Community Health Problem
Different ethnic groups have different health problems. These vary due to the following: Genetics, Environmental factors, Access to care, Cultural factors. Black Americans are people who originated from any of the black racial groups of Africa, they make up to 28% of Georgia`s population. They constitute approximately 12% of America`s population. They are concentrated in certain cities like Mississippi, Alabama, Georgia, South Carolina and Maryland. Some of these African Americans families have been in the U.S for so many generations while others are fresh migrants from places such as Africa, the Caribbean, and West Indies.
This paper will focus on HIV/AIDS among the African Americans.
HIV infection is the fifth leading cause of death in the United States; it mostly kills people who are between the ages of 25-44 years. It is the leading cause of death for African Americans men between the ages of 35-44 years. There are approximately 850,000 to 950,000 U.S residents living with HIV infection and a quarter of these people are not aware of their infected status. Every new year, there are approximately 40,000 new HIV infections in the United States and 5million new cases worldwide.
Racial and Ethnic groups have been greatly affected by the HIV/AIDs epidemic in the U.S. Although only a quarter of the United States has been represented by the African Americans and Hispanic persons, more than half of the new AIDS cases reported are among these populations. Their children are the most affected with a representation of more than 80% of the pediatric AIDS cases in the year 2000. At least 78% of the HIV infected women become infected mostly through heterosexual transmissions. HIV- infections acquired through drug injections has been a major factor among the young communities, with 50% of these cases being African American. In 1996, approximately 6,750 African Americans in the U.S were diagnosed with AIDS. Out of this 53% were infected heterosexually and 43% were infected through injection drug use (IDU).The cases of AIDS among the African American women has greatly increased over the last decade; majority being infected heterosexually. The increase rate has been between 15-30% since 1996.
The common ways of acquiring HIV infection is through unprotected sexual intercourse with an infected partner. This is the main mode of infection. What mainly happens is that HIV- infected semen and vaginal secretions infect mucous membranes during unprotected vaginal and anal sex; the risk of contracting the virus is greater when one has sores on the areas. The main culprits here are the careless prostitutes and sex workers. One can protect him/herself by using a condom during intercourse. Another mode of transmission is by sharing of sharp objects for example, needles. According to CDC, HIV can be transmitted through the sharing of contaminated needles and syringes. By “contaminated”, I mean those needles that carry the HIV virus. Drug users who inject drugs into their bodies are most vulnerable to acquiring the virus through this method another group of people who could contract the virus through this mode is those who put on tattoos and body piercings.
There is also the mother to child transmission where the pregnant mother passes the infection to the unborn child through the placenta. To prevent this mothers are advice to get tested for HIV when they get pregnant in order to start medication that can prevent their unborn baby from contracting the disease. They could deliver through the caesarean section so as to reduce the risk of transmission during birth. Mothers can also infect their children through breast feeding since the HIV virus is also found in breast milk; HIV positive mothers are therefore advised to bottle feed their children in order to avoid passing the virus to their children.
Another method of transmission is through blood transfusions. This is no longer a common way of transmission in the United States since blood donated is screened for the HIV virus and other infections before it is transfused. Another method of transmission is through unprotected oral sex where a person performing oral sex on an infected person is at risk of being infected especially if he/she has sores or cuts in the mouth. People are advised to protect themselves by using plastic food wraps, dental dams and condoms during oral sex.
HIV is a virus that damages human immune cells thus weakening the body’s immune system and if untreated can lead to most infected people to develop AIDS. This virus is found in blood and other body fluids such as semen. Other rare transmission methods according to CDC include accidental needle injury, transplant with infected organs and artificial insemination with infected semen. These modes are very rare in the U.S. Heterosexuals are at a greater risk of acquiring the infection and this affected so many African Americans and has claimed a lot of lives.
Some factors that have contributed to the poor health among African American women are their lack of trust of health care system, lack of awareness, cultural differences, religious beliefs, language barriers, inadequate screening and treatment and racial and gender bias. African Americans are the community that’s greatly infected by the HIV virus in the United States. By the end of 2007, they accounted for 46% of people living with HIV infection in 37 states. In 2006, the African Americans accounted for 45% of new HIV infections in the 59 states. Compared to the members of other races and ethnic groups, the blacks account for a very high proportion of HIV cases at all its stages, that is; from its new infections to its death.
According to the statistics, the black men accounted for 65% of new infections among all blacks in the year 2006, this was approximately 6times as high as that of white men, nearly 3times that of Latino men and twice that of black women. Again in the year 2006, the rate of new HIV infection for black women was almost 15times as high as that of white women and nearly 4times that of Latina women. Although the number of new infections have stabilized among the blacks from 2005-2008, the estimated HIV diagnosis has increased approximately by 12%.
The reason for this could be due to increased testing or diagnosis or uncertainty in the statistical models. From the year 2005-2008, the rate of HIV diagnoses among the blacks has increased from 68/100,000 persons to 74/100,000. This increase reflects the largest increase in the rates of HIV diagnoses by race. In 2008, an estimated 18,328 African Americans received AIDS diagnosis and this number had remained relatively stable from 2005. According to statistics, 67% of the infected homosexual men were not aware of their infected status. African Americans also experience high rates of sexually transmitted diseases (STDs) than any other race/ ethnicity in the United States. The presence of some of these STDs can increase ones chances of contracting HIV infection.
The Centre for disease control and prevention (CDC) is quite committed towards fighting HIV among African Americans. It works with partners across the nation so as to fight HIV epidemic. The largest share of CDC prevention funds for black American communities which is approximately $244 million is used to support the state and local health departments and community organizations and health care providers across the U.S. The CDC gives financial aid to these partners so that they can implement programs to reduce the risk behavior of HIV among the African Americans, to help those living with HIV, to increase centers for testing and to protect partners from infection. They have built certain programs over time and these include; The Maryland AIDS Administration, US Helping us and Hope Health, Inc.
CDC also helps in the expansion of HIV prevention services and it also increases the opportunities for HIV diagnosis and treatment. CDC also develops new and effective interventions that are specifically tailored for the needs of the blacks. They have involved black people to carry out researches involving HIV prevention. The NAPWA is another program that works with community-based organizations, elected officials, government agencies, individuals, private industry and coalitions to build capacity for national HIV Testing Day and other HIV testing events; to reduce AIDS stigma, to work with the community planning groups and to promote HIV-positive visible leadership. It focuses on the African Americans, Latinos and the youth, mainly the women, gay and bisexual.
AIDS Arms is program that provides HIV testing and prevention services. It offers intake and outpatient medical care services, treatment and assistance. It also provides care access, education and it supports the HIV positive individuals. This organization is located in Dallas it supports African Americans, Hispanics, women, youth and families.
The 7th day of February each year is designated as National Black HIV/AIDS Awareness Day (NBHAAD).This is a national HIV testing and treatment community mobilization initiative that’s designed to offer encouragement to the blacks living in the United States and territorial areas. This organization encourages them to get tested, get educated, get treated and get involved with HIV prevention. This organization partners with CDC so as to mobilize communities and address local epidemics and the best practices that will curb the spread of HIV among the blacks and the country as a whole. This year’s theme for this organization is it takes a village to fight HIV/AIDS! It is with the help of this organization that most African Americans get to know more about the programs and agencies and their existence and the services that they offer.
These organizations are encouraged to promote NBHAAD and they should also get more involved in its support across the nation so that all the blacks can be able to know about it and utilize its services. HIV awareness and testing will provide many blacks with the vital information that they require so as to protect their health and that of their families. The other organizations should also encourage their employees to get involved in the activities of NBHAAD and try to educate the employees on matters relating to HIV/AIDS, its prevention and management. Lastly these organizations should develop HIV/AIDS policies for the workplace.
There are a number of challenges and barriers to the treatment of HIV/AIDS treatment among the African Americans. Some of these include their level of education. Most black Americans have disadvantaged education, majority of them are illiterate and those with low levels of literacy are quite unlikely to be adherent to the HIV medication. These individuals are usually emotionally distressed in most cases and are less optimistic about life. Education and health literacy are important factors in HIV treatment adherence and access to medical care. Education is a key factor in the fight against HIV and it mostly goes hand in hand with awareness. For a community to be taught the disease they have to have some knowledge about the disease. Another challenge facing the blacks is their financial instability. Most of the blacks have a hard time securing a good job; they therefore end up getting the hard and dirty jobs. They lead a quite had life and are exposed to so many diseases. It’s easier for them to acquire the opportunistic diseases that attack a HIV positive person.
The anti HIV medications are quite expensive and most blacks are of lower socio economic levels thus they have difficulty accessing care and are often unable to obtain quality medical care. Another issue is language barrier which is the inability for one to express him/her in a way someone else can understand. For this reason it`s hard to treat or even give counseling to such a person since there some aspect of language barrier. Another reason could be stigmatization where those who are infected become too afraid to speak out or to even seek medical attention they end up dying out of stress and depression and lack of treatment. They fear being rejected by their families, community and they are even afraid of being judged. This is mainly because HIV is viewed as being different from other diseases. People think it’s caused by wrong choices one makes and thus to most people its batter to suffer from a heart disease than to suffer from AIDS .
In my opinion, the best way to curb and control the spread of this deadly disease is to raise awareness among the African Americans. The country should ensure that all the blacks can access quality education and they should be taught about HIV/AIDS in these schools. The same education should be taught in the workplaces and also in there should be workshops and road shows about the same in the neighborhoods so that everybody gets to know about the effects of the disease, its prevention and how to avoid it.
Another recommendation is that, the drugs for the HIV positive patients should available to all those who require them and they should be absolutely free since most blacks cannot afford them. They should be readily available and the patients should be taught on the importance of following the prescription and the dangers of not doing the same. Still on that note, the government should ensure that the blacks get good incomes and should abolish any form of racism towards the African Americans.
Lastly, HIV/AIDS should be shown great love and should be a lot of care and support since they are normal citizens. They should be taught on how to eat healthy and how best to take care of their health, how to relate with their HIV negative spouses and friends. These people should also be given counseling so as to be able to view life positively and to avoid stress and depression.