ABC News (02.19.10) - Friday, February 26, 2010
HIV prevalence among US blacks is so significant that focusing
on high-risk groups within the community leaves the majority
unaware of their risk, warned a report presented at the recent
17th Conference on Retroviruses and Opportunistic Infections.
African Americans account for 12 percent of the population but
half of US HIV cases.
"Part of our challenge is that a lot of the black community
has not perceived itself to be at risk based upon the
evolution of how we understood risk of HIV in the United
States," said Dr. Kimberly Smith of Chicago's Rush University
Medical Center. "If we start to focus on this as a community
challenge rather than focusing on individual risks, then that
may move us in the right direction."
Smith noted new research showing HIV rates in US cities with
large black populations are comparable to and sometimes exceed
those reported in sub-Saharan Africa. For example, the HIV
rate in Washington, D.C., is 3 percent (6 percent among black
men) and reaches nearly 14 percent among MSM in New York City.
African-American HIV mortality rates reveal a similar
disparity, with an eight-fold excess risk for black men and
20-fold for black women. Smith cited several factors that
contribute to this gap, including late diagnosis, poor access
to care, poor response and adherence to treatment once it is
initiated, and the fact that up to 20 percent of HIV-infected
black people never see an HIV provider until at least five
years after diagnosis.
"While we've made great strides in developing interventions
and targeting individual risk behavior, the bottom line is
that behavioral change programs are not enough to get ahead of
the curve," said CDC's Dr. Kevin Fenton, director of the
National Center for HIV/AIDS, Viral Hepatitis, STD and TB
Fenton noted that only 16 percent of US residents with HIV
have private insurance, and 62 percent are unemployed.