By Jaime Cunningham
In December, NEWSWEEK argued that new signs of life were showing in the AIDS activism movement. Let's hope so. Recent research published in The New England Journal of Medicine shows that within certain populations in America, the prevalence of HIV-infected people is higher than in certain parts of Africa:
More than 1 in 30 adults in Washington, D.C., are HIV-infected—a prevalence higher than that reported in Ethiopia, Nigeria, or Rwanda. Certain U.S. subpopulations are particularly hard hit. In New York City, 1 in 40 blacks, 1 in 10 men who have sex with men, and 1 in 8 injection-drug users are HIV-infected, as are 1 in 16 black men in Washington, D.C. In several U.S. urban areas, the HIV prevalence among men who have sex with men is as high as 30%—as compared with a general-population prevalence of 7.8% in Kenya and 16.9% in South Africa.
What’s interesting is that the research shows that a person’s sexual network, more than just his or her lifestyle choices, defines the risk of getting HIV in America. So, black and Hispanic women are at increased risk due to the instability of their sexual relationships —which is attributed to the high rate of incarceration of men in their networks—and their vulnerable or dependent economic situation, which may cause them to be fearful of suggesting safer-sex options to their companions. And black men who have sex with men are at high risk because of the likelihood of their choosing to engage in sexual activity with someone who is racially similar, and because of the prevalence of HIV within their sexual networks.
America’s epidemic most strongly affects the urban regions of the Northeast and West Coast, and small towns and cities in the South. Part of this is because these local populations have unprotected sex within “relatively insular social-sexual networks.” Lower-income black Americans with poor education and unstable housing are disproportionally affected, and black or Hispanic women make up more than 25 percent of new HIV infections in the U.S.
More than 20 percent of the estimated 1 million HIV-positive Americans are unaware of their status. Additional behavioral studies, better communication, and preventive education need to be directed toward the identified at-risk communities. It’s time to admit that HIV is still a major threat to Americans.