Hiv/Aids Among Young African Americans
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There is health crisis among young African Americans, and prudishness, politics, and lack of focused resources is damaging our ability to respond. The salient facts are these: one in four new HIV infections in the United States occur in people under the age of 22.
AIDS is already the sixth leading cause of death among 15 to 24 year olds in the United States (Centers for Disease Control and Prevention, 1996) and the leading cause of death among 25 to 44 year olds. In the 12 month period preceding July, 1996, two thousand, six hundred and sixty-seven people aged 13 to 24 were diagnosed with AIDS.
A recent study from the Centers for Disease Control warns that, ÐŽ§while the rate of new AIDS cases reported among people born before 1960 appears to be reaching a plateau, the rate among younger Americans continues to escalateÐŽÐ(Centers for Disease Control and Prevention, 1995). And AIDS threatens to become endemic among particularly vulnerable young African Americans. Young people of color, gay, youth, and young women who have sex with HIV positive men are at the center of this expanding epidemic. The National Academy of Sciences has reported that the United States has the highest rate of sexually transmitted diseases of any developed country and that, ÐŽ§an effective national system for STD prevention currently does not existÐŽÐ (Institute of Medicine, 1996).
There are obvious reasons why government has fallen short in its responsibility to fight the epidemic in the African American community: funding is limited and political salvos from right and left stifle development of innovative programs.
Community-based organizations have made valiant efforts to reach young African Americans with effective prevention messages, but they, too, have been hampered by inadequate funding and other constraints. Much expertise needed to reach young people with powerful and effective messages is vested in the private sector, but we have failed to form large scales, sustained, public-private alliances to fight HIV. There are numerous examples of innovative and effective HIV prevention programs for young people at the local level. But the sum is less than the parts-as a nation, we are failing to reach too many young African Americans at high risk for HIV (Center for Disease Control and Prevention, 1995).
Social vulnerability, the need to gain love and respect through sex, and power differentials within relationships are particularly important risk factors in the subgroups of young African Americans most affected by the epidemic, young gay men, and sexually active women. These vulnerability factors should more closely inform HIV prevention efforts. A lot of the young African Americans have personal needs and desires that can make them particularly vulnerable, but some factors are more relevant for those at high risk for HIV. To a large extent, these risk factors are a product of the marginalization of these groups in the larger society (Rosenberg, 1994).
Socially based vulnerability, including homophobia, sexism, poverty, and homelessness are all factors in young African Americans contracting HIV, The need to find acceptance, respect and love through sex, the discovery phase of sex, gay and straight, power dynamics with older partners, coercion and force and difficulty in communicating needs as well as sex work play an important role in teens contracting the virus also. All stated are contributing factors that need immediate attention to prevent the spread of HIV/AIDS among our young African Americans (Sugerman, 1991).
The statistics suggest the urgent need to implement HIV prevention interventions targeting young women in order to prevent future infections and increase risk reduction behaviors. However, the paucity of culturally relevant HIV prevention interventions targeting African Americans is evident. The CDC recognizes two interventions as effective that target this population in its Compendium of Effective Interventions.
Other interventions in the Compendium may include a sample of African American women; however, these programs are not culturally relevant or targeted toward this population (Prather et al, 2006). Prevention efforts focused almost exclusively on white gay men and injection drug use. Researchers, however, should ensure interventions are culturally competent, thereby meeting the needs of the intended populations, and improving their overall quality of life. Researchers should take a more afrocentric approach in intervention delivery and focus on a belief or custom grounded in the cultural heritage of people of African descent, or at least reflect on their life experiences, history and traditions and lack of medical attention.
In an era when antiretroviral therapy can help HIV-infected individuals lead healthier lives, African Americans with HIV/AIDS are more likely than other racial groups to postpone medical care and become hospitalized, with the result that they are more likely to die from HIV related causes. In fact, more than half of all people who died from AIDS related causes in the U.S. in 2002 were African American (Kaiser Family Foundation, 2006).
Prevention with persons who are at very high risk for HIV infection such as young African Americans must be continuously educated and supported at different phases of their lives. Since the beginning of the epidemic, new at risk groups have emerged in addition to those that have been traditionally at high risk (CDC, 2003).
There are many opinions as to what are the most effective approaches to mitigating the problem of spreading the HIV/AIDS virus among the population in general and the African American community in particular. There is a sector who believes that the least troublesome and least expensive way is to promote abstinence; just saying no to sexual activity and drug use. They believe that a prohibition on these modes of behavior is the only means that can be undertaken to insure that individuals will not put themselves at risk of contracting the HIV/AIDS virus that is what they are taught in school, abstinence is the safest sex you can have.
The premise is that by doing away with the most obvious occasion that allow the contracting of this deadly disease, and others, there is less probably that there will be cause for concern as to its acquisition or spread. Some abstinence advocates have stirred up a controversy with their views on some of the programs proposed, but they have not provided an affective means to end transmission of HIV/AIDS among our young adults.
What is needed? Given the social and economic characteristics of poor African American communities, a more systematic approach must be taken to help build stable communities. Public policies that address the root causes of the health disparities that devastate the African American community are urgently needed. These policies must