection CD4 Cell Count Drops Below 200 Cells/Milliliter of Blood Could Lead to Death

What is a Health Disparity? “The differences in the incidence, prevalence, mortality, and burden of disease and other adverse health conditions that exist among specific population groups in the United States.” -The National Institute of Health Factors that contribute to a health disparity: Inequalities in income and education Environmental and economic conditions Specific health behaviors and lifestyle patterns Access to care Quality of services

Higher Prevalence of STD Why is HIV/AIDS a Health Disparity in African Americans in Massachusetts? Incarceration Higher Prevalence of STD Access to Care Socioeconomic Status Stigma HIV/AIDS is a major health crisis for African Americans from all ages, geographic locations, socioeconomic status, and sexaul orientations.

Massachusetts Demographics 2012 White population: 75.9 % Minorities: 24.1 % African Americans: 6.5% https://www.census.gov/quickfacts/table/PST045215/25 http://aidsvu.org/state/massachusetts/

HIV/AIDS Prevalence in Massachusetts by Race/Ethnicity Thalita http://www.mass.gov/eohhs/docs/dph/aids/2012-profiles/epidemic-glance-data.pdf

White Population Black Population http://aidsvu.org/map/?state=MA

General Statistics regarding HIV/AIDS Prevalence in Black People in MA Kim http://www.mass.gov/eohhs/docs/dph/aids/2012-profiles/epidemic-glance-data.pdf http://aidsvu.org/state/massachusetts/ GRAPH THIS ONE http://kff.org/hivaids/state-indicator/estimated-death-rates-per-100000-of-adults-and-adolescents-with-an-hiv-diagnosis-by-raceethnicity/?state=MA

Higher Prevalence of STDs Thalita http://www.cdc.gov/std/hiv/stds-and-hiv-fact-sheet-press.pdf http://www.mass.gov/eohhs/docs/dph/cdc/aids/std-surveillance-2013.pdf

Drug Treatment Programs Comfort Socioeconomic Status Location LGBTQ Freindly? Contact phil - head of special population, works with HIV patients, Affordable care act? Romney: ASK MR LAYNE ABOUT SITE http://www.positivelyaware.com/archives/2012/12_07/healthc are-question.shtml http://www.mass.gov/eohhs/docs/dph/aids/resources- guide.pdf

Where do people go to get treatment? -Not all areas have accessible HIV/AIDS Care Center -Hyde Park -34 % African American -No treatment facility These are some examples of HIV/AIDS treatment centers in Massachusetts

What is a socioeconomic status? Socioeconomic Status Reflects the social standing or class of an individual or group. It is measured by income, education and occupation. Socioeconomic status reflects the social standing or class of an individual or group. It is measured by income, education and occupation. Ultimately effects where an individual lives and what resources an individual or group has access to http://www.apa.org/topics/socioeconomic-status/ key factor in determining the quality of life for individuals after they are affected by the virus

Effects of Socioeconomic Status -Affording health insurance -Access to education -Distance from healthcare facilities -correlation between low SES and earlier death from HIV/AIDS http://www.mass.gov/eohhs/docs/dph/communications/hom- chapter-1.pdf Having HIV prior to having health insurance does it make it higher ? Kim http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0114822#s3

Stigmas -Injection Drug Use -Homosexuality -Denial -Prisons

Incarceration http://www.prisonpolicy.org/reports/rates.html Fourteen percent of cases (1,158) were homeless, incarcerated, or had missing address information http://c.ymcdn.com/sites/www.cste.org/resource/resmgr/ccabstracts/madoh.pdf

Conclusions African Americans suffer from the largest HIV/AIDS Health Disparity in Massachusetts Many factors contribute to HIV/AIDS being one of the most prevalent disparity in African Americans in Massachusetts We Need to focus on these issues http://www.cdc.gov/hiv/group/poverty.html

What has been done? What can we do? 4 classes of antiretroviral drugs 28 different formulations of antiretroviral therapies Clinical trials Longer life expectancy -Treat drug abuse differently -Acknowledge multiple comorbidities -Comprehensive Care -Proactively Advocate People are now living with this for years as long as their on these drugs → longer life expectancy In 1996-97 the life expectancy at age 20 of an HIV-positive person was 19 years, in other words they could only expect to live, on average, in the absence of any improvement in treatment, till they were 39. By 2011, this had improved to 53 years, i.e. death on average at 73. -http://www.aidsmap.com/Life-expectancy-in-HIV-positive-people-in-the-US-still-lags-13-years-behind-HIV-negative-people/page/3040314/ What can we do?.... -Community-level interventions, in particular, would be ideal for these foci of high HIV prevalence. -Structural interventions to improve socioeconomic conditions in these areas may reduce HIV infection rates.

References HIV/AIDS. (n.d.). Retrieved June 16, 2016, from http://kff.org/state-category/hivaids/ Massachusetts - AIDSVu. (2012). Retrieved June 16, 2016, from http://aidsvu.org/state/massachusetts/ The Role of STD Prevention and Treatment in HIV Prevention. (2010, April). Retrieved June 16, 2017, from http://www.cdc.gov/std/hiv/stds-and-hiv-fact-sheet-press.pdf Population estimates, July 1, 2015, (V2015). (2014). Retrieved June 16, 2016, from https://www.census.gov/quickfacts/table/PST045215/25 Satcher, D., Pamies, R. J., & Woelfl, N. N. (2006). Multicultural medicine and health disparities. New York: McGraw-Hill. Skala, L. (2014, May 28). Breaking Down Mass Incarceration in the 2010 Census: State by State Incarceration Rates by Race/Ethnicity. Retrieved June 16, 2016, from http://www.prisonpolicy.org/reports/rates.html Not too sure how to do the massgov ones http://www.mass.gov/eohhs/docs/dph/communications/hom- chapter-1.pdf