Black Americans less likely to remain in HIV care

09 February 2016
Two men of African origin

New research indicates that only 38% of black Americans living with HIV consistently remain in HIV care, compared to 50% for Hispanic/ Latino Americans, and 49% for white Americans. The findings were released by the Centers for Disease Control (CDC) in the Morbidity and Mortality Weekly Report, to mark National Black HIV/AIDS Awareness Day in the USA (February 7).

In the USA, black Americans have a higher percentage of HIV infections, compared to other ethnic groups. In 2013, black and African Americans accounted for 45% of all new HIV infections, despite only accounting for 12% of the USA population.

Keeping people in HIV care after their diagnosis means they have a better chance of getting and staying on treatment and achieving viral suppression. As a result, they are more likely to stay healthy, as well as reduce their chances of passing HIV to others.

The researchers classed ‘consistent retention of care’ as having had two or more CD4 count or viral load tests around every three months from 2011 to 2013.

The research looked at 9,824 adults and adolescents who received an HIV diagnosis in 2010, in 12 jurisdictions across the USA. Of all the patients included, 54% were black, 17% were Hispanic and 24% were white.

Overall, 61% remained in care in 2011, 50% in both 2011 and 2012, and 43% from 2011 to 2013. 28% of all black patients did not access HIV care during any of the three years – compared to 23% for Hispanics and just 19% for whites.

The low percentage of black Americans remaining in care was consistent across sex and transmission category. Within all black patients, men had a lower retention to care than women over the three years – just 35% were retained, compared to 45% for women.

The findings on ethnic disparities are consistent with other similar studies. Barriers include a lack of health insurance, limited access to health services and stigma – which is ‘particularly prevalent among blacks’.

The CDC says: “Efforts to establish early HIV care among blacks are needed to mitigate racial/ethnic disparities in HIV outcomes over time.” It is therefore vital to ensure that approaches are identified to improve early detection of HIV, and linking people to care, so that disparities can improve. 

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