HIV/AIDS among African Americans: progress or progression?

Objectives: To review data on the extent of HIV infection and associated ri sk behaviors, the occurrence of AIDS, and HIV-related mortality in African Americans and to suggest what can be done to reduce HIV exposure and infect ion in this population. Design/methods: Review of epidemiologic, published, multisite data on HIV i nfection in, and related behaviors of, African Americans. Results: On every epidemiologic measure in common use, African Americans, c ompared with the four other federally recognized racial/ethnic groups, have the most severe epidemic. The trend data show continuing growth in the Afr ican American epidemic despite the availability of effective behavioral int erventions and biomedical treatments. Few published intervention studies wi th African American populations have been adequately evaluated; nor have th ey focused proportionately on men who have sex with men, a group in the Afr ican American community with continuing high rates of infection. Conclusions: Rates of HIV transmission and disease among African Americans are high, disproportionate, and are not declining as significantly in respo nse to effective interventions as they are among whites. Attention is urgen tly needed to increase our understanding of risk behaviors, social networks , and specific factors in the African American community that can be altere d to reduce HIV infection. Macroenvironmental factors - poverty, social cla ss, racism - need to be studied to suggest possible intervention components to reduce rates of HIV transmission and to increase the use of therapies t hat are more effectively slowing disease progression and lowering death rat es among whites. (C) 2000 Lippincott Williams & Wilkins.