Why HIV/AIDS is still killing African Americans: while new treatments emerge, deadly disease continues to ravage Black families

What's new in the fight against HIV/AIDS? I wish I could report a dramatic decline in the number of infections, but unfortunately, that is not the case. Statistics indicate that HIV/AIDS continues to ravage the Black community. In the United States more than a million people have HIV/AIDS, and of that number, African-Americans are vastly overrepresented. Although Blacks comprise only 13 percent of the U.S. population, they accounted for 50 percent of HIV/AIDS cases diagnosed from 2001-2005 (based on 33 states with mature HIV surveillance).

There is a bit of good news to celebrate, however. New medications are being developed that appear to be better tolerated, longer lasting and more potent. The new medicines still need to be given in combination with older drugs, most often as part of a regimen consisting of several pills a day.

While there are now more than 20 approved drugs to treat HW/AIDS, in many patients, the virus develops resistance to one or more drugs, usually because patients do not take their drugs as prescribed. In some cities, the number of patients affected with a resistant strain is surging. That will probably continue if persons with a resistant virus have unprotected sex or share a needle, thereby passing along the infection.

In another development, the Centers for Disease Control and Prevention (CDC) has revised its recommendations for HIV testing in health care settings to make HIV testing a routine part of medical care. The recommendations call for HIV screening for patients who are 13 to 64 in all health care settings and without the need for a separate written consent. People at high risk for HIV should be tested annually, and H1V screening should be part of the routine prenatal tests for all pregnant women. The CDC recommendations emphasize the importance of voluntary testing, noting that patients can decline or opt out of testing if they choose.

One reason for the proposed routine testing is that approximately 250,000 persons are unaware they have HIV and could unwittingly be spreading HIV to their partners. It is estimated that new sexually transmitted HIV infections could be reduced by more than 30 percent per year if all HIV-infected persons knew of their infection and adopted appropriate behavioral changes.

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In certain segments of the African-American population, young men and women have been severely impacted. Data from a study of 450 men who have sex with men and tested positive for HIV/AIDS indicated that 46 percent were Black (compared with 21 percent White and 17 percent Hispanic). Additionally, among young African-American women, HIV/AIDS ranks as the No. 1 cause of death for Black women aged 25 to 34. But most women get the disease through heterosexual contact.

Recently, the CDC and the National Medical Association (NMA) each released new recommendations concerning HIV/ AIDS, designed to reduce HIV/AIDS infection and enable patients to receive critical diagnosis, treatment and counseling.

In July, the NMA released its Consensus Panel Report on HIV/AIDS. The report notes that policies and practices regarding HIV/AIDS need to include special populations (such as prisoners, foster and adopted children, people in special care settings, and youth transitioning to adulthood), as these groups are often missed for screening and diagnosis. The NMA report recommendations include legislation and policy, capacity-building for prevention and treatment, funding for research, access to care and patient responsibility.

Certainly, the recommendations by the CDC and the NMA, if implemented, could turn the tide in the fight against HIV/AIDS. It is critical to establish a multifaceted effort to effectively combat the problem and significantly reduce its prevalence.

WILBERT C. JORDAN, M.D.

COPYRIGHT 2007 Johnson Publishing Co.
COPYRIGHT 2008 Gale, Cengage Learning