African American communities are often not strangers to known disparities and suffering is often at the forefront in most cases. Black communities have suffered such scenes as the bombing of black wall street, the Harlem riots and even the vents of hurricane Katrina which devasted the lives of many. However, there is one prowler that has made its way into the loves and homes of many African American families causing emotional, financial and socioeconomic destruction. Truly society may have its bouts with drug addiction and black communities have experienced the war on drugs by president Nixon in 1971 which spanned from a 1968 campaign aimed at black communities (Huebl, 2018). It is not simply an easily identifiable enemy that ravages the homes of African Americans as research will soon indicate.
Background and History 背景和历史
Making its way onto the front pages of the center for disease controls weekly report addressing mortality and morbidity came springing forth in 1981 what would soon become the HIV/AIDS epidemic. However 1981 is not necessarily where HIV began or has its origin however; according to research scientist believed that humans who fed on the meat of chimpanzees likely contracted the illness as early as pre 1940s Congo (theaidsinstitute.org, 2019). At first HIV was not referred to as the human-immunodeficient virus but was first known as the simian immunodeficient virus or better worded as SIV, however HIV quickly spread among those within the U.S. in the late 70’s to early 80’s (theaidsinstitute.org, 2019). The beginnings of HIV within the U.S. saw most of its cases spread among those who had sexual activity man to man and doctors who saw patients come into their visits complaining of cancer, pneumonia and other illnesses uncommon at that time (theaidsinstitute.org, 2019). By the time scientists and researchers correctly identified what HIV was, over 80 cases were identified among those in the black community by 1982 (cdc.gov, 2019). As research would further demonstrate once HIV/AIDS began to ravish the black community it did not see any signs of slowing down and in fact impact the births of many infants where pediatric cases of AIDS showed fluently in over 50 percent of African American babies born (cdc.gov, 2019).
Impact on African Americans 对非裔美国人的影响
In recent studies HIV/AIDS has continued to lay waste to many black communities and specific groups within those communities are most susceptible. Blacks are known to be three times more likely to contract HIV/AIDS than their white counterparts and in black communities where the disease is rampant in men who are of homosexual nature and are at highest risk for infection (Davidson, 2011). National estimates in 2005 had African Americans equating as much as half of new HIV cases with a 10 times more likelihood of infection compared to Caucasians (Davidson, 2011). The numbers become even more astonishing as focus pans in on the African American female who have 23 times the likelihood of contracting HIV/AIDS (Davidson, 2011). With such epidemiological understanding of the healthy status of the black community HIV/AIDS is far from an endemic and has moved on to be a pandemic ravishing not just one community but many. Numbers among the black homosexual community show that over 66 percent of HIV positive patients do not know they are infected and account for over 46 percent of those who test positive for the infection (Davidson, 2011).
Many African Americans who suffer from the onslaught of HIV/AIDS may not entirely have the means necessary to seek treatment and many may lack education or equivalent health literacy to know what means are necessary to ensuring a reduction in infection rates. The is a debilitating burden within the minority black communities of disease infection due to HIV/AIDS and many may not even be tested due to potential barriers they may suffer. Studies shown that between 2010-14 nearly 50 African Americans were infected with HIV per 100,000 persons and were fourth five percent of the total infections for those years (cdc.gov, HIV/AIDS, 2019). The impact on black communities continued as many heterosexual infections increased as over 65 percent and black women consisting of over 61 percent of those infections (cdc.gov, HIV/AIDS, 2019). There can be no understatement to the onslaught of HIV within the black community as reports further indicated that within those years near 64 percent of children 13 years of age and younger were found to be infected with HIV (cdc.gov, HIV/AIDS, 2019). African who have garnered much distrust for prevention efforts may do so due to the 1932 Tuskegee incident as black males were studied without their knowledge as to the effect of prolonged exposure to syphilis (Thomas, 1991).
Determinants of Disparity 差异的决定因素
Many factors affect the black community when it comes to seeking treatment and testing for HIV/AIDS. Many abstain from seeking testing which adds to the burden of the disease. Socioeconomic status may substantially affect how African American perceive being tested for HIV/AIDS and may be a self-imposed barrier to healthcare access. Incidence reports indicate that socioeconomic status coupled with a lack of education adds to the already quantifiable degree of HIV/AIDS infection within the black community (Tramonte, 2015). Poverty among those in the black community is one determinant that adds to the growing cases of poor health, lack of healthcare access, potential drug use which steadily increases risk of infection within their community (Tramonte, 2015). Black communities suffer from insufficient education in HIV/AIDS prevention intervention and many stigmas that cause some to avoid seeking treatment (Tramonte, 2015). A side note is that nearly 25 percent of those in black communities suffer some form of poverty coupled with joblessness, a feeling of displacement and homelessness adds to the list of determinants (hrsa.gov, 2019).
The Impact Hits Home 影响家庭
The impact of HIV/AIDS on the black community has been so severe that many experience losses at an astonishing rate. In 2013 alone on average over 46 percent of deaths associated with HIV/ADIS infection were attributed to African Americans (cdc.gov, HIV/AIDS, 2019). Black teens have also been greatly impacted by HIV/AIDS infection within the black community. This is unfortunate as many teens 13 to 18 years of age account for over 67 percent of new HIV infections among blacks (Charles, 2011). The impact has steadily increased over the years and as of 2018 nearly 470,000 African Americans are reportedly HIV positive or living with AIDS in the U.S. (Richard Wolitski, 2018). There are an estimated 74,000 African Americans who go undiagnosed not knowing they are HIV positive and African Americans are said to comprise the 43 percent of Americans who live daily with HIV/AIDS (Richard Wolitski, 2018). There are alarmingly high numbers of HIV/AIDS increases among African American gay men which has accounted for as much as 58 percent of cases diagnosed positive for HIV within the black community (Richard Wolitski, 2018). African American women are most severely affected as data demonstrated that nearly 4600 new cases of HIV were those among black women (Richard Wolitski, 2018). With so many occurrences of infection among those of a single demographic there may yet be some correlation or reason why infection rates are high among blacks compared to other ethnicities.
An Intersecting Point 交点
With an ethnic group at higher than average risk for infection of HIV/AIDS the African American community may be question the reason why they may appear as targets in this pandemic? To this end there must come some intersecting point where a correlation of behaviors may be examined as to why the disease rates are much higher. Some potentials to consider may be high poverty rate in low income black communities. Blacks are often plagued with joblessness, imprisonment, homelessness and poor education (Tramonte, 2015). With such factors the next to examine is whether a specific demographic within the black community are more susceptible to HIV/AIDS infection. Research has indicated that men who are sexually active with other men who are of the same ethnicity (African American) are over 22 times more likely to be infected with HIV (Davidson, 2011). Not only are men more likely to be infected they may have bisexual tendencies (are sexually active with both men and women) and thus spread the disease to black women who are the second highest infected in the black community (Charles, 2011). The third highest impacted group are black teens between the ages of 13 and 18 who comprise roughly 67 percent of new HIV infections (Charles, 2011).
The intersecting cause equates many times to poor health literacy within the African American community, a distrust of testing facilities, poor inclusion in studies and a lack of education on preventive measures. Those economic and social causations add to the alarming growth of infection rates within black communities and appear as though they will continue to do so less some measures are implemented to reduce infection rates. Intersecting causalities of the spread of HIV/AIDS within the black community can be attributed to the practice of having multiple sex partners, infection by other sexually transmitted diseases, low-income status, mass incarceration and drug use (intravenous) (Davidson, 2011). The coincidental infection rates of heterosexual partners due to economic struggles are intersecting reasons associated with the disease. Many black women are infected due to using their body to perform sexual favors in exchange for food or clothing which places them at increased risk for infection. The increased rates at which African Americans are infected with STDs aside from HIV/AIDS makes it more likely that they will be diagnosed with HIV/AIDS at some point in their life (Davidson, 2011). With such alarming factors associated with risk in the black community there is a great need for intervention to turn the tide for the better.
Intervention of the Heart 爱心介入
The African American community is in much disarray and requires emotional and mental rehabilitation to reestablish the fundamentals that makes a community work. In this format what make a black community work is to have the figure heads in place as role models that will guide the young and inspire change within their corridors. What most African American communities lack is a father and mother figure both under the same roof and often this is due to mass incarceration of black males. Some research has indicated the fact that nearly 3 of 4 African American children will grow without their father or become the product of a unmarried home (Hernandez, 2016). Within the United States black males are 32 percent more likely to be incarcerated and thus translates to an increased risk of infection among those within the black community (Wendy Sawyer, 2017).
The intervention initiative must focus on helping black males become anchored in their communities by seeking higher rates of employment and education. The inte4rvention must also instill the need for the black father to be a role model to his children and by doing so help to guide the decision his young children may make. By reducing incarceration rates of black males, it in turn reduces the potential exposure to HIV and eliminates exposure to risky sex acts in prison. When the heart of the family is in its rightful place the community can then begin to heal and the health disparity of HIV/AIDS may see a reduction. Its simply a matter of the heart of the individuals and the heart of the community in which people grow that will place upon them the greatest level of social and environmental influence thus shaping their ability to make sound decisions. Then by encouraging an increase in college applicants and graduates within the black community they may establish organizational support or structure. If the community begins to thrive then access to healthcare also increases which means treatment of illness and a reduction in health disparity and preventive measures. By unifying the community under the premise of brighter futures and implementing policies to govern adherence to laws black communities affected by HIV can overcome the disparities they face and thrive again.
The Larger Picture of African American Health 非裔美国人健康的蓝图
With the continual spread of HIV/AIDS within African American communities combined with the high death rates associated with illness, these communities are crumbling from within. Studies indicate that in 2016 nearly 7000 deaths of African Americans results from a stage 3 AIDS diagnosis coupled with the fact that nearly 1 in every 7 African Americans are said to be unawares they are HIV positive (cdc.gov, HIV and African Americans, 2019). With such mortality rates communities can be expected to see major disruptions in household structure. This also may lead to more children entering the foster care system or having to fend for themselves in an already harsh environment. African American communities are experiencing higher rates of HIV infection when compared with other ethnicities and struggles with treatment due to poor access to healthcare (hiv.gov, 2019). HIV/AIDS has such an impact on African American lives that they are more likely to die from HIV/AIDS that any other racial demographic (Fullilov, 2019).
With the advent of antiretroviral medication black communities have seen a slight decline in deaths associated with HIV/AIDS of 7 percent (Fullilov, 2019). However, that decline does not shun the fact that African Americans are often overly represented in surveillance data for HIV infection rates. Not only are they overly represented but such representation also leads to an increased in stigmatization of the African American (Fullilov, 2019). African Americans will continue to undergo marginalization where those who live in poverty, experience high amounts of incarceration along with drug abuse add to the increase of HIV/AIDS infections within the black community (Fullilov, 2019). By addressing the environmental and social factors within black communities and providing greater opportunities for education, there is hope that the future of the African American man and woman may be one that is bright and full of life.
The Ability to Work Among the Masses 在群众中工作的能力
Being a man of African American decent it is highly likely that I would have the ability to work within the community and promote some form of change. The issue would be whether the people within those communities highest affected would want the intervention of change to disrupt what they may consider as norms. To some living in a community that acts or does as it may please might promote some sense of freedom. It is however this freedom that may lead to many black males and females being incarcerated. With such incarceration comes children who live without the positive influence of both parents and therefore fall victim to the ideals of a broken society. I am nether troubled by someone’s gender or sexual identity nor am I bothered by their socioeconomic status. As a person who was raised in poverty, I know what it is like to grow up a low-income community, however I also recognize what it means to be tightly knitted together in such communities. It is this knowledge that would drive me to greatly impact the health of all who dwell behind its walls and walk its corridors.