In the U.S., Black men are at high risk of contracting HIV compared to men of other races. Black men who have sexual intercourse with men are even at a higher and growing rate of contracting the virus. Here is everything you need to know about black men and HIV.
New therapies have greatly impacted the transmission rates for people at high risk of contracting HIV and improving the lives of those already living with the virus.
Pre-exposure prophylaxis (PrEP) is recommended for persons at risk of contracting HIV either from sex or injection drugs.
When PrEP is taken properly, it reduces the chances of getting infected with HIV by 99% from sex and 74% from injections; this is per the Centers for Disease Control and Prevention.
By following and adhering to HIV treatment, persons living with the virus can live long and healthy lives like HIV- negative people.
Antiretroviral therapy reduces the viral load in one’s body to a detectable level. It may also help:
- Lower the risk of complications
- Slow HIV progress
- Reduce the chances of HIV transmission
That said, most Black men at risk of contracting HIV aren’t on PrEP, have not been diagnosed, and don’t receive antiretroviral therapy. Here, we look into these disparities and how they can be addressed to reduce their chances of contracting the virus.
HIV Rates in Black Men
Although Black people only made up 13% of the U.S. population in 2018, 42% of new HIV diagnoses were from this group. This is according to the CDC.
In 2018, almost 38 000 new cases of HIV were diagnosed in the U.S. and dependent areas. Out of those cases, 11,905 cases diagnoses were in Black men, with 9,444 cases of the total cases in Black men, being Black men who have sex with men (MSM).
According to the CDC, HIV diagnoses were associated with:
- Male-to-female sexual contact in 15% of cases
- Male-to-male sexual contact in 79% of cases
- Male-to-male sexual contact and drug injection in 2% of cases
- Drug injection in 4% of cases
- Signs and Symptoms of HIV Infection
Signs and symptoms of severe HIV infection are similar for all people regardless of their race or sex. They include:
- Sore throat
- Night sweat
- Mouth ulcers
- Muscle aches
- Swollen lymph nodes
Black Men and HIV – Life Expectancy
Antiretroviral therapy prevents HIV from progressing. This helps in lowering viral count while boosting the immune system.
However, antiretroviral isn’t a cure for HIV; It increases life expectancy for individuals living with the virus, including Black men.
According to a 2017 study involving around 90,000 people, it was found that persons in their 20s living with HIV with a CD4 (white blood cell) count above 350 cells per mL each year after starting antiretroviral therapy can live up to 78 years. That’s almost the same life expectancy for HIV-negative persons.
Increasing HIV Rates Among Young Black MSM
While HIV diagnosis rates are decreasing among most populations in the U.S, according to CDC, these cases increased between 2014 and 2018 in Black MSM aged 25 to 34.
The CDC also stressed the high rates of HIV in Black MSM in a 2016 press release stating racial disparities in the HIV pandemic.
According to the founder of BlaqOut in Kansas City, Dr. Rashaan Gilmore, the CDC predicted that unless there are changes, half of all Black men in the U.S., regardless of their age who has sex with men will contract HIV in their lifetime.
HIV Care Among Black Men
While taking PrEP daily lowers one’s risk of contracting HIV, Black MSM reports low use of PrEP.
According to the CDC, 18.8% of HIV-negative Black MSM used PrEP in the past 12 months as of 2017, compared to 30.9% of HIV-negative white MSM who reported using PrEP.
Additionally, most Black MSM don’t get diagnosed with HIV. About 1 in 5 Black MSM lived with the virus without knowing in 2018, compared to 1 in 7 of HIV – positive individuals in the U.S.
Even after they are diagnosed with the virus, most Black MSM is less likely to suppress viral load using treatment. Suppressing viral load helps increase the chances of living a healthy life.
In 2018, only 61% of Black MSM diagnosed with the virus had suppressed viral loads, compared to 65% of total persons living with the virus in the U.S.
Black Men and HIV – Racism and Medical Mistrust
Above everything else, racism is the biggest hindrance Black men face when accessing healthcare and support to prevent and treat HIV. Most Black men report cases of discrimination due to their race from healthcare professionals and the general community.
Direct exposure to racism and discrimination from healthcare providers led to medical mistrust in Black people in the U.S.
Due to medical mistrust among Black MSM, these individuals are less likely to seek the medical intervention of any kind citing race or sexual orientation.
Social and Economic Influences
Social and economic inequalities also hinder HIV prevention and care among Black men.
Due to racism, there have been unequal economic opportunities and a wealth gap between Black and white people in the U.S. Most Black people are deprived of the right to housing, education, and employment. All these socioeconomic inequalities have led to higher cases of HIV in Black men.
For instance, an individual experiencing housing challenges may find it difficult to access high-quality education and healthcare. In the long run, such an individual may face challenges in protecting their general health.
Black Men and HIV – Conclusion
Black men have higher chances of being diagnosed with HIV than other populations in the U.S. Black MSM are especially less likely to use PrEP to help prevent contracting HIV.
Among the things contributing to the high chances of Black MSM contracting the virus are racism, medical mistrust, discrimination, and economic disparities.
To reduce the chances of Black MSM contracting HIV, they should be provided with equal opportunities to access PrEP and get tested. They should also be allowed to access HIV treatment to suppress the viral load.
According to the CDC, persons at high risk of getting HIV should get tested at least once per year, and sexually active Black MSM may benefit from regular tests.