April 24, 2007
Health Disparities in HIV/AIDS Diagnosis
From the current issues of JAMA:
During 2001-2005, HIV/AIDS diagnoses, diagnosis rates, and RRs were higher among black males and females than among any other racial/ethnic population in the United States. In 2005, the annual rates of HIV/AIDS diagnosis among black men and women were seven and 21 times higher than rates among white men and women, respectively. For black men, sexual contact with men was the primary mode of HIV infection; for black women, high-risk heterosexual contact was the primary mode. In a recent study of MSM in five cities, 46% of blacks were infected with HIV, compared with 21% of whites and 17% of Hispanics. In 2004, HIV/AIDS was the fourth-leading cause of death among blacks aged 25-44 years in the United States.
During 2001-2004, HIV diagnosis rates among black males and females declined by 4.4% and 6.8%, respectively. A 2007 study reported similar declines among blacks in Florida. These declines were observed among black heterosexuals and injection-drug users but not among MSM. Although these declines in rates of new HIV diagnoses are encouraging, they might not directly reflect trends in HIV incidence because they are also affected by changes in testing behavior and surveillance practices. Regardless of the trends, blacks remain disproportionately affected by high rates of HIV/AIDS. Several factors might contribute to these higher rates (e.g., higher overall prevalence of infection and undiagnosed infection among MSM or greater likelihood among females of high-risk heterosexual contact).