HIV and AIDS are abbreviations for Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome respectively. HIV is a human virus which attacks the immune system. The virus attacks T-helper cell, a type of white blood cell within the human immune system. As the HIV multiplies within the human body, it invades more T-helper cells which are responsible for fighting illnesses and gradually diminish an individuals immunity (Whiteside, 2016). Eventually, it reaches a point where the human body finds it hard to fight off infections. At such a point, the infected person shows a set of symptoms and illnesses which are called AIDS. It is then said a person has AIDS when their immune system is so weak to defend against infections and diseases and the symptoms of HIV invasion become apparent (Whiteside, 2016).
Defining the term African American
An African American is a term used to refer to American citizens who are of African descent. African Americans are the sons of the Africans who were taken to America during the Trans-Atlantic trade to work in the White plantations (Walton, Smith & Wallace, 2017). The term African-American, thus, describes the sons and daughters born to Africans who were taken to work in American plantations during the colonial time. These sons and daughters obtained citizenship as conferred by the Act of Congress following the ratification of the Fourteenth Amendment to the U.S Constitution in 1924 (Walton et al., 2017). The act required that every Native American born in the U.S be granted American citizenship.
Rate of HIV Infection Within African Americans in Comparison to Other Racial/Ethnic Groups in the United States
African Americans account for the highest percentage of those living with HIV, new HIV diagnoses and those who have already been diagnosed with AIDS as compared to other American races or ethnicities. According to DiNenno et al. (2018), 44% of all the new HIV diagnoses were African Americans in 2016. This was stunning as the African Americans account for only 12% of the United States population.
In numerical terms, 17, 528 African Americans were diagnosed with HIV in 2016. Out of these new diagnoses, more than half, representing 58%, were bisexual or gay men (DiNenno et al., 2018). This implies that gay and bisexual accounts for the highest new HIV diagnoses among the African American men. Whereas the new HIV diagnoses among heterosexual African American men, the rates remained stable for gay African American men.
When the new HIV diagnoses for a minority group such as Hispanic is compared to that of African Americans, the gap is huge. Whereas in 2016 African Americans accounted for 44% of the entire new infections in America, Hispanics accounted for only 24% (DiNenno et al., 2018). African Americans accounted for new diagnoses which were almost double of the Latinos. This shows that of the minority groups, African Americans were leading in new HIV infections.
Differences Between HIV and AIDS Within Male and Female African Americans
New HIV and aids diagnoses among the African Americans were high among the men than women with numbers almost doubling. Out of the 17, 528 African Americans who received HIV diagnoses, 12, 890 were men while 4, 560 were women (DiNenno et al., 2018). It means that African American men stand a high chance of being infected with HIV than women which suggests unique risk factors.
Ecological Framework
The high prevalence of HIV and AIDS among the African American men can be understood when examined through an ecological lens. The ecological framework is divided into three levels; micro, mezzo, and macro.
Micro
Gay or bisexual men
Statistics indicate that more than half of the African American men diagnosed with HIV are gays or bisexuals (DiNenno et al., 2018). Among these victims, 39% are young men falling within the age range of 25 and 34. In the United States, gay and bisexuals makeup two percent of the population and account for 70% of new HIV infections (DiNenno et al., 2018). This implies that a much higher proportion of gays are living with HIV which in turn increases the chance of a gay to contract the virus. Similarly, most gay and bisexual men engage in anal sex without taking preventive medicine or using a condom (DiNenno et al., 2018). Anal sex has been identified as the riskiest type of sex in which one can easily get infected with HIV. Therefore, the fact that many of African American men engage in gay and bisexual relationships increases their chances f contracting HIV.
Lack of awareness of HIV status
In 2010, 24% of African American bisexual and gay men living with HIV did not know about their status (DiNenno et al., 2018). This had not changed so much in the year 2014 when 20% of the African American gay and bisexual men lived with HIV but had not been tested (DiNenno et al., 2018). Further reports indicate that one in six gay and bisexual men living with HIV is not aware of his HIV status (DiNenno et al., 2018). In general, people who live with HIV and are not aware do not take medicine that can help them stay healthy or even to prevent transmitting the virus to their partners (DiNenno et al., 2018). Thus, they easily transmit the virus without their knowledge. This is the case with African American men, and especially the gay and bisexuals. Given the fact that a significant percentage does not know their HIV status puts them at risk of spreading the disease amongst themselves as they do not remember to use condoms so that they cannot infect their partners.
Higher rates of other Sexually Transmitted Diseases (STDs)
In the United States, race and ethnicity are population characteristics linked with other elementary determinants of health status such as high rates of income inequality, poverty, low educational attainment and unemployment (2014 Sexually Transmitted Diseases Surveillance, n.d.). Individuals experiencing financial problems languish in life circumstances that increase their risk of STDs because they do not afford quality sexual health services (2014 Sexually Transmitted Diseases Surveillance, n.d.). African Americans account for the highest poverty rates in America among the minority groups with 27.4% (Albelda, Badgett, Schneebaum & Gates, 2017). High poverty rates, therefore, among African American men deny them access to sexual health services such as condoms for quality and prevented sex which exposes them to STDs such as syphilis, gonorrhea, and Chlamydia which are risk factors for HIV.
Drug and substance abuse
Undoubtedly, drug and substance abuse drags people into risk sexual behaviors. According to Munoz-Laboy, Parker & Wilson (2016), drug use plays a central role in same-sex sexuality among many African American men. Drug transactions, alcohol use, and addiction are motivating factors for allowing and rationalizing unprotected sex with fellow men among African Americans (Munoz-Laboy et al., 2016). Drug and substance abuse was also attributed to access to male sex partners. Therefore, drug and substance abuse is the main factor that drives African Americans into gay and bisexual relationships who finally have unprotected sex and risk the chance of HIV infection.
Mezzo
Support from community-based organizations
Community-based organizations are playing a crucial role in establishing programs to help the African American men access medical attention and sensitize them on the pandemic. In the early days of HIV disease during the 1980s, Ryan White HIV/AIDS Program responded to the needs of Black people living with HIV by offering comprehensive and culturally competent care (Whiteside, White & Jones, 2017). This included primary care, support, and specialty services. Ryan White has come up with capacity-building programs such as the Minority Aids Initiative (MAI) which was established in 1988 aimed at engaging people living with HIV in early care.
Another community-based initiative was the Bruthas Project which sought to reduce HIV risk behaviors among the African American men engaging in same-sex as well as heterosexual (Operario, Smith, Arnold & Kegeles, 2010). The organization established several counseling sessions in which the participants would be involved and the goals included discussing sexual dynamics and risk behaviors, reviewing triggers for unsafe sexual behaviors and engaging African Americans in ways they can reduce unsafe sexual behaviors so that they can reduce HIV infections.
Creation of awareness in schools and colleges
The highest percentage of new HIV infections among the African American men occurred among young men who are within the school age (DiNenno et al., 2018). This makes the schools and colleges important institutions to create awareness among the individuals about HIV epidemic. In a study conducted at the historically black colleges and universities (HBCUs) to examine the knowledge of students and to strengthen them on HIV prevention efforts (Sutton et al., 2011). 82% of the students had average and high knowledge scores which showed that the college was playing a significant role in creating HIV awareness among the students. However, the researchers realized that African American students were still engaging in risk behaviors as 60% of those who reported having more than two sex partners did not always use condoms (Sutton et al., 2011). This was an indication that the colleges needed to put more efforts in sensitizing students about risk behaviors and how to prevent HIV infections.
Currently, schools and colleges are structuring curriculums with behavioral objectives. In particular, sexual education is focusing on abstinence and safe sex among the young people (Pound, Langford & Campbell, 2016). Schools are creating awareness on HIV by educating young people to avoid pressures, seeking help when troubled and negotiate safer choices when they should engage in sex. The aim is to increase perceptions of risk (Pound et al., 2016). An inclusive language is being encouraged so that gays and bisexuals who are at increased risk of HIV infections are not locked out of sexual education. The sexual education programs in schools aim at creating HIV awareness to reduce new infections among the young people.
Creation of awareness in religious institutions; churches, mosques, and temples
Religion is a large part of American life as is manifested in a personal belief system. There have been responses from major denominations to AIDS even though the epidemic has been interpreted in light of beliefs and teachings of each denomination. Nonetheless, those interpretations have led to articulations on AIDS prevention, education, care and shaping people's attitudes within the churches, mosques, temples and in public towards those at higher risk of HIV infection such as gay and bisexual (Abara, Coleman, Fairchild, Gaddist & White, 2015). HIV awareness is facilitated by the religious institutions among the youth during conferences with the aim of reducing risk behaviors among the youth and enhance prevention.
Furthermore, the responses of the religious institutions towards HIV infections have affected their activities which have consequently influenced public education and created more awareness of the disease among the church members and the public. Similarly, positive responses of the religious institutions towards HIV have shaped health policy, care for the sick and attitudes towards infected individuals (Abara et al., 2015).
Macro
Health policies regarding HIV/AIDS in the United States
Good policies set a firm foundation for addressing social problems. In June 2001, the United Nations General Assembly Special Session on HIV/AIDS (UNGASS) adopted a declaration of commitment on HIV/AIDS. United States government was part of the declaration, and hencef...
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