US blacks struggle with HIV

REUTERS

Aids patient, Woodrow Woody Barron, 69, of Plainfield, New Jersey, with his certified nursing assistant, Halema, at the Broadway House for Continuing Care, New Jerseys only specialised nursing facility for people living with HIV/Aids. Barron, who has lived with Aids since 1986 and has been living at the facility since 1997, contracted the virus through sharing a needle with a fellow drug user.

As a gay black man growing up in Chicago’s notorious Cabrini Green public housing project, Arick Buckles knows first-hand how the stigma of HIV can keep people infected with the virus from seeking treatment.

It took him six years after he tested positive for HIV to get care.

He finally sought care after suffering pneumocystis pneumonia, a lung infection that strikes HIV patients.

The predominantly black housing project where Buckles grew up was such a hub of crime and poverty that the city tore it down several years ago.

“If I were to disclose my status, I felt my homosexuality would be revealed,” said Buckles, 40, who was so fearful of that prospect that he kept his HIV status, and his sexual orientation, in the closet.

Buckles’ tale is still too common, despite widespread US efforts to foster awareness of the virus that causes Aids and its treatment over the past three decades, says Dr Kevin Fenton, director of the National Center for HIV/Aids Prevention at the US Centers for Disease Control and Prevention (CDC).

Pierre Lynch, 24, poses for a portrait during a break in a working group session for peer educators and peers in the group, Sexy with A Goal, at the Aids Service Center of New York City.

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“Stigma is a huge issue,” Fenton said. It can keep people from getting tested, and for those who know they are HIV positive, it can keep them from getting treatment.

He said stigma affected a broad spectrum of communities in different forms, but for many blacks in America, it existed on top of poverty, poor access to treatment and poor outreach for prevention services.

HIV transmission rates have fallen from 130 000 new infections a year during the epidemic’s peak in the mid-1980s to 50 000 a year, a level little changed since the mid-1990s.

Of the estimated 1.1 million Americans living with HIV, nearly one in five of those individuals remain undiagnosed.

Up to 44 percent of new infections is clustered in 12 major cities. Within these communities, HIV rates are highest among blacks, Hispanics and gay and bisexual men of all races.

CDC researchers will present the latest US data this week at the International Aids Society’s Aids 2012 conference in Washington.

Peer educator Pierre Lynch, right, 24, and empowerment trainer, Franklin Burns, 29, members of the group, Sexy with A Goal, at the Aids Service Center of New York City.

REUTERS

According to a report released last week by the Black Aids Institute, black gay and bisexual men make up one in 500 Americans overall, but account for one in four new HIV infections in the US.

It found that by the time a black gay man reaches 25, he has a one in four chance of being infected with HIV. By age 40, he has a 60 percent chance.

Fenton said there was nothing unique about blacks that make them more vulnerable to HIV infection.

“What we believe is that the infection is becoming concentrated in these minority groups as a reflection of the social and structural drivers of health inequalities overall,” he said.

A CDC study published on Friday in the Lancet medical journal found that black men who have sex with men in the US are 72 times more likely than the general population to be HIV-positive.

Lack of access is just part of the story in the African American communities Buckles now serves as an outreach worker at Chicago House, a social service agency that provides housing and support services to HIV-affected and at-risk families.

In Washington, a city with one of the highest infection rates in the country, CDC has been working with local health officials to increase testing.

Since its start in 2006, HIV testing in Washington is up 400 percent, rising from fewer than 30 000 tests in 2006 to 122 000 in 2011.

At United Medical Center in the predominantly black part of the nation’s capital, nurses saw they needed to reach a wide range of people who ordinarily may not get tested. They began offering free HIV testing.

Patients get immediate results and those who test positive are offered care.

Dr Lisa Fitzpatrick, who sees patients at the centre, said more doctors needed to make testing routine.

“There’s no reason why I should test someone for diabetes and high cholesterol and not HIV,” she said.

Fitzpatrick, who is black, said many of her patients had full-blown Aids because they had avoided or delayed treatment. She sees religious influences making many people in the black community wary of discussing HIV and sex. They consider it a gay-only issue.

In New York, a group of mostly black, gay and HIV-positive men is trying to break the silence by handing out condoms and trying to educate other young gay men at risk.

Sexy With A Goal, or Swag, is an affiliate of the Aids Service Center of New York City. The group hopes its efforts will help young men understand “safer sex is sexy”.

The CDC recently launched a campaign aimed at overcoming the stigma called “Let’s Stop HIV Together”. The Food and Drug Administration this month approved the first at-home HIV test that experts say may help reach people who don’t want to be seen at a clinic.

In June, the CDC launched a two-year pilot programme to offer HIV testing in community pharmacies and retail clinics in 12 urban areas and 12 rural areas with high rates of HIV.

One new study funded by the National Institutes of Health offers gift cards to patients who follow-up a positive HIV test result with treatment.

Dr Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases at the institute, said researchers did not know enough about how to reach those most at risk.

“They’re still, relatively speaking, a disenfranchised population. Many of them are in inner cities; many of them don’t have access to healthcare,” he said.

Dr David Malebranche, of Emory University School of Medicine, treats HIV/Aids patients from a predominately black neighbourhood in Atlanta. Researchers were just starting to understand that ending America’s HIV crisis would mean addressing the same lack of health-care access that puts blacks at higher risk for heart disease and diabetes, he said.

“We’re realising it’s not just unprotected sex. When you compare people of different genders, ages, races and sexual orientation, rates of unprotected sex are pretty comparable. So it’s got to be something more.” – Reuters