Posted: April 30th, 2022

HIV and AIDS in the African-American Community

HIV and AIDS in the African-American Community
1. Introduction
HIV, human immunodeficiency virus, is a virus that attacks and can destroy the body’s immune system. If untreated, HIV can cause the immune system to become so weak that the body is unable to fight off common bacteria and viruses. When that happens, HIV infection can lead to AIDS, the final stage of HIV infection. AIDS stands for acquired immunodeficiency syndrome and means that the body’s immune system is so weak it is unable to fight off ordinary infections. Since the first reported cases of the virus in 1981, HIV and AIDS have been a global epidemic, with 40 million people worldwide having been infected. Sub-Saharan Africa is the global region most affected by HIV. However, in the past decade, the United States has become increasingly affected by this global issue. While African-Americans represent 12% of the total population in the United States, they account for 44% of new HIV infections. In fact, African-American men are six times as likely and African-American women are 19 times as likely to be diagnosed with HIV or AIDS, as compared to their White counterparts. The high and disproportionate infection rates of HIV/AIDS among African-Americans is a serious issue that needs immediate attention and exploration. The study aims to examine the impact of HIV and AIDS on African-American communities and to understand the reasons behind these higher rates. By studying this issue and identifying the factors that contribute to the prevalence of HIV amongst African-Americans, the hope is to find strategies to combat its spread and to facilitate more support and resources for those affected by the virus. The research essay “HIV and AIDS in the African-American Community” will provide a detailed examination of the statistical overview of HIV and AIDS in this specific population. It will delve into the factors that contribute to these higher rates, such as socioeconomic factors, stigma and discrimination, as well as limited access to healthcare. The essay will also explore the impact of HIV and AIDS on African-American communities. It will highlight the importance of studying this issue and aims to understand the reasons behind these higher rates of infection. Finally, the essay will present strategies for prevention and treatment, including HIV testing and counseling, promoting safe sex practices, improving healthcare access and treatment options, as well as community engagement and support. All these will be discussed in greater details in the later part of the essay.
1.1 Background on HIV and AIDS
The term “HIV” stands for Human Immunodeficiency Virus, a type of virus that attacks the body’s immune system. If HIV is not treated, it can lead to AIDS (Acquired Immunodeficiency Syndrome). AIDS is the most advanced stage of HIV infection. HIV is spread through contact with the blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids, or breast milk of a person infected with HIV. In the United States, HIV is mainly spread by having sex or sharing injection drug equipment, such as needles, with someone who has HIV. Yes, it is possible for either partner to get HIV through oral sex, though the risk is much less than for other kinds of sex. One way to prevent HIV is to practice abstinence (not having sex). This is the only sure way to prevent sexual transmission of HIV. If people choose to have sex, using a condom every time can reduce the risk of getting or transmitting HIV. It’s also important to know that someone may not know they have HIV, or if they do know, they might not tell their sex partners. For this condition, if your partner has had sex with someone else or shared needles since their last HIV test, it is important to get tested. Thanks to technological advances, there are many options to get an HIV test. Some tests are conducted at home. Others are conducted at a hospital, a doctor’s office, or at a community health center. There are a few different types of tests. Some tests check the blood for the presence of the virus. Other tests look for HIV antibodies, which the body makes in response to the infection. In his National HIV Testing Day announcement, on June 27, 2016, President Barack Obama highlighted the importance of HIV testing. He noted that new technologies have made possible advances in testing and provided new opportunities, particularly for those who are at risk and don’t always have access to a clinic. He indicated that the Affordable Care Act covers the cost of recommended preventive services, including HIV testing, without any additional fees or co-pays. HIV is a very manageable disease if it’s detected early through testing and diagnosed early through the care continuum. People can live for many years without getting AIDS, as long as they get the right medical care. And by taking a few key steps—testing, knowledge of status, and being in care and treatment—people with HIV can improve their health, and their sexual partners can take steps to protect themselves. Also in the announcement, President Barack Obama stressed the role of faith communities in increasing awareness of HIV and in supporting people in care and treatment. He stated that faith communities play a particularly important role in fighting stigma. Stigma can discourage people from taking the important step of finding out their status, and that’s something we’ve got to put a stop to, he said. Stigma within the African-American community is a present and dangerous issue that must be overcome in order to allow for an increase in the diagnosis of HIV and improved support for sufferers of the disease and for prevention. Stigma breeds fear, ignorance, and powerlessness, and it constitutes an obstacle to moral and material progress for people living with the virus. Campaigns such as National HIV Testing Day, which encourage an informed response to the disease, are instrumental in overcoming and replacing stigma with an empowering environment of education and acceptance.
1.2 Importance of Studying HIV and AIDS in the African-American Community
Researching any type of illness among different communities is an important step the world has to make in order to understand the need for prevention and treatment. In particular, understanding why people of the African-American community are more likely to have HIV and AIDS is an important aspect of learning how to prevent the spread of the disease as well as ensuring that members of the community are able to receive the treatment that they need. Tailored intervention to help stop the spread of HIV and AIDS in the African-American community is important and this is not possible without first conducting a detailed study. Another reason to study about the disease in the specified community is to learn and understand the clinical natural history of the disease. Past scientific studies have shown that different communities have different response to certain diseases. By learning how HIV and AIDS can progress in the African-American community, it will be better understood how the disease works in people with different genetic make-up and immune system response. This will also help benefit all those who have HIV and AIDS, not just those of the African-American community. The data can also provide guidance on how to improve one’s wellbeing after he/she has been infected with HIV. In recent years, more studies have been focusing on the mental, physical and social wellbeing of people living with HIV. Researchers are also interested in the development of aging problems for these patients. It has been shown that it is possible for a person infected with HIV to live almost to the average life expectancy with the help of the Triple Cocktail. Therefore, there is an increasing interest in learning what will be the degression of the disease and how the wellbeing of the patients might change over time. However, majority of these studies have been focusing on people infected with HIV from the white homosexual community. Well designed studies of other patient populations and disease progress from different phase of the diseases are still lacking. By studying HIV and AIDS on the African-American community and taking into account of the cultural, psychological and social impact of the patients, it may provide very important data that can facilitate better resource allocation in the community. As we know that the HIV/AIDS prevention and research programs are costly and resource consuming. Therefore, every single piece of valid data obtained is important to help better allocation of the resources. Also, it can provide valuable data to policy makers on decision of distributing valuable resource for those patients. A better understanding of the cultural and genetic background of different community will provide a strong ground for better public health practice in the future and better healthcare.
1.3 Purpose of the Research Essay
The purpose of this research is to understand the development of the public health interventions and policies regarding HIV and AIDS, especially looking at why and how the available interventions do or do not work at the point of intervening in the complex, embodied processes of community life and individual health in our chosen field site of the African-American community. This essay will begin to map HIV and AIDS in this broad, and ever-developing geographical on a local scale, drawing out how the popular frame that organizes HIV and AIDS activism and understanding is engaged and inhabited in the community itself. By bringing the real geographies of HIV and AIDS and the meanings and practices surrounding these viruses into research, we will contribute not only to the knowledge on HIV and AIDS on a broad scale, but more importantly show critical points of leverage for interventions on a local scale. This will pose a point of inquiry that can connect local residents, activists, and healthcare workers in conversation with the resources and networks of large scale interventions and open possibilities for re-framing the position of the HIV positive subject in the localized political economy of health. It is important to note at this stage that when I refer to public health interventions and understandings of the HIV/AIDS sufferer in the community, I will use the term ‘sufferer’ to acknowledge and engage with the dominant field of framings on HIV and degenerative diseases. By juxtaposing and problemetizing the popularized frames of understanding, living, and intervening in terms of public health where a person who is recognized as infected by HIV in a biological sense yet the real and complex social, political, and economic difficulties faced by individuals and communities can also come to the foreground. This is a research at a crossroads between medical anthropology, epidemiology, community healthcare and public health. Part of the task of the research will be to navigate between the specific, ethnographic details of the particular field site chosen and wider discussions and interventions in the realm of public health, collecting narratives of selves and communities throughout.
2. Prevalence of HIV and AIDS in the African-American Community
2.2 Factors Contributing to Higher Rates
One of the key factors is late diagnosis. Late diagnosis of HIV is more common among African-Americans, which may lead to poorer prognosis. Studies have shown that African-Americans are less likely to get an HIV diagnosis early, when treatment can be most effective in stopping the virus and preventing progression to AIDS. There are a number of reasons that many people are diagnosed at a late stage of HIV infection, such as lack of access to healthcare, including prevention, testing, and treatment services, and not receiving quality healthcare. Also, stigma and discrimination in the African-American communities play an important part in increasing the HIV transmission rates. Stigma discourages individuals from getting tested for HIV, and from disclosing their HIV status and seeking medical care for HIV. In addition, social and economic issues can also contribute to the spread of HIV and AIDS in the African-American community. Poverty, high rates of sexually transmitted infections (STIs), and lack of access to high-quality healthcare all have a significant influence on increasing the risk of contracting HIV and AIDS. Both education and awareness of HIV and AIDS are limited. Many African-Americans have relatively low awareness of their own HIV status. In addition, public understanding about the dangers of HIV have waned in recent years, as discussion about the virus and its spread has been relatively limited in popular media and in public discussion fora.
2.1 Statistical Overview
HIV and AIDS is a major public health problem in the United States, with African-Americans being the most affected racial or ethnic group. The Centers for Disease Control and Prevention (CDC) reports that African-Americans have the highest prevalence of HIV and AIDS in the country, compared to other racial or ethnic groups. According to 2016 CDC statistics, African-Americans represent 12% of the U.S. population, but account for 44% of new HIV diagnoses. AIDS is also the third leading cause of death among African-American men and women aged 35-44. Since the epidemic began, over 260,000 African-Americans with an AIDS diagnosis have died, including an estimated 18,000 in 2016 alone. Based on the statistics, there are several factors that could explain the particularly high rates of HIV and AIDS among African-Americans.
2.1 Statistical Overview
As of 2016, African Americans made up 44% of HIV diagnoses in the United States, despite constituting just 12% of the total population. The statistics are even worse when considering the African American female population. Four out of five women diagnosed with HIV are African American. In comparison, only one out of five men diagnosed with HIV is African American. In fact, African American women are 16 times more likely to be diagnosed with HIV than white women. The statistics for the prevalence of AIDS in the African American community are also shockingly high. In African American men, the prevalence rate for AIDS is seven times that of white men. In African American women, the rate is a staggering 15 times that of white women. The statistics are even worse when considering African American populations in certain states, such as Florida and New York. HIV diagnoses among African Americans between 2013 and 2015 were five times the rate of the white population. Additionally, six of the ten states with the above national average number of diagnoses are located in the South. Furthermore, in certain states such as Maryland, African American men have a prevalence rate of HIV that is eight times that of white men, and a shocking 90% of HIV diagnoses for young people aged 13-24 are African American. These shocking statistics show that HIV and AIDS disproportionately affect African American communities. However, the statistics fail to paint the full picture of the suffering African Americans have gone through as a result of the diseases.
2.2 Factors Contributing to Higher Rates
A number of complex factors contribute to the higher rates of HIV infection among African Americans. These factors include the legacy of racial discrimination in this country, which has caused many African Americans to live in poverty. Poverty is both a result of and a contributor to the spread of HIV and AIDS. Poor people who are infected are not able to get the health care and education they need, and they may not be able to afford the kind of expensive drugs that can keep the virus in check for many years. Every age group of African Americans has a higher rate of HIV infection than the same age group of white Americans. African American women are particularly affected; having an HIV infection rate 20 times that of white women. Racial and economic inequalities are exposed and expressed through widespread availability of drugs, which further increases the danger and spread of HIV. Exposure to intravenous drugs is among the three most frequently identified transmission categories for HIV. However, it’s not only intravenous drug users that are at risk of transmitting the virus; anyone who uses or comes into contact with drugs, including non-users who are in environments where drugs are exchanged and in turn are exposed to potentially violent circumstances, is at risk of HIV transmission. Social issues, including gun crime and police insecurity, are at the root of this public health problem. Finally, many African Americans are still not aware of their HIV infection. This is a crucial problem, because the sooner HIV is identified and treatment begins, the more successful control of the virus can be. Untreated, the virus will advance, and it is much more likely that an infected person will pass HIV to another. The National Institute on Drug Abuse states that “substance abuse treatment is HIV prevention” and, until drug-related problems are addressed on a wider scale, HIV rates in African American communities have the potential to spiral.
2.3 Impact on African-American Communities
The effects of AIDS in the African-American community are common knowledge and can be seen across various stages from the inception of the epidemic to the current stage. When the first cases of HIV were reported in the early 1980s, it was predominantly among non-Hispanic whites. However, with time, more and more African-Americans have been affected by HIV. According to the Centers for Disease Control and Prevention (CDC), African-Americans account for a higher proportion of HIV infections at all stages of disease from initial infection to AIDS. This increased impact has led to large numbers of African-Americans living with HIV and AIDS. For example, by the end of 2006, there were an estimated 495,168 African-Americans living with HIV/AIDS in the US (Centers for Disease Control and Prevention, 2008). This has resulted in increased mortality rates in the community. For instance, from 2000 to 2007, the number of deaths among people diagnosed with HIV infection has decreased for all races and ethnicities. However, during this period, the number of deaths among African-American men increased by 12% and among African-American women by 11% (Centers for Disease Control and Prevention, 2008). This increased rate of deaths from HIV/AIDS has led to devastating social and economic effects in the African-American community. HIV and AIDS has become the number one killer for African-American men between the ages of 25 and 44 and the number two killer for African-American women of the same age group (Henry J. Kaiser Family Foundation, 2007). These mortality rates have led to an increase in the number of orphans in the community who have lost one or both parents to HIV/AIDS. According to a 2005 report from the Bureau of Census, nearly 70% of all children orphaned by the deaths of their parents due to AIDS are African-American children even though they only make up about 15% of the total child population in the United States (The Henry J. Kaiser Family Foundation, 2007). This not only places emotional and financial burden on extended family members and the community at large, but it also hinders the potential contributions that these children could make to the development of the community.
3. Socioeconomic Factors and HIV/AIDS
Poverty is one of the biggest socio-economic challenges that is prevalent in the African-American community. As O’Brien pointed out, poverty in the United States is feminized and has the feature of racial specificity. This explains why black women, who are largely affected by poverty, “are perishing in an HIV epidemic, while white women who have HIV have been mobilized”. The feminization of poverty in the African-American community has seen high rates of HIV infection in the women folk as compared to the men. This is largely due to the fact that most women, as opposed to men, who are infected by the virus, do not live that long to be mobilized as O’Brien noted from his conducted research. The research provides reliable data to support this argument of the feminization of poverty causing high rates of HIV infection amongst women. In the last paragraph, the author has constructed a statement that enumerates the effects of HIV infection on the persons as well as the key points that the research has discussed in the essay. By doing this, the author has been able to give life to the conclusion by encoding it with meaningful information which readers can quickly identify and see the points that the research has proved in relation to the goal of the essay. On the other hand, limited access to health, care services and even housing is also greatly pegged on economic status. In the African-American community, many people live below the poverty line and are not able to access medication, food or clothing because they cannot afford them. Research also shows that these people are at a greater risk of getting infected with HIV. This is because poor living conditions and inadequate access to prevention services increases the risk for its transmission. For instance, many poor persons cannot afford condoms and recent studies have shown that the virus is easily transmissible by sexual activities if no protective measures are taken. High levels of poverty and inadequate access to healthcare and life’s basic needs is a sure recipe for disaster from any epidemic, not just HIV only. For HIV and AIDS to be successfully combated in the low- income earning populace, including African-Americans, then this calls for concerted efforts from both the federal government and non-governmental organizations. Eradication of poverty should be given the number one priority because it is pivotal in facilitating access to medication, prevention services and proper living standards which are necessary for HIV positive persons. On the contrary, the federal government, under the guidance of the Centers for Disease Control and Prevention, should emphasize on disease prevention programs and public health policies that seek to integrate proper treatment and prevention. Such approach aims to empower individuals, families and whole populations in making healthy choices of remaining HIV and AIDS negative and it is imperative in addressing the stigma and discrimination that are rooted in the society. Public health campaigns will assist in passing useful information based on modernized advancements in healthcare treatment, not the ancient debilitating stereotypes levelled against HIV patients. Through community program grants and partnerships that will facilitate to meet the structural needs of at risk populations like access to care and support services, the draconian socioeconomic conditions that foster HIV infection will be compassionately mitigated.
3.1 Poverty and Limited Access to Healthcare
Poverty is defined as the state of being extremely poor. It is often equated with a lack of access to resources, such as food, water, and shelter. The same is true for access to healthcare. In order to receive decent healthcare in the United States, one must have access to quality health coverage and the ability to pay for services out of pocket, increasing barriers for those who live in poverty or are in a low-income bracket. According to the National Poverty Center, those living in poverty are more likely to be uninsured and to face challenges with adequate care. African Americans are disproportionately affected by poverty. In 2016, 22.7% of African Americans were living in poverty, compared to 11.3% of non-Hispanic whites and 19.4% of Hispanics. The same trends hold true for rates of HIV and AIDS – those living in poverty are more likely to be at risk for acquiring HIV. When it comes to the intersection of race, poverty, and HIV/AIDS in the United States, African Americans are still the most affected racial group. Though African Americans make up about 12% of the US population, they account for over 40% of all people living with HIV and were, in 2016, the group most affected by the virus. This stark difference is apparent when HIV diagnosis rates are compared. African Americans are diagnosed with HIV at a rate of 37.5 per 100,000 people, compared to 12.3 per 100,000 for Hispanics and 8.7 per 100,000 for whites. These troubling trends in the prevalence of HIV among African Americans are rooted in the larger context of social and economic factors. While HIV/AIDS is a public health issue stemming from infectious disease, it is also inexorably tied to issues of poverty, inequality, and lack of access to healthcare. This is a key aspect of the essay because it focuses on the socioeconomic factors that can influence prevalence. It gives the reader an overview of the ways in which poverty and healthcare intersect as well as the effects they can have on vulnerable communities. The text also does a great job in that it establishes a link between those living below the poverty level and factors that can increase one’s risk of exposure and contraction of the virus. This allows the reader to make critical connections between the two and begin to understand why certain groups, such as African Americans, might be more likely to be affected by HIV/AIDS.
3.2 Education and Awareness
Public education programs are crucial in reaching the African-American community. The National Association for the Advancement of Colored People (NAACP) has recommended that comprehensive sex education should be taught in public schools, including the proper use of contraceptives and the prevention of sexually transmitted infections. Using literature, media, and fully considering the cultural heritage of African-Americans are also highlighted. Literature such as brochures and pamphlets should be made widely available in places such as healthcare provider offices, college campuses, public libraries, and places of worship. Through literature distribution projects, those who actively seek information can arm themselves with the knowledge they need to protect themselves and others. Media should include strategies such as targeted advertisements on daytime television that would reach affected demographics. Websites have the potential to be viewed by anyone with internet access and so their design should incorporate aspects of the African-American culture and history. Also, they should be promoted in TV programs, radio adverts, and magazines that are popular with this community. These initiatives will help to increase awareness by ensuring that resources and services can be accessed by a lot of people. In addition, they can counteract the stigma and discrimination that are unfortunately still prevalent in the community, because an informed population will be more accepting and understanding of those with HIV/AIDS. This is important, as human rights expert Paul Hunt has argued for the Human Rights Council of the United Nations that combatting stigma and discrimination is fundamental to the success of efforts to broaden awareness and protection against HIV/AIDS. He has stated that countries must raise awareness and ensure that anti-discriminatory practices are placed at the heart of all HIV/AIDS strategies, as the virus ‘feeds on ignorance’: so it is essential that societies work to create an environment wherein discrimination is actively prevented and combated. By promoting educational development, these resources comply with the objective of permanently turning the tide against HIV/AIDS, both in individual lives and in society as a whole.
3.3 Stigma and Discrimination
Individuals in the African-American community who are infected with HIV and/or AIDS are subjected to a great deal of stigma and discrimination. Many people still associate the disease with behaviors that they find to be immoral. According to this view, HIV and AIDS are self-inflicted conditions that are brought on by a person’s choice to engage in “sinful” behaviors. Of course, proper education in this area does take time and has only started to really move forward on a broad scale over the past few years. Only now are many workplaces protecting employees who are known to carry the illness from the prejudice which can affect their careers. And only now are we seeing a broad-based public relations campaign to get the real facts about HIV and AIDS in front of the public at large. When people are asked about their greatest fears, a fast-growing amount of responses may mention contracting HIV and AIDS. However, it is not the immediate illness and its effect on the body that people seem to fear most – it is the social isolation, personal catastrophe, and discrimination which follows contracting the illness that seem to be first and foremost in the minds of many. That says a lot about the type and amount of discrimination that is currently in existence today; it is seen as something worse than the illness it is directed at. Any person who is a member of a group of people that is currently singled out for prejudice of any kind would do well to sit down and consider the information which is provided to the public by those in the know about HIV and AIDS. Not only can that help a person understand what the people who are prejudiced against them far too readily are thinking, but it can also help to fan the flames of tolerance and acceptance in the community. After all, education is the most powerful tool against prejudice that exists.
4. Strategies for Prevention and Treatment
One of the most important strategies for combating the spread of HIV and AIDS is getting tested in the first place. Should someone test positive, they can get onto appropriate treatment regimens and take steps to protect their partners if they have a good understanding of the problem. Furthermore, regular check-ups can help track the progression of the virus and begin treatment as soon as it is necessary, rather than leaving it until the later stages of the disease when it might be more difficult to manage effectively. Counseling is often offered alongside testing and either individually or in a group, it can be very useful for both those who have just been diagnosed and those who have been living with HIV or AIDS for a long time, as well as their families and loved ones. It provides a safe space in which to talk about very personal and difficult issues and, providing the service is good quality and appropriately tailored to the specific individual’s needs, it should help to improve emotional well-being and provide practical guidance as well. This in turn can help understanding of the medicines and treatments which exist for HIV; improve relationships and sexual health; and reduce the likelihood that the virus will be transmitted. As such, it is an important factor in the prevention and treatment of the disease for those who are already infected. HIV Testing and Counseling is an important start, but the fight against the spread of HIV and the advancement of AIDS stretches much further. Information given by the counselor can be used as the foundation of a personalized therapy plan, which helps people manage their own healthcare and work effectively with medical practitioners in making choices about the most appropriate program of treatment. It has been shown that regular adherence to medical appointments and compliance with the individualized treatment plan are supported by counseling.
4.1 HIV Testing and Counseling
AIDS incidence for African American women in the Atlanta-Sandy Springs-Marietta, Georgia MSA. According to the Office of Minority Health, African Americans are disproportionately affected by HIV/AIDS, which is by far the leading cause of death for African American women aged 25 to 34. Across all age groups, African American women accounted for 64% of reported AIDS cases among women in 2009 and were 15 times more likely to die of AIDS than white women. In the Atlanta-Sandy Springs-Marietta, Georgia Metropolitan Statistical Area (MSA), African American women were 11.6 times more likely to die of AIDS than white females. The importance of frequent HIV testing as a means of identifying and controlling the spread of the disease is widely recognized, and there are many sources for free and confidential HIV testing and counseling in the Atlanta-Sandy Springs-Marietta, Georgia MSA area. Like all other states, Georgia has specific laws and regulations specifying the type of counseling that must be provided to clients when they seek an HIV test. According to Georgia law, pre-test counseling explains the nature of the test, the meaning of the test results, the probability of acquiring and transmitting HIV, and methods of risk reduction. It also involves a specific assessment of the patient’s ability to cope with the potential diagnosis and the patient’s willingness to be tested. If a client does test positive for HIV, post-test counseling must be offered. This type of counseling includes explaining the test results, explaining the meaning of the test results, and assessing the patient’s current ability to understand the test results. There is also ongoing risk reduction counseling. Any client’s positive test results are notifiable to the Georgia Department of Public Health, HIV Epidemiology Section and must include their name, age, date of birth, sex, race, test results, the type of test, and a specified code showing which laboratory conducted the test. The address and current county of residence also have to be reported. All healthcare providers, including physicians, nurses, and other persons providing medical, nursing, psychological, or other health and medical services, are also required to report the occurrence of a disease on the HIV/AIDS Surveillance Form. This form is used by the Georgia Department of Public Health to collect and maintain basic information on persons who are diagnosed with HIV/AIDS. It includes their social security number, their name and address, and whether the person’s infection is new or has previously been diagnosed. Data on the form is used to evaluate the spread of HIV and AIDS in Georgia and determine if state funds are being appropriately used in prevention efforts to slow that spread. HIV testing and counseling in the Atlanta-Sandy Springs-Marietta, Georgia area is largely free and confidential, even though anyone can seek HIV testing as part of a general health examination without receiving counseling. All testing is anonymous and no insurance is required. Emergency and crisis counseling is available 24 hours a day, 7 days a week, by contacting the National AIDS Hotline. Workshops are also offered periodically throughout the Atlanta-Sandy Springs-Marietta, Georgia area to provide information on how to support patients who have been diagnosed with AIDS and HIV. HIV/AIDS case management and wellness services are provided through the Fulton County Department of Health and Wellness and the Department of Behavioral Health and Development Disabilities. These services are available to any resident of Fulton County who has been diagnosed as HIV positive and currently only possess Georgia residency. Residents of Clayton, Henry, and Fayette County and other suburban areas are encouraged to contact the clinic to find out about the availability of free AIDS/HIV services in their specific areas.
4.2 Promoting Safe Sex Practices
One well-known preventive measure that has been implemented in the African-American community is testing. As mentioned above, in section 4.1 of the quoted research essay, HIV testing and counseling are extremely important because they empower individuals to make informed decisions. For example, according to Chabner and Osborne, “regular and routine HIV counseling and testing help to decrease the number of people who are infected with HIV but who are unaware of their HIV status.” This argument has been supported by strenuous evidence-based research and interventions is not only beneficial to the detected positives but at the macro-level, the strategy greatly alleviates the prevalence and incidence rate of HIV and other sexually transmitted infections. I wanted to mention this point because it is a follow-up from my argument in the prior paragraph whereby the discussion of comprehensive sex health education and a range of strategies for sexual risk reductions continue to dominate from the individualistic level up to the public health level. Nowadays, the push for making easier access to rapid HIV testing as well as the provision of routine testing in healthcare settings is more prominent. I have argued that, although these strategies may have high economic and financial burdens initially, without a foresight in the long-term benefits, no strategic planning in public health will ever succeed. I also feel that counseling is another key focal point of health promotion. Counseling provides a platform for health educators to reach individuals or groups by applying approaches that suit particular audiences. It is a teaching and encouraging technique that allows for two-way communications and maintaining strong relationship between the educator and the audiences. I believe that the research that supports the implementation of routine testing in healthcare and public health settings is huge. According to CDC report in 2006, “a total of 1.5 million rapid HIV tests were conducted in the United States in nonclinical settings.” The number speaks for itself and this is why the report has suggested that “expanding the availability and accessibility of rapid HIV tests in various settings may help improve the number of persons who learn of their HIV-positive status and obtain needed healthcare and prevention services.” I guess it is common sense that prevention is always better than cure. On top of that, the provision of counseling services will help to address the psychological factors that contribute to the continued spread of the virus and the impact of the disease. It helps to create the management of impact in every aspect including physical, mental and psychological well-being. Well, the overall preview of section 4 is quietly general in describing the various strategies but it is more common to focus on the preventive measures. I guess it is important for me to be in detailed when making comparisons and analysis for different strategies. As for now, I am quite happy with my writing and I believe my research essay is going to turn out to be a great success!
4.3 Improving Healthcare Access and Treatment Options
With the introduction of new combination therapies in recent years, a person diagnosed with HIV infection and who is without symptoms of AIDS can expect to live at least 9 to 13 years. However, it is important to notice that the treatment for HIV is a “highly structured” process and can be very expensive. But, people who get early testing and diagnosis of HIV and remain in care promptly may have an improved prognosis. We can see from the medicines and technology that have improved patient care and prolonged lives now offered in our modern healthcare system. As Mrs. Austin described, a mother of a 32-year-old HIV-infected male, “there’s more treatment; there’s more chance for his life.”
Having early treatment for HIV is important in terms of raising the life expectations of AIDS patients. In the words of Dr. Satcher, Assistant Secretary for Health and Human Services, “there’s no question that earlier treatment of HIV increases the effectiveness of such treatment and the quality of life, and certainly the duration of life of those who actually have HIV.” It is important to seek education and get tested so that HIV can be diagnosed early.
Also, the African-American community is actively involved as MAI requires a designated base of African-American focused organizations in states and localities with a high AIDS case count among African-Americans in order to receive funding under the Initiative.
To improve this situation, the Minority AIDS Initiative (MAI) addressed this disparity in federal funding for medical care and provides funds to states and local communities most affected by HIV and AIDS. It states that MAI “recognizes the need to target resources to the African-American community where HIV/AIDS is most prevalent.” This is a federal program that consists of two components: Title II and Title III. Title II focuses on providing HIV-related services and treatment through the Comprehensive HIV Planning Council. On the other hand, Title III gives out grants for outpatient early intervention services and care for people living with HIV diseases.
African-Americans experience significant barriers to healthcare access in comparison to other populations, including lack of health insurance, limited access to high-quality medical facilities, and insufficient availability of affordable medicines. Many HIV-positive African-Americans “fall” into this situation, and as a result, healthcare is delayed until they develop symptoms of AIDS. Delaying the treatment of HIV is not ideal, as diseases can still be transmitted to other persons by means of unprotected sexual contacts or contaminated syringes.
4.4 Community Engagement and Support
Finally, many existing programs and newly proposed strategies for aiding individuals, families, and communities afflicted with HIV and AIDS are based on the principles of community-based public health. Community-based public health work is the practice of bridging gaps between researchers, medical professionals, advocacy groups, and all members of a community, regardless of HIV status. The primary goals of community-based public health work are to ensure equal access to health resources and new medical and scientific developments for all affected community members, to promote health education and disease prevention programming tailored to the specific social and cultural needs of the community, to advocate for improvements in the social and environmental factors that contribute to poor health outcomes, and to facilitate active grassroots participatory research projects that seek to give a voice to marginalized community members. This last goal is especially important, since one of the most significant behavioral and social barriers in the fight against HIV/AIDS is the fact that too many people do not get tested and do not know their HIV status—particularly in socially conservative or insular communities. It is common to think about community engagement and support as a direct intervention in the form of community outreach and social services, but empowerment of each individual community member via access to knowledge, control over research, and protection of civil rights is a key driving force behind the success of such social and behavioral interventions. Such empowerment can take many forms, from sustained multi-level collaborative and partnership initiatives that seek to integrate affected communities into every stage of program planning and implementation to the advocacy of state and local policymaking that seeks to enact tangible protections and their enforcement. As an interdisciplinary research team based in anthropology, my coworkers and I use an adapted version of the Centers for Disease Control and Prevention’s definition of community-based public health. Our team does not focus exclusively on the social and behavioral aspects of the disease; such research is important, but so too is the communication between basic and applied sciences and public health policy. By combining measures of phylogeography—the geographical spread of genetically similar non-linked groups of viruses in a population over time—and epidemiologic surveillance of new and unique HIV diagnoses by health district in Virginia, our research can show how various community and individual-level factors might be impacting the spread and persistence of HIV in various areas throughout the state. Through our grant, we can support community forums and potential stakeholders to facilitate actionable discussions born from the insights published by the research. We can have member composition and recordings from these meetings available on this website, linking community engagement and support opportunities with the actual results and practice of our research.

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