The Disproportionate Impact of HIV in America
A Pivotal Moment in America
It has been a year full of seismic shifts. A series of core-shaking events ranging from a global pandemic to an upwelling of the Black Lives Matter movement has exposed deeply entrenched inequities in our society.
We need only look at the statistics emerging from the COVID-19 pandemic to see these inequities at work. According to the CDC, Americans who are Black, Hispanic/Latinx, American Indian, and Alaskan Native are nearly three times more likely to become infected with COVID-19 than white Americans and approximately five times more likely to be hospitalized due to infection.
Rather than being an anomaly, studies have revealed a health gap between white Americans and Americans of color so wide that it has been named a public health crisis. This divide is perhaps most evident in the disproportionate impact of the HIV epidemic.
The Story of HIV, Told Through the Numbers
Advances in HIV treatment and prevention over the past several decades are reason to feel hopeful. The number of people infected with HIV each year has plummeted by more than two-thirds since the height of the epidemic in the 1980s, and we’ve dramatically transformed the outlook for those living with HIV. However, our efforts to combat the HIV epidemic have stalled in the face of a serious issue—HIV prevention and treatment are not accessible to everyone who needs them.
According to the CDC, Black Americans are the most affected racial or ethnic group with a lifetime HIV risk of one in twenty for men and one in forty-eight for women (compared to an overall risk of one in ninety-nine for all Americans). Gay and bisexual Black men have been hit hardest of all: it’s estimated that if current infection rates continue, one in two will contract HIV in their lifetime. Gay and bisexual Hispanic/Latino men face a similarly distressing statistic, with an estimated one in four at risk of HIV infection.
These numbers paint a bleak picture, yet Jonathan Mermin, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention, offers hope. “As alarming as these lifetime risk estimates are,” he says, “they are not a foregone conclusion. They are a call to action.”
The Social Factors Driving Risk
There is a complex set of socioeconomic factors—such as income, housing, and occupation—that impact a person’s risk of contracting HIV and affect the quality of care they receive. In the United States, HIV infections are mainly concentrated in urban areas and among those of a lower socioeconomic status.
Like COVID-19 and HIV, poverty rates in the United States reveal clear racial and ethnic disparities. The data shows that one in four Black Americans and Native Americans live in poverty and one in five Hispanics/Latinos. For white Americans, the number is one in ten.
There are significant barriers to accessing quality healthcare for those living in poverty, including financial insecurity and fear of discrimination. Many services that help to decrease HIV transmission rates—such as prevention education, substance abuse counseling, STI treatment, and antiretroviral therapy (ART)—remain mostly out of reach for these communities. In this way, the people who are most vulnerable to HIV infection continue to face an ever-growing risk.
Fighting These Challenges
An HIV diagnosis today is vastly different than it once was. With antiretroviral therapy (ART), a person living with HIV can suppress the virus and stop the progression of HIV disease. Not only will maintaining viral suppression help them stay healthy, but it also means they will have effectively no risk of transmitting HIV to others.
For those at risk of infection, pre-exposure prophylaxis (PrEP), an HIV prevention method available by prescription, can virtually eliminate that risk. However, unless we ensure HIV prevention, testing, and treatment are widely available and affordable, we will continue to see tens of thousands of new infections year after year.
Want to learn more about PrEP? We explain the basics in “All About PrEP for HIV Prevention.”
These are significant issues to tackle, but we can each do our part by talking with our doctors if we’ve never had an HIV test or if we think we may be at risk of infection. We can support organizations like NMAC and Black AIDS Institute that work to make HIV services more accessible to communities of color. And we can encourage our elected officials to help fight HIV through government funding and programs.
Lastly, we should avoid perpetuating the fear and stigma that’s often associated with HIV. When we talk about HIV openly and neutrally, we help create a culture where everyone feels safe to seek testing and care.
Looking for a supportive partner to help manage your HIV medications? We’re here for you. You can reach out and talk with an HIV specialist between 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends; call or text 1-800-874-5881, or download the mobile app for secure messaging.