Each year Dec. 1 commemorates World AIDS Day. People worldwide are united on this day to show support for people living with HIV and to remember those who have died from AIDS-related illnesses.
Each World AIDS Day has focused on a specific theme beginning with its founding in 1988. This year’s theme is “Equalize” whereby the United Nations-AIDS is urging nationstates — particularly “first-world” countries—to address the inequalities which are holding back progress in ending AIDS.
The yearly acknowledgement fosters awareness-raising activities around the world. Many people will wear a red ribbon, the universal symbol of awareness of, support for and solidarity with people living with HIV. These individuals will take this day to make their collective voices even louder on important issues in their lives.
Additionally, groups of people living with HIV around the world take the opportunity to join like-minded organizations to encourage AIDS response mobilizations in support of the communities they serve and to raise needed funds.
The AIDS epidemic for the past 40 years has taken an extraordinary toll on African-Americans who represent 13% of the U.S. population. Three years ago, the Black community comprised 42% of the 36,801 new HIV diagnoses in the United States and dependent areas.
Broken down by category, the Centers for Disease Control and Prevention (CDC) has reported that 79% of African-Americans infections since 2019 involved male-to-male sexual contact, 14% heterosexual contact, 4% injection drug use and 3% male-to-male sexual contact combined with intravenous drug use.
For Black women, 91% of the new HIV infections were attributed to heterosexual contact. The HIV infection rate among Black women is the highest compared to women of all other races and ethnicities.
Statistics compiled by the U.S. Department of Health and Human Services Office of Minority Health revealed that, presently, African-Americans are 8.1 times more likely to be diagnosed with HIV infections, as compared to the nation’s White population. Black males have 8.4 times the AIDS rate as compared to White males. Black females have 15 times the AIDS rate compared to White females.
African-American men are 6.4 times as likely to die from HIV/AIDS infection as non-Hispanic White men, and African-American women are 14.5 times more likely to die from the infection as White women. The CDC also reports that approximately 13% of African-Americans with HIV do not know their status, and few are receiving adequate HIV care and treatment that will help them get and keep viral suppression and live longer, healthier lives.
The COVID-19 pandemic has led to disruption in HIV testing and access to clinical services. Although the full impact of the pandemic on HIV in the U.S. will not be known for some time, recent CDC data have shown concerning setbacks to HIV prevention, including sharp declines in HIV testing and diagnosis. There has also been a significant slowing of pre-exposure prophylaxis (PrEP) prescriptions which medical experts say are vital to halting illness which, left unchecked, will develop into full-blown AIDS.
Despite the advances in scientific understanding of HIV and its prevention and treatment as well as years of significant study by the global health community and leading government and civil society organizations, far too many people with HIV, or at risk of HIV, still do not have access to prevention, care and treatment. There is still no cure for HIV/AIDS.
“We have made great progress in the fight against HIV/AIDS in the United States, but we still have important work to do that affects the lives of many Americans,” said Dr. Richard Wolitski, director of the Office of HIV/AIDs and Infectious Disease Policy at the U.S. Department of Health and Human services.
Wolitski said the estimated 470,000 African-Americans living infected with HIV include more than 70,000 persons who are unaware of their infection and, therefore, are at a higher risk of illness and transmitting the virus.
“When we look at the results in key reports and at the indicators we use to monitor our national progress, we generally see improvement across all racial and ethnic groups,” he said.
African-Americans are the notable exception. Data from the CDC which shows overall improvement can often mask the fact that the gains are not consistent across groups.Wolitski said some of the disparities have “become worse” as some groups more than others realize greater benefits from advances in prevention and treatment.
“We can’t reach our national goals without further improving HIV-related results for African-Americans,” he said. “Success in this population, like success in other populations, benefits everyone.”
A CDC analysis in 2019 found that Black gay and bixsexual men were less likely to receive an HIV disgnosis, use PrEP (a proven HIV medicine) to prevent HIV, and be virally suppressed compared to White gay and bisexual men. A more recent CDC study found that Black transgender women accounted for 62% of HIV infections among transgender women with HIV living in the seven largest U.S. cities.
Globally in 2021, approximately 85% of people with HIV knew their status. The remaining 15%, based on the latest data from UNAIDS, did not know they had HIV and still need access to HIV testing services. HIV testing is an essential gateway to HIV prevention, treatment, care and support services.
At the end of last year, an estimated 28.7 million people with HIV (roughly 75%) were accessing antiretroviral therapy globally. That means that 9.7 million people are still waiting, the vast majority living in third-world nations.
The vast majority of people with HIV reside in low- and middle-income countries. UNAIDS data revealed that in 2021, there were 20.6 million people with HIV (53% in Eastern and Southern Africa, 5 million (13%) in Western and Central Africa, 6 million (15%) in Asia and the Pacific, and 2.3 million (5%) in Western and Central Europe and North America.
There have been numerous success stories and promising signs on the HIV/AIDS front. New global efforts have been mounted to address the epidemic, particularly over the past decade. UNAIDS has reported that the number of people who have newly acquired HIV has declined over the past 10 years. In addition, the number of people with HIV receiving treatment in resource-poor countries has dramatically increased in the past decade and dramatic progress has been made in preventing perinatal transmission of HIV and keeping pregnant women alive.
The United States has made significant strides in HIV treatment, care, and prevention. HIV was once the leading cause of death for young LGBTQ people, but because of scientific advances fewer people as a whole are becoming infected with HIV and those who do are living longer and healthier lives.
The CDC has additionally reported that HIV infections have declined by 73% between 1984 and 2019, and the age-adjusted death rate has dropped by more than 80% since its peak in 1995.
“We know that too few African-Americans living with HIV are receiving HIV care and achieving and maintaining a suppressed viral load,” Wolitski said. “Improving the rate of viral suppression among African-Americans living with HIV is important to not only preserve their health, but also to reduce onward transmission of the virus to others.”
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