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Issues

Women and AIDS

Women living with HIV/AIDS often place the needs of their families ahead of their own, including health care. Ryan White outreach and primary care programs empower these women to live longer, healthier lives and HRSA works to better educate providers to address the unique needs of this population.

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Gay Men

Gay men have been heavily impacted by HIV/AIDS since the beginning of the epidemic. Gay men have helped lead the way towards creating high standards of culturally competent care and integral to the creation and direction of the Ryan White HIV/AIDS Program.

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Cultural Competency

Culturally competent service providers are crucial to recruiting and retaining people living with HIV/AIDS into primary care, particularly when they are members of historically disenfranchised communities and populations such as people of color, gay men, women, and substance users.

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Confidentiality

Ryan White confidentiality guidelines have helped allay the fears that many people living with HIV have around unwanted disclosure and HIV discrimination.

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Treatment Advances

The Ryan White HIV/AIDS Program ensures people living with HIV/AIDS have access to the latest treatments, including life-saving AIDS medications. Advances in vaccine and pharmaceutical research promise new ways to treat, and perhaps halt, HIV infection in the future.

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African-Americans

African-Americans are the racial and ethnic group most disproportionately affected by the HIV/AIDS epidemic. By providing culturally competent, comprehensive care the Ryan White HIV/AIDS Program is committed to turning this tide.

Aging

Wonderful advances in treatment have brought with them the promise of longer life for people living with HIV. The Ryan White HIV/AIDS Program has been there, growing with the people it serves and ensuring that the program’s aging patients have many years of good health and happiness to look forward to, every step of the way.

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HIV/AIDS Stigma

Stigma represents one of the most complex and pervasive barriers to health care for people living with HIV/AIDS. From the beginning, the Ryan White HIV/AIDS Program has fought against the discrimination and isolation that stigma creates, a commitment that helps more people engage and remain in care.

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Rural Challenges

In rural America, unique challenges add to the complexity of providing care for people living with HIV/AIDS. The Ryan White HIV/AIDS Program is, thus, a critical source of support in remote areas, helping patients overcome barriers to care as well as providing technical assistance for providers.

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Addressing HIV Among African-Americans

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If we fail to end AIDS in the Black Community…we fail to end AIDS.

—Phill Wilson, President and CEO of the Black AIDS Institute

The early days of the HIV/AIDS epidemic in the United States imbued the collective consciousness with images of young gay White men in New York and San Francisco dying quick, brutal deaths from a mysterious disease. AIDS appeared to have descended overnight; but as terrifying as it was, media and health officials assured the public that its cause resided in the dangers of gay promiscuity, not pathogens. As James Curran, a medical doctor and spokesperson for the U.S. Centers for Disease Control and Prevention (CDC), explained in a 1981 New York Times article, “The best evidence against contagion is that no cases have been reported to date outside the homosexual community.”

It quickly became apparent, however, that the disease originally called gay-related immunodeficiency (GRID) could impact anyone—and quickly did. Communities of color, and most notably African-Americans,1 were disproportionately impacted from the start. While African-Americans individually may not have believed they were at risk for HIV infection,2 they understood its threat to their communities. While other communities pointed only to gay White men, William Hawkeswood notes in Transforming Anthropology that Harlem residents in New York City understood that the “epidemic thing” had infected “Blacks…who had connection with the white gay scene” and were heterosexual men and women who used injection drugs.3

Phill Wilson, president and CEO of the Black AIDS Institute, is a gay African-American man who has lived with AIDS since 1981. He says that “back in the day, as our friends and loved ones got sick, we knew it was serious. Little did we know that it would be the health catastrophe of our generation.”

The devastating impact of HIV on African-Americans cannot be overstated. In 1981, Blacks accounted for approximately one-quarter of all new HIV infections.4,5 Seven years later, African-Americans surpassed Whites in the number of new HIV infections for the first time—a trend that continues to this day.6 Blacks, who account for about 14 percent of the total U.S. population, represent nearly one-half of the estimated 50,000 new HIV cases that occur every year, and about 500,000 of the almost 1.2 million people living with HIV/AIDS (PLWHA) overall.7,8,9,10,11

The lifetime risk of HIV is far higher among African-Americans than any other ethnic group. Black women have a 1 in 32 chance of acquiring HIV in their lifetime, compared to White women, who have only a 1 in 588 chance of HIV infection.12 Black men are at even greater risk, with a 1 in 16 lifetime chance of acquiring HIV, compared to White men, who bear a 1 in 104 risk.13

 

Bar Graph of Estimated New HIV Infections in the US in 2009 for Most Affected Subpopulations
View as a table
Estimated New HIV Infections in the U.S. in 2009, for Most Affected Subpopulations
Subpopulation Number of New Infections
White MSM 11,400
Black MSM 10,800
Hispanic MSM   6,000
Black Heterosexual Women   5,400
Black Heterosexual Men   2,400
Hispanic Heterosexual Women   1,700
White Heterosexual Women   1,700
Black Male IDUs   1,200
Black Female IDUs      940


Source: CDC. CDC fact sheet: estimates of new HIV infections in the United States, 2006-2009. Available at www.cdc.gov/nchhstp/newsroom/docs/HIV-Infections-2006-2009.pdf. Exit Disclaimer Accessed December 15, 2011.
* The term MSM refers to “men who have sex with men.”
** The term IDU refers to “injection drug user.”

 

Bar Graph of Estimates of New HIV Infections in the US in 2009 by Gender and Ethnicity
View as a table
Estimates of New HIV Infections in the U.S. in 2009, by Gender and Ethnicity (Rate per 1,000)
Gender White Hispanic Black
Male   15.9   39.9 103.9
Female     2.6   11.8   39.7


Source: CDC. CDC fact sheet: Estimates of new HIV infections in the United States, 2006-2009. Available at www.cdc.gov/nchhstp/newsroom/docs/HIV-Infections-2006-2009.pdf. Exit Disclaimer Accessed December 15, 2011.

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