Spotlight on HIV/AIDS Disparities
December 1st is World AIDS Day. According to the Centers for Disease Control and Prevention (CDC), at the end of 2003, an estimated 1,039,000 to 1,185,000 persons in the United States were living with HIV/AIDS. In 2003, 32,048 cases of HIV/AIDS were reported from the 33 areas (32 states and the US Virgin Islands) with long-term, confidential name-based HIV reporting. When all 50 states are considered, CDC estimates that approximately 40,000 persons become infected with HIV each year.
In 2003, men who have sex with men (MSM) represented the largest proportion of HIV/AIDS diagnoses, followed by adults and adolescents infected through heterosexual contact. In 2003, almost three quarters of HIV/AIDS diagnoses were made for male adolescents and adults.
Persons of minority races and ethnicities are disproportionately affected by HIV/AIDS. In 2003, African Americans, who make up approximately 12% of the US population, accounted for half of the HIV/AIDS cases diagnosed. Of the rates of AIDS diagnoses for all racial and ethnic groups, the second highest was the rate for Hispanics. The highest rate was that for African Americans (76.4 cases per 100,000 people), followed by the rates for Hispanics (26.0/100,000), American Indians and Alaska Natives (11.2/100,000), whites (7.0/100,000), and Asians and Pacific Islanders (4.9/100,000).
AIDS disproportionately affects African American children in the United States. Although only 16% of children in the United States are African American, 62% of children reported with AIDS in 2003 are African American. The proportion of children reported with AIDS who are Hispanic (22%) is slightly more than the proportion of US children who are Hispanic (20%). The proportion of cases among White and Asian/Pacific Islander children is lower than the proportion of children of these races/ethnicities in the total population. No American Indian/Alaska Native children were reported with AIDS in 2003.
Further, the rate of AIDS among African American children in 2003 was 1.1 (per 100,000)-a rate 11 times higher than among White children (0.1). These rates reflect the disproportionate racial/ethnic distribution of HIV and AIDS among African American women in the United States.
The Good News
During the mid-to-late 1990s, advances in treatment slowed the progression of HIV infection to AIDS and led to dramatic decreases in AIDS deaths. Although the decrease in AIDS deaths continues (3% decrease from 1999 through 2003), the number of AIDS diagnoses increased an estimated 4% during that period.
Better treatments have also led to an increasing number of persons in the United States who are living with AIDS. From the end of 1999 through the end of 2003, the number of persons in the United States who were living with AIDS increased from 311,205 to 405,926-an increase of 30%.
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Below offers just a sampling of programs currently implemented throughout the Department of Health and Human Services:
The Minority HIV/AIDS Initiative (MAI): MAI provides funds to community-based organizations, faith communities, research institutions, minority-serving colleges and universities, health care organizations, state and local health departments, and correctional institutions to help them address the HIV/AIDS epidemic within the minority populations they serve.
HHS is working through its agencies to provide grants for programs dealing with HIV/AIDS prevention and education, research, faith-based initiatives, prison programs, expansion of treatment capacity, bilingual/bicultural services, and other special projects.
The agencies are:
- Centers for Disease Control and Prevention
- Substance Abuse and Mental Health Services Administration
- National Institutes of Health
- Health Resources and Services Administration
- Office of Minority Health
- Indian Health Service
The Office of Minority Health (OMH) : Through its HIV/AIDS Health Promotion and Education Cooperative Agreement Program, and other grant programs, OMH works to improve the health status, relative to HIV/AIDS, of targeted minority populations by engaging national minority-serving organizations in educational and outreach efforts that are broad in scope to address the HIV/AIDS crisis.
Health Resources and Services Administration (HRSA): HRSA oversees the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act B federal legislation that addresses the unmet health needs of persons living with HIV disease by funding primary health care and support services. Ryan White helps provide services primarily to racial and ethnic minorities through local community health centers. For more information, visit http://hab.hrsa.gov/.
The Centers for Disease Control and Prevention (CDC): CDC's HIV mission is to prevent HIV infection and reduce the incidence of HIV-related illness and death, in collaboration with community, state, national, and international partners. CDC's programs work to improve treatment, care, and support for persons living with HIV and to help build capacity and infrastructure to address the HIV/AIDS pandemic.
The Centers for Disease Control and Prevention's Global AIDS Program Emergency Plan for AIDS Relief: Under the direction of the U.S. Global AIDS Coordinator's Office, Department of Health and Human Services CDC Global AIDS Program (GAP) is a partner in the unified federal government effort to implement Emergency Plan for AIDS Relief. GAP helps resource-constrained countries prevent HIV infection; improve treatment, care, and support for people living with HIV; and build capacity and infrastructure to address the global HIV/AIDS pandemic. For more information, visit http://www.cdc.gov/nchstp/od/gap/WAD.htm.
Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA currently provides funding for substance abuse prevention and treatment services for people with or at risk of HIV through its Targeted Capacity Expansion Initiatives for Substance Abuse Prevention (SAP) and HIV Prevention in Minority Communities: Services Grants Program. The awards are targeted to African American, Hispanic/Latino and other racial and ethnic minority communities that have been highly affected by the twin epidemics of substance abuse and HIV/AIDS.
The Leadership Campaign on AIDS: The Office of HIV/AIDS Policy created The Leadership Campaign on AIDS (OHAP/TLCA) in 1999 as part of the Minority HIV/AIDS Initiative. OHAP/TLCA supports external and internal partners by offering technical assistance for organizational development, resource development, communications and media outreach, website development, graphic design, logistical support, program development, and evaluation support. Pursuing an innovative outreach strategy, OHAP/TLCA works with civic, public health, and faith leaders who have not previously been involved in the fight against HIV/AIDS to educate, motivate, and mobilize leaders in minority communities across America to get involved in the fight against HIV/AIDS. For more information, visit http://www.hhs.gov/ophs/ohap/