The Heavy Burden of Disease in the Black Community and Its Impact On the Hiv Epidemic

Summary

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The 2003 Institute of Medicine Report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care," documented continued inequalities in the delivery of care that contribute to a disproportionate burden of disease among African-Americans. It is not surprising then that HIV should be so highly prevalent among African-Americans, But the rates of HIV infection are so much higher than in Caucasians, and in other minority groups, that it seems as if other factors may be in play. There are certain diseases that increase the risk of HIV infection. Some of these conditions are more prevalent in African-Americans or are under-treated in these populations.

Sexually Transmitted Diseases (STDs) Increase Transmission of HIV Sexually transmitted infections can increase an individual's ability to both transmit and acquire HIV. A person with HIV and an STD often has a higher level of HIV in the blood and in semen and vaginal fluids. For example, one study showed that men with gonorrhea had ten times as much HIV in their semen as men with HIV and no STD. Furthermore, STDs can damage the reproductive tract by creating inflamed tissues, tiny tears and sores. These lesions can increase the ability of a person to transmit the virus, but can also increase the likelihood of an uninfected person contracting the virus. An impact of STDs was well demonstrated in a study conducted in the African country of Tanzania. In one region, clinicians were able to reduce the rate of new HIV infections by 42% simply by treating symptomatic STDs.

There are other concerns. The CDC reports that 25% of HIV infected individuals are not aware of their status. These patients may have high levels of HIV replicating in the blood, increasing the likelihood that they could infect someone else. Studies in Africa showed a strong association between the amount of HIV in a person's blood and their ability to infect their partner. Effective treatment of HIV can reduce the amount of virus to levels that are undetectable and reduce the likelihood of infecting someone else. So the failure of individuals to get tested and treated can contribute to high infections rates in our communities.

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The Heavy Burden of Disease in the Black Community and Its Impact On the Hiv Epidemic

As early as 1895, Booker T. Washington was alarmed by striking disparities in the access to health care for African-Americans. Concerns for the declining health status among African Americans were echoed by W.E.B. Dubois, in his masterpiece, "The Souls of Black Folk."

Fast forwarding to 1985, the Department of Health and Human Services commissioned the Malone-Heckler report, ...

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