African American Community and HIV Cseneca Greenwood Program Coordinator for Butterfly Project AIDS Project East Bay Mario Ruberte East Bay AIDS Education and Training Center April 9, 2004

What is the percentage of African American population in the Unites States?

According to the 2000 U.S. Census 12.3% AA= 34,658,190/Total U.S. = 281,421,906

How does the AA population compare to general population of HIV positive individuals?

CDC Study of 2002 AA account for 39% of all AIDS cases diagnosed since the beginning of the epidemic. AA accounted for 50% of all new AIDS cases reported in 2002, and were 42 % of all people living with AIDS in the U.S.

CDC Study of 2002 Concluded that the HIV/AIDS epidemic is a major health crisis among AA, affecting men and women of every age & sexual orientation Fact: In the year 2000, AIDS was the leading cause of death for AA men & women of ages (CDC, National Center for Health Statistics, National Vital Statistics System, National Viatal Statistics Reports, Leading Causes of Death for 2000, Vol. 50, No. 16, Sept. 2002)

Estimated Percentage of Diagnoses of HIV/AIDS By Race 2002 Total number of cases 26,464 ~ CDC/2002

Estimated Percentage of Diagnoses of HIV/AIDS By Race and Sex Men Total number of men =72,323 ~ CDC/2002

Estimated Percentage of Diagnoses of HIV/AIDS By Race and Sex Women Total number of women = 30,264 ~ CDC/2002

According to the Kaiser Family Foundation an estimated 67% of AA women with AIDS contracted HIV through heterosexual sex, compared to 59% four years earlier. According to the CDC the leading cause of HIV infection among AA women is heterosexual contact, followed by injection use.

And, the leading cause of HIV infection among AA men is sexual contact with other men, followed by IDU, and heterosexual contact.

Recent studies suggest that 30 percent of all black bisexual men may be infected with HIV, and up to 90 percent of those men do not know. The CDC have referred to these men as the “bridge” to infection from gay men to heterosexual women. NY Times/Linda Villarosa/”Startling statistics raise AIDS fears among blacks:

62% of children born to HIV infected mothers were AA. 65% of all pediatric AIDS cases (under age of 13) reported in 2001 were among AA. CDC//HIV AIDS Surveillance Report, Year End Edition Vol. 13. No.2 Suffer the children…

What about the African American Transgender Community?

According to the CDC MSMs, especially MSMs of Color, are the single highest group at risk for HIV/AIDS. With regard to HIV surveillance and prevention, the CDC’s current practice is not to separate MTF TG and TS people from the MSM category, with no attention paid to the risks of FTM TG people. Medical Advisory Bulletin 08/02 – Gender.Org

The Kristen Clements study found that over 35% of all MTFs surveyed were HIV infected. Of that 35%, almost two thirds (or 63%) were African Americans. Kristen Clements/SFPDH 02/1999

The Rose Project summarized from previous studies researched that the AA MTF TG population have a greater than 50% HIV prevalence… And found in their local study of 71 AA TGs that 60% (42 people) were HIV +. The Rose Project Study/2002

A study of sex workers in Atlanta reported a 68% HIV seroprevalence in MTFs and that MTFs are often induced by their clients to engage in barrier-free sex. Medical Advisory Bulletin 08/02 – Gender.Org – Study of sex workers in Atlanta

What are the factors that contribute to the high prevalence of HIV in the African American Community?

“Experts say that AA generally have sexual relations with other AA, which confines the virus within the black “sexual network”. (NY Times/Linda Villarosa/040504) Down Low: Bisexual men living double lives Patriarchal Society – male dominated society Poverty: According to the 2000 Census Bureau, approx 1 in 4 AA households live in poverty. IDU: Sharing of needles Low self-esteem General Contributing Factors

Factors specific to TG Community Sex work: HIV status is not often discussed with their sex partners, pressure from clients to engage in barrier-free sex Priorities: HIV is not a high priority due to other health and social needs Drug abuse: Helps them cope, disrupts judgment Barriers: Stigma, discrimination, and lack of society sensitivity The Rose Project (2002); Medical Advisory Bulletin 08/02 – Gender.Org – Study of sex workers in Atlanta)

Factors specific to TG Community Transphobia - Mental Health Outcomes: 37% of AA TGs suffered from depression 41% of AA TGs ever attempted suicide (Keatley Study of 332 TG individuals) Feelings of isolation, rejection and powerlessness (CAPS/UCSF “What are the HIV prevention needs of MTF TG persons.)

What are the general African American attitudes towards HIV/AIDS in the U.S. ?

More than 35% of African Americans say HIV/AIDS is the most urgent health problem facing the nation (compared to 13% of whites). However, this number has decreased from 56% in 1995! Source: The Washington Post/Kaiser Family Foundation: National Survey on the Public’s Attitudes towards HIV/AIDS in the U.S. and the World, July 2002

African Americans are almost twice as likely as whites to say that AIDS is a serious problem for people they know. (63% compared to 33% of whites) Source: The Washington Post/Kaiser Family Foundation: National Survey on the Public’s Attitudes towards HIV/AIDS in the U.S. and the World, July 2002

And more than half of AA (55%) say they are personally concerned about becoming infected with HIV (compared to 26% of whites) However this number has decreased from 71% in 1995! Source: The Washington Post/Kaiser Family Foundation: National Survey on the Public’s Attitudes towards HIV/AIDS in the U.S. and the World, July 2002

What are the Cultural Growth Challenges Facing The African American Community?

Cultural Growth Challenges Religion – Strong influence on cultural values. Restriction, misguidance and misinformation. Sexuality – Embracing it at an early age. Victim hood – Perpetuating the myths.

Conclusion Mind, Body and Soul The need for treating the whole person.

Resources CDC: HIV/AIDS Among African Americans, 2003 The Henry J. Kaiser Family Foundation : Key Facts: African Americans and HIV/AIDS – 09/2003 U.S.Census Bureau : 2000 Census, Poverty Report Gender.Org : Medical Advisory Bulletin – 08/2002 Rose Study : Valerie Rose, Dr.PH, MPH, Susan Scheer, Ph.D, MPH, Joyce Balls, MPE, Kimberly Page-Shafer, Ph.D, MPH, Willi McFarland, MD, Ph.D, MPH. SFDPH, Center for AIDS Prevention Studies, UCSF, SF, CA Kristen Clemens Study : Kristen Clements, MPH, Mitchell Katz, MD, Rani Marx, PhD, MPH. SFDPH, Joanne Keatley Study: : UCSF/CAPS 2001 Gender.Org : Medical Advisory Bulletin – 08/2002 New York Times : “Startling statistics raise AIDS fears among blacks” Linda Villarosa, April 5, 2004.