2. Triple Whammy—HIV, Mental Disorders, African Americans
HIV Epidemiology Among African Americans
From 2006 to 2009, 171,840 cases of HIV infection were reported in the United States, with African Americans accounting for: [CDC HIV Surveillance 2009]
- 50% of all cases
- 64% of cases in women
- 66% of cases attributed to heterosexual contact
- 68% of cases in children ? 13 years of age
Among HIV-infected African American males in 2009, an estimated 68% were attributed to men having sex with men (MSM), 9% to injection drug use (IDU), 20% to heterosexual contact, and approximately 3% to MSM plus IDU. Among HIV-infected African American females in 2009, 87% of cases were attributed to heterosexual contact and 13% to injection drug use.
In 2010, an estimated 72% of HIV-infected African American males were infected as a result of having sex with men; 9% as a result of injection drug use (IDU), 20% as a result of heterosexual contact, and approximately 3% as a result of both having sex with men and IDU. Among HIV-infected African American females in 209, 87% of cases were attributed to heterosexual contact and 13% to injection drug use [CDC HIV Surveillance 2009]
By the end of 2009, an estimated 250,745 African Americans had died of AIDS. In 2007, HIV was the ninth-leading cause of death for all African Americans and the third-leading cause of death for African Americans 35 to 44 years of age. In 2010, an estimated 16,188 African Americans were diagnosed with AIDS. At some point in their lifetimes, an estimated 1 in 16 African American men and 1 in 32 African American women will be diagnosed with HIV infection. [CDC African American fact sheet, 2013]
- In 2009, the estimated rate of new HIV infections for African American men was more than seven times that of white men, and twice as high as that of Latino men and three times as high among African American women.
- In 2010, African American MSM represented an estimated 72% of new infections among all African American men, and 36% among all MSM. More new HIV infections occurred among African American men between the ages of 13 and 24 than any other MSM age and racial group.
- In 2010, approximately 87% of African American women with HIV became infected through heterosexual sex. The estimated rate of new HIV infections for African American women was 20 times the rate among white women and almost 5 times that among Latina women. [CDC African American fact sheet, 2013]
Learning Objectives of the Overall Curriculum
- Describe the evolving demographic composition of the US population
- Discuss the epidemiology of HIV in African Americans
- Identify the HIV-associated mental disorders observed in African Americans
- Describe the mental disorders commonly observed in HIV-infected patients
- Discuss the connections among substance abuse, mental disorders, and HIV in African Americans
- Describe the diagnostic challenges seen in African Americans with substance abuse and mental disorders
- Discuss possible therapeutic approaches to mental disorders in African Americans
References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fourth edition, text revision. Arlington, Virginia; American Psychiatric Association; 2000.
US Census Bureau. Overview of race and Hispanic origin: 2010. Available at: www.census.gov/prod/cen2010/briefs/c2010br-02.pdf. Accessed December 28, 2011.
US Office and Management and Budget. Revisions to the standards for the classification of federal data on race and ethnicity. Available at: http://www.whitehouse.gov/omb/fedreg_1997standards. Accessed December 28, 2011.
Centers for Disease Control and Prevention. HIV Surveillance by race/ethnicity (through 2009). Available at: http://www.cdc.gov/hiv/topics/surveillance/resources/slides/race-ethnicity/index.htm. Accessed January 2, 2012.
Centers for Disease Control and Prevention. HIV among African Americans [fact sheet]. Available at: http://www.cdc.gov/hiv/topics/aa/index.htm. Accessed January 2, 2012.
