Mortality rates of Black Americans living with HIV decreasing

11 February 2015
An HIV ribbon

Mortality rates of black and African Americans living with HIV decreased by 28 percent from 2008 to 2012, according to new data released from the US Centres for Disease Control (CDC) last week. However, despite this consistent decline in deaths of people living with HIV (PLHIV) over time, the overall numbers and rates of deaths among black Americans are still higher than any other race or ethnicity in the United States.

Black Americans are disproportionately affected by the HIV and AIDS epidemic in the US. Black Americans make up only 12 percent of the US population, however they account for 41 percent of all persons living with HIV. In an analysis of a CDC-funded testing outreach programme, they found that black Americans accounted for 45 percent of all those tested, and 54.9 percent of all newly identified people living with HIV. Black men who have sex with men (MSM) were particularly affected. They accounted for only 8.8 percent of all those tested, but 37.3 percent of all new positive blacks.

HIV testing is a critical gateway to HIV services and life-saving antiretroviral treatment. It also helps efforts to prevent HIV, as onward transmission can be significantly reduced once a person is aware of their status, and on treatment. As such, linking people to care after diagnosis is a critical issue. Under the US National HIV/AIDS Strategy, 85 percent of newly diagnosed people should be linked to HIV medical care within 90 days. However, the new figures from the programme show that only 44.5 percent of black Americans are being linked to care within the 90 days.

The data also shows that despite the real numbers of mortality between races, the patterns of mortality among categories were the same. The highest number of deaths was recorded among older PLHIV. By transmission category, MSM had the lowest mortality rate, compared to those infected by injecting drug use, who had the highest mortality rate.

Black Americans were the group least likely to test for HIV, with 15 percent of those living with HIV unaware of their status, compared to 13 percent for white Americans living with HIV and unaware of their status. This may contribute to the increased death rate for black Americans, compared to white and Hispanic Americans. The death rates among these groups were 20.5, 18.1 and 13.9 percent respectively. Increasing HIV testing uptake and linkages to care is therefore vital in order to curb the epidemic in the US.