KNOWLEDGE IS POWER. Don't guess read, educate, inform the youth in this country!
Who is affected by HIV in the United States of America?
The NAMES Project AIDS quilt
The HIV epidemic has been more serious among some groups than others. In the 1980s, the most commonly identified ‘ vulnerable groups’ in the USA were men who have sex with men, injecting drug users, haemophiliacs and Haitians. However, the inclusion of Haitians in this group caused a lot of controversy. Find out more on our History of HIV in the United States of America page.
A 2010 study found that wealth also determines vulnerability; HIV prevalence was four times higher among heterosexual people in poor urban neighbourhoods than the national average. 5 Within these high-poverty areas HIV prevalence didn't change depending on race or ethnicity. Rather, higher HIV risk was attributed to high HIV prevalence, limited access to health care and other basic services, and high rates of substance abuse and incarceration. 6
It is not solely individual behaviour, but also a person's sexual network which determines an individual's HIV risk in the USA. For example, African American males are much more likely to be infected because of the high HIV prevalence in this community and a tendency to choose racially similar partners.
The table below compares the percentage of new HIV diagnoses among various ethnic groups to the percentage of the population that each ethnic group represents. There were 42,181 new infections in 2011. 7
RACE NUMBER OF NEW HIV DIAGNOSES IN 2011 8 % OF POPULATION 9
Black/African American 47.05% 13.1%
White 28.44% 63%
Hispanic/Latino 20.28% 16.9%
Asian 1.95% 5.1%
Multiple races 1.68% 2.4%
American Indian/Alaska Native 0.45% 1.2%
Native Hawaiian/Other Pacific Islander 0.16% <1%
African Americans accounted for 46 percent of new HIV infections in 2011. 10
As the table above shows, African Americans are disproportionately affected by the HIV epidemic. Both African American men and women are most likely to be infected through unprotected sex with a man, with injecting drug use being the second most likely route of HIV transmission. Factors such as heightened levels of poverty, lack of access to adequate healthcare, and stigma surrounding men who have sex with men characterise the epidemic among African Americans.
A Kaiser Family Foundation survey reported the concern about HIV among the African American community. 40 percent of this community reported feeling 'very concerned' about being infected with HIV, compared to 11 percent among the white community. This figure jumps up to 50 percent among young African Americans - those under 30 years of age. White people are less than half as likely to know a friend or family member living with HIV, or who has died of an AIDS-related illness. 11
Hispanics/Latinos accounted for 22 percent of new HIV infections in 2011. 12
This is relatively proportionate to their share of 17 percent of the USA population, but they are still more than 3 times as likely to be infected with HIV than whites. 13 14
It is estimated that 1 in every 36 Hispanic/Latino men will be diagnosed with HIV in their lifetime compared to 1 in 106 Hispanic/Latino women. 15 Of all male diagnoses in 2011, 79 percent were transmitted via sex between men, 11 percent via unprotected heterosexual sex, and 8 percent via injecting drug use. Among females, 86 percent of HIV infections were the result of unprotected heterosexual sex, and 14 percent injecting drug use. 16
Language barriers, cultural factors, and migration patterns have been identified as barriers to HIV prevention and treatment within the Hispanic/Latino community. 17
Men who have sex with men
Pedro Zamora, an HIV-positive reality TV show star, who died of AIDS-related illnesses in 1994
Men who have sex with men (MSM) accounted for 65 percent of new HIV infections in 2011. 18
MSM are the group most affected by HIV in the USA. The concentrated epidemic among MSM increases the likelihood of HIV exposure for all MSM in the country, partially accounting for the high rate of transmission. Alongside this, only 66 percent of MSM living with HIV in 2011 were aware of their infection. This left 34 percent of MSM remaining unaware of their risk of transmission to others, or that their own health was deteriorating. 19
Higher numbers of sexual partners, greater numbers of sexually transmitted infections (STIs) and having unprotected anal sex are some of the reasons why HIV transmission is more common among MSM. The CDC recommend that MSM test for HIV at least once a year in order to know their HIV status. 20
The availability of antiretroviral treatment may also have lessened the fear surrounding HIV, leading to complacency about using condoms. 21 This complacency is evident in Washington D.C, where a study revealed 40 percent of MSM had not used a condom with their last sexual partner. The study also found that, contrary to popular belief, men older than 30 had more sexual partners and were less likely to use condoms or get tested than their younger counterparts. 22
People who inject drugs
People who inject drugs (PWID) accounted for 8 percent of new HIV infections in 2010. 23
Among those living with HIV in the USA, around 16 percent are people who inject drugs (PWID). The majority of PWID who are living with HIV are African Americans, both for males and females.
Throughout the epidemic, prevention efforts among PWID have been controversial. At the start of the HIV epidemic, needle exchange services – where users exchange their used needles for new clean ones – were not permitted any federal funding, even though in some areas of the USA these programmes have proved to be successful in reducing the rate of HIV transmission. 24 25 The ban on federal funding for needle exchanges was lifted in 2009. However, in a controversial move Congress failed to allocate funding for needle exchanges for the 2012 fiscal year. 26
Young people aged 13-24 accounted for 21 percent of new HIV infections in 2011. 27
This is despite only making up 17 percent of the USA population. Infections among young people follow the same trends as other vulnerable groups. Of all infections among young people in 2010:
72 percent were among young MSM
57 percent were among young African Americans, 20 percent among Hispanics/Latinos, 20 percent among whites
78 percent were among young people aged 20-24 28
It is thought that 60 percent of young people living with HIV are not aware of their infection. 29 This has huge repercussions regarding the onwards transmission to others, via unprotected sex or sharing needles for drug use. Sexually transmitted infections (STIs) are also commonplace amongst this age group, which makes people more vulnerable to HIV infection.
The number of AIDS diagnoses among young people has increased by 29 percent since 2008. 30 A sense of complacency, or an attitude of 'it doesn't affect me' has prevented young people from testing for HIV and subsequently accessing antiretroviral treatment (ART) to prevent the onset of AIDS.
Geographical differences in HIV and AIDS prevalence are due to concentrations of key populations that are typically at risk of HIV infection in certain areas, and variations in healthcare between different states.
The epidemic was once concentrated mainly in the gay populations on the East and West coasts. However, in recent years HIV has also become increasingly prevalent within the African American and Latino communities in many Southern states as well as certain urban areas in the Northeast and West.
The South continues to represent a majority of all HIV and AIDS relation diagnoses, with the Northeast very close behind. However, both areas have seen improvements, or at least stability, in their diagnoses between 2008-2011. This represent