HIV and the African-American Community

Medically Reviewed By William C. Lloyd III, MD, FACS

Overall, the rate of new HIV infections among African-Americans—men and women—is eight times that of whites.

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HIV has had a strong impact on African-Americans, especially among gay and bisexual men ages 13 to 24. This group is infected with HIV at a faster rate than people in any other segment of the population in the United States. Many don’t even know they have HIV because they’ve either never been tested for it or they don’t get tested often enough. This puts them at risk of developing AIDS, since HIV is the virus that causes AIDS.

It’s not just Black men who are disproportionately affected by HIV. The virus affects more Black women in the U.S. than women of other races, too. In fact, Black women are infected with HIV at a rate that is 20 times that of white women and five times that of Hispanic women.

Why HIV is more prevalent in African-Americans

There are several reasons why HIV hits African-Americans so hard. First of all, research shows African-Americans tend to mostly have sex with other African-Americans. And because African-Americans are infected at a higher rate than other people of other races, the virus has a greater chance of spreading with each new sexual encounter. 

In addition, studies show that African-Americans tend to experience higher rates of other sexually transmitted diseases (STDs), such as herpes or gonorrhea. If you get an STD, you’re more likely to get HIV than someone who doesn’t have an STD. This is because the same behaviors that can lead to contracting HIV, such as having unprotected sex, also put you at risk for all types of STDs, and because having sores or broken skin helps the HIV virus pass more easily.

Many African-Americans may also feel reluctant to get tested for HIV. This could be because HIV is associated with stigma, discrimination and rejection. When you don’t know if you are HIV positive, you can unknowingly infect others. This contributes to the spread of the virus.

Finally, poverty may also play a role in the high rate of HIV among African-Americans. According to the CDC, African-Americans experience a high rate of poverty, and the issues associated with poverty—including limited access to HIV prevention education and high-quality health care—may play a major role in increasing the risk of HIV infection.

How to protect your health

These five steps can help you reduce your risk for HIV and protect your sexual partners from the virus.

1. Know your HIV status

Get tested and urge your partners to do the same. It’s the only way to know if you have HIV or not. There are three ways to test for HIV: a mouth swab, a urine sample, or a blood sample. For a testing location near you, visitwww.aids.gov/locator. Type in your ZIP code and you’ll get a list of local testing sites, including those that offer free testing. If you have health insurance, your health plan must cover the cost. Some states offer anonymous testing, which can link your test results to a unique identifier rather than your name. Call the CDC at 1-800-232-4636 to find anonymous testing sites in your area.

2. Get retested

If you test negative, get tested again yearly. Or, if you engage in risky behavior, get tested as often as every three to six months. What constitutes risky behavior? Having unprotected sex with someone whose HIV status you don’t know; having a history of STDs; or sharing needles, syringes, or other equipment for injecting drugs. All pregnant women should also be tested during the first trimester. If you live in areas with a high rate of HIV among women, get tested again in the third trimester. Staying up to date on your status can help you treat the virus as soon as possible and avoid infecting others.

3. Take your medication 

If you test positive, there is medication available to help control the virus and protect your immune system. It can help you live longer, reduce your chances of developing other illnesses, and keep you from spreading the virus to others.

4. Don’t risk it

If you don’t know your partner’s HIV status, use a condom every time you have sex. Limit the number of people you have sex with, too.

5. Talk with your doctor about PrEP and PEP

If you’re HIV-negative but you’re with someone who is HIV-positive—or if you don’t know the HIV status of your sexual partner—talk with your doctor about pre-exposure prophylaxis (PrEP). PrEP is a medicine that helps prevent HIV infection if you’re exposed to the virus. It involves some of the same medicines used to keep the virus under control for people living with HIV.

Similarly, if you’ve been exposed to HIV by having unprotected sex, talk with your doctor. If you receive post-exposure prophylaxis (PEP) medication within three days of possibly being exposed to the virus, it can reduce your chances of getting HIV.

Summary

African-Americans are disproportionately affected by HIV for several reasons, including high rates of poverty among Black Americans and a stigma against homosexuality and HIV. You can take steps to lower your risk for HIV and to prevent the spread of the virus.

Steps include getting tested and retested for HIV, using protection during sex, and talking with your doctor about medicine that helps treat or prevent HIV.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Apr 22
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