Racial Groups and Hivaids

Epidemiological findings show that HIV/AIDS is a major health problem among all racial groups in the United States. The magnitude of this problem, however, has a profoundly disporportionate impact on African Americans and Hispanics (Brown & Sankar, 1998; Flaskerud, 1999; Flaskerud & Ungvarski, 1999; Ory & Mack, 1998; Ward & Duchin, 1998). For example, 69,151 adults/adolescents AIDS cases were reported in 1996, in which 38% were whites (approximately 75% of the U.S. population), 41% African Americans (13% of the U.S. population), and 19% Hispanics (10% of the U.S. population) (Ward & Duchin, 1998). In addition, whereas the proportion of newly reported AIDS cases among whites decreased from 60% in 1985 to 40% in 1995, the proportion of newly reported cases among African Americans and Hispanics within the same period increased from 25% to 40% and 15% to 19%, respectively (Flaskerud & Ungvarski, 1999).

In general, American Indians and Asian Americans are yet underrepresented among HIV/AIDS cases in proportion to their number in the total population in the United States. For example, although African Americans and Hispanics constitute approximately 22% of the U.S. population in 1992 (National Commission on AIDS, 1992), these racial groups represented nearly 47% of AIDS cases reported in 1992. By contrast, in the same year American Indians and Asian Americans made up 3% of the total population in the U.S., but accounted for only 0.6% of the AIDS cases. Similar results were reported by the CDC (1998) and Sy, Chng, Choi, and Wong (1997).

In the specific case of women, approximately 77% of AIDS cases reported in this gender group has been African Americans or Hispanic (Ward & Duchin, 1998). These findings suggest those mental health professionals interested in serving persons with HIV/AIDS in the United States should expect a significant number of African Americans and Hispanics in their clinical practice.

Table II shows a summary of exposure category in male adults/adolescents across racial groups. In general, a greater number of African American and Hispanic males have been reported with AIDS through 1997, compared with Asian and American Indian males. In the case of "men who have sex with men" as a risk factor for HIV infection, whites have taken the lead since 1981 (first year when AIDS symptoms were reported to the CDC). It should be noted, however, that African Americans and Hispanics have historically constituted a small number in the United States compared to whites. Therefore, 32% and 44% of AIDS cases among African Americans and Hispanics, respectively (Table II), reported through 1997 is in disproportion to the number of persons from these two racial groups in the U.S. population (Ward & Duchin, 1998). Another significant finding is that the number of AIDS cases resulting from heterosexual contacts (Table II) have been higher among African American and Hispanic males relative to whites, Asians, and American Indians.

Table III shows a summary of exposure category in female adults/adolescents across racial groups. In general, in comparison with white females, African American and Hispanic women have been dramatically affected by the HIV/ AIDS epidemic. For example, in a total of 92,424 AIDS cases reported to the CDC (1997), African American and Hispanic women represented 51,410 and 18,663 cases, respectively. These figures together represent 76% of AIDS cases reported to the CDC as of June 1997 (CDC, 1997).

Table IV shows a summary of exposure category in children (<13 years old) across racial groups. In general, a greater number of African American children have been diagnosed with AIDS relative to other racial groups in Table IV. In addition, in the case of the "mother with/at risk for HIV infection" category (Table IV) the percentage of AIDS among African American and Hispanic children is disproportionally higher for these groups, relative to white, Asian, and American Indian children. Because injecting drug use and heterosexual contacts have been the major risk factors for HIV infection among African American and Hispanic women (see Table III), it is not surprised to find out (Table IV) that most AIDS cases among children in these two racial groups have been associated with vertical transmission (i.e., transmission of HIV from mother to infant; Ward & Duchin, 1998).

In terms of results in Tables II-IV, mental health professionals interested in providing services to racial minority groups would probably have the largest number of HIV/AIDS cases from the African American and Hispanic communities, relative to the Asian and American Indian groups. In addition, in the process of individual, family, and group therapy, injecting drug use and heterosexual contacts would constitute two critical variables to consider during the management of emotional or psychological problems resulting from knowing about the HIV or AIDS status among members from such groups.

TABLE II. AIDS Cases by Exposure Category in Male Adults and Adolescents across Racial Groups through June 1997«

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