By race/ethnicity, African Americans face the most severe burden of HIV in the United States (US). At the end of 2007, blacks accounted for almost half (46%) of people living with a diagnosis of HIV infection in the 37 states and 5 US dependent areas with long-term, confdential, name-based HIV reporting. In 2006, blacks accounted for nearly half (45%) of new infections in the 50 states and the District of Columbia. Even though new HIV infections among blacks overall have been roughly stable since the early 1990s, compared with members of other races and ethnicities they continue to account for a higher proportion of cases at all stages of HIV—from new infections to deaths.

Estimated Rates of New HIV Infections,
by Race/Ethnicity and Gender, 2006

Source: CDC. Subpopulation Estimates from the HIV Incidence Surveillance System—United States, 2006. MMWR. 2008; 57(36):985–989.

The Numbers

New HIV Infections¹

• In 2006, black men accounted for two-thirds of new infections (65%) among all blacks. The rate of new HIV infection for black men was 6 times as high as that of white men, nearly 3 times that of Hispanic/Latino men, and twice that of black women.
• In 2006, black men who have sex with men (MSM)² represented 63% of new infections among all black men, and 35% among all MSM. HIV infection rates are higher among black MSM compared to other MSM. More new HIV infections occurred among young black MSM (aged 13–29) than among any other age and racial group of MSM.
• In 2006, the rate of new HIV infection for black women was nearly 15 times as high as that of white women and nearly 4 times that of Hispanic/Latina women.

HIV and AIDS Diagnoses³ and Deaths

• Although new HIV infections have remained fairly stable among blacks, from 2005–2008 estimated HIV diagnoses increased approximately 12%. This may be due to increased testing or diagnosis earlier in the course of HIV infection; it may also be due to uncertainty in statistical models.
• At some point in their lifetimes, 1 in 16 black men will be diagnosed with HIV infection, as will 1 in 30 black women.
• From 2005–2008, the rate of HIV diagnoses among blacks increased from 68/100,000 persons to 74/100,000. This increase reflectsthe largest increase in rates of HIV diagnoses by race or ethnicity.
• In 2008, an estimated 18,328 blacks received an AIDS diagnosis, a number that has remained relatively stable since 2005.
• By the end of 2007, an estimated 233,624 blacks with a diagnosis of AIDS had died in the US and 5 dependent areas. In 2006, HIV was the ninth leading cause of death for all blacks and the third leading cause of death for both black men and black women aged 35–44.

Prevention Challenges

Like other communities, African Americans face a number of challenges that contribute to the higher rates of HIV infection.

Sexual risk behaviors, such as unprotected sex with multiple partners, with a partner who also has other sex partners, or with persons at high risk for HIV infection can be common in some communities.

Injection drug use can facilitate HIV transmission through the sharing of unclean needles. Casual and chronic substance users may be more likely to engage in unprotected sex under the influence of drugsand/or alcohol.

African Americans continue to experience higher rates of sexually transmitted diseases (STDs) than any other race/ethnicity in the US. The presence of certain STDs can significantly increase the chance ofcontracting HIV infection. A person who has both HIV infection and certain STDs has a greater chance of infecting others with HIV.

The socioeconomic issues associated with poverty, including limited access to quality health care, housing, and HIV prevention education, directly and indirectly increase the risk for HIV infection and affect the health of people living with HIV.

Lack of awareness of HIV status. In a recent study of men who have sex with men (MSM) in five cities, 67% of the HIV infected black MSM were unaware of their infection.

Stigma also puts too many African Americans at higher risk. Many at risk for HIV infection fear stigma more than knowing their status, choosing instead to hide their high-risk behavior rather than seek counseling and testing.

What CDC is doing

CDC has initiated a wide range of activities to (1) better understand those factors that drive the HIV and AIDS epidemic among African Americans in the US, (2) expand HIV testing and access to medical care, (3) develop new interventions and scale up the availability of effective interventions, and (4) mobilize African American communities to combat the HIV crisis. Some examples of CDC activities:

• CDC works closely with state and local health departments and community-based organizations (CBOs) to effectively utilize current HIV prevention interventions proven to be most effective for African Americans.
• CDC research has led to new interventions that reduce HIV risk in African Americans. CDC continues to identify, develop, and evaluate new behavioral and biomedical interventions for individuals at greatest risk and those living with HIV.
• CDC is conducting research to better understand and plan interventions to address the social, community, financial,and structural factors that place many African Americans at risk and hinder access to prevention and care.
• CDC is working with African American leaders from every sector to mobilize communities of color against HIV and deliver culturally appropriate campaigns and messages, including the Act Against AIDS campaign. For more information, visit www.cdc.gov/hiv/aaa.
• In 2010, CDC announced a second 3-year expanded HIV testing program that supplements an initiative started in 2007 to increase HIV testing among African Americans. CDC is expanding the program to an additional five state, territorial, andmetropolitan health departments. It also broadens the target population to include African Americans and Hispanics/Latinos, as well as MSM and injection drug users of any race/ethnicity. Funding for the program was increased from $36 million to approximately $62 million.