Thompson PI, Smith D, Miller K, Brown M, Davis L; International Conference on AIDS.
Int Conf AIDS. 1998; 12: 902 (abstract no. 43279).
Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA.
ISSUES: African-Americans remain disproportionately affected by the HIV epidemic in the United States. In 29 states where newly identified HIV infections are reported to CDC, African-Americans were 54% of reported cases compared to whites at 36%. Due to the long interval between HIV infection and the development of AIDS, HIV infections may more accurately represent the current demographic epidemiology of the epidemic than newly reported AIDS cases. PROJECT: CDC is assessing its HIV prevention efforts in African-American communities. To date, critical analysis of epidemiological and research program data was conducted, and eight focus groups of specific sub-populations (e.g., injection drug users, women, Gay/bisexual men, adolescents, etc.) were held. Governmental and non-governmental consultants have participated in a multi-phased process including defining the problems, assessing programs, and designing and implementing strategies. The implementation strategies will include developing evidence-based approaches and strengthening, supporting, and redesigning existing HIV prevention strategies. RESULTS: Examination of existing epidemiological data revealed that in 1996, for the first time, the number and proportion of annual AIDS cases reported among African-Americans (28,346; 41%) exceeded that among whites (26,229; 38%). This "parity" is occurring despite the fact that African-Americans are 13% of the US population and whites constitute 73%. Focus group participants described a variety of emotions in reaction to HIV and AIDS including: fear, denial, and compassion for those infected and affected. HIV/AIDS is also associated with the stigmas of homosexuality, promiscuity, and substance abuse. Racism and discrimination, gender role socialization, hopelessness, and lack of knowledge were social and cultural factors repeatedly identified as facilitating the spread of HIV through African-American communities. Denial of the existence of HIV/AIDS in the community was an especially strong theme in all focus group sessions. Faith communities were seen as playing a key role in HIV prevention by shaping attitudes towards those who are infected. Programs with a holistic approach (dealing with the whole person--not just HIV infection) were viewed as most effective. Finally, inadequate funding has reportedly prevented many programs from reaching large segments of their intended audiences. LESSONS LEARNED: The African-American initiative can serve as a model for the development of similar assessments in other people of color communities. In-depth needs assessments such as that conducted by the African-American Initiative help to elucidate the strengths and weakness of current program strategies and identify gaps in services. Specific behavioral and community interventions must be designed, implemented, and evaluated with culturally appropriate leadership and participation from affected communities.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Adolescent
- African Americans
- Centers for Disease Control and Prevention (U.S.)
- Disease Outbreaks
- Female
- Focus Groups
- HIV Infections
- HIV Seropositivity
- Humans
- Male
- Pregnancy
- United States
Other ID:
UI: 102231445
From Meeting Abstracts