Understanding the Impact of HIV/AIDS in the Black and African American Community

Understanding the Impact of HIV/AIDS in the Black and African American Community

The Black and African American community experiences a disproportionate impact from HIV/AIDS. In 2018, although comprising just 13% of the U.S. population, Black and African American individuals accounted for 42% (16,002) of the 37,968 new HIV diagnoses in the United States, as reported by the Centers for Disease Control and Prevention.

Systemic obstacles to prevention and care, along with the stigma associated with HIV/AIDS within the Black and African American community, contribute to the rising number of cases.

Fortunately, diversity in nursing and culturally sensitive care can play a role in reducing health disparities, whether among Black and African Americans or other groups, such as Native Americans or Indigenous people.

This guide explores the impact of HIV/AIDS within the Black and African American population and provides insights for nurses to deliver appropriate care.

The History and Stigma of HIV/AIDS in the Black and African American Community

Dr. Alicia Morehead-Gee, medical director of HIV prevention at AltaMed Health Services, emphasizes the role of stigma.

“HIV-related stigma includes viewing the condition as a ‘shameful’ ailment, a ‘gay’ ailment, or a ‘death sentence,'” she notes. “However, these are all misleading and incorrect notions. Anti-LGBTQIA+ stigma continues to intersect with HIV-related stigma in our nation.”

When a health condition becomes stigmatized, individuals often avoid learning whether they have the condition. They may shun testing and disregard symptoms.

Even upon diagnosis, they might resist taking HIV medications due to concerns about confidentiality.

“Because of [the stigma], individuals might forego HIV testing or decline HIV prevention or treatment medications,” Morehead-Gee explains. “This reluctance may arise from a fear of being stigmatized by others for their sexual orientation or HIV status.”

“It’s important to address the stigma-related issues so that we can effectively prevent and treat HIV.”
Discrimination and Barriers to Adequate Care and Prevention

Stigma isn’t the sole barrier faced by Black and African Americans in terms of preventing, diagnosing, or treating HIV/AIDS. Long-standing healthcare inequities, disparities, and discrimination influence attitudes and beliefs concerning HIV/AIDS within the Black and African American community.

A survey conducted in 2016 among Black American adults revealed that nearly one-third (31%) believed that HIV/AIDS was deliberately created, while 40% thought a cure was being withheld, and one out of three (33%) believed that antiretroviral treatment was harmful.

Morehead-Gee points out, “Limited access to healthcare results in fewer opportunities for HIV testing, along with reduced awareness and access to HIV prevention and treatment medications. This has significantly contributed to the HIV disparities impacting African Americans.”

Better outcomes for Black and African American patients are observed when they are treated by healthcare providers of the same background. However, only 5.4% of physicians are Black. Cultural competence and enhanced representation in the healthcare field can positively affect patient care.
Addressing Challenges Arising from HIV/AIDS in the Black and African American Community

Professionals in the healthcare sector can address stigmas, discrimination, and restricted care access through various initiatives. Collaborations with community organizations, volunteer work, fundraising, and a commitment to understanding discrimination and dismantling it can all contribute.

Addressing these challenges also necessitates individual efforts, such as:

Cultivating cultural competence in nursing through formal education and informal mentoring by experienced nurses
Recognizing unconscious bias and its repercussions
Advocating for the needs of Black and African American patients and communities
Demonstrating inclusion
Establishing respectful and open communication with patients to foster trust
Grasping the origins of stigma and addressing them sensitively (This could involve being mindful of how trauma can impact interactions and encouraging patients to share their circumstances, needs, and history. Avoid presenting information in a manner that might come across as lecturing or judgmental, as this could inadvertently reinforce stigma and erode patient trust.)

Efforts to Reduce Stigma

Healthcare and public health systems have launched campaigns to educate Black and African American communities about HIV and how to prevent or treat it. These campaigns utilize billboards, printed public service announcements, and social media.

Community outreach conducted within churches, barbershops, beauty salons, or other spaces perceived as safe by Black and African Americans can help diminish stigma. These trusted community settings can serve as a promising avenue for reliable education about HIV, blood pressure, and other health matters.

“Expanding outreach in these settings, as well as in schools and other community events, can help decrease HIV stigma and enhance knowledge about HIV prevention and treatment,” according to Morehead-Gee.

As trusted professionals, nurses can provide both formal and informal education about HIV/AIDS, and they can advocate for LGBTQ+ equality to combat stigma. Nurses can also exemplify respect for individuals identifying as LGBTQ+ or those living with HIV or AIDS.

Myths About Seeing a Nurse Practitioner vs. a Doctor

Eliminating Barriers to Healthcare and Prevention

Educational efforts alone are insufficient in addressing HIV/AIDS disparities among Black and African Americans. Morehead-Gee underscores, “More can be done to enhance healthcare access in African American communities by establishing more primary care and specialty care clinics to deliver these services.”

Alongside improving healthcare accessibility, providers can promote annual health check-ups that encompass routine HIV/AIDS testing. They can also simplify the scheduling and access of such examinations.

Nurses can further champion public policy measures to heighten healthcare access and diminish patient out-of-pocket expenses.

Providers can additionally bolster trust in healthcare by exhibiting respect and commitment to minimizing healthcare disparities. This might entail expanding staff diversity, forging partnerships with trustworthy organizations, and educating legislators, funders, and the public regarding the access gaps in their communities and the steps to address them.

Actions Nurses Can Take to Mitigate Challenges in Healthcare, Education, and Prevention

Nurses can encourage patients to undergo yearly check-ups and identify barriers like transportation limitations or the necessity for care outside regular working hours. They can advocate within their organizations to address these barriers.

Further actions nurses can pursue encompass mentoring Black and African American nurses and encouraging more individuals from these backgrounds to pursue nursing.

Morehead-Gee’s counsel to nurses:

[We must] acknowledge the impact of historical oppression and inequity on the current HIV landscape. The prevailing HIV disparities aren’t a result of divergent behaviors or practices among African Americans; rather, they stem from longstanding discriminatory practices against African Americans in education, employment, housing, and healthcare access. Therefore, we have a significant task ahead of us in combating these inequities, alongside the stigma influencing people’s perceptions of HIV.

We must strive to create a welcoming, inclusive environment for people to learn about HIV, get tested, and access appropriate prevention or treatment medications. Through these endeavors, we can address the disparities and bring an end to the HIV epidemic.

Caring for Patients Impacted by HIV/AIDS: FAQ

How does HIV impact patient care?

In the event that HIV advances to AIDS, it heightens a patient’s susceptibility to other infections. Nurses should treat these patients with the same precautions taken for other immunocompromised individuals. They should uphold hygiene standards and ensure vaccinations and boosters are up to date.

HIV patients, similar to others with significant chronic conditions, might require additional support for their mental and emotional well-being.
What kind of medical care is necessary for HIV?

Patients with HIV undergo antiretroviral treatments that lower the virus count in their bloodstream.

Especially when treated early, individuals with HIV can lead lives comparable to what they had envisioned prior to

their positive diagnosis. This underscores the critical importance of early diagnosis and treatment for HIV. Such early intervention can also decrease the risk of transmitting HIV to others.
What are the risks for HIV patients?

HIV patients are at risk of progressing to AIDS, which weakens their immune systems and heightens their vulnerability to illnesses. Among the most prevalent infections in individuals with HIV are pneumonia, certain cancer types, hepatitis, shingles, and fungal infections like thrush.
What precautions should nursing assistants adopt while caring for residents with HIV/AIDS?

Nursing assistants providing care to residents with HIV/AIDS should adhere to the same precautions used for any other bloodborne pathogens. Gloves should be worn when coming into contact with blood, whether directly or in feces or vomit.

Nurses should also take all feasible measures to prevent exposing residents to other infections by regularly and thoroughly washing their hands, staying current with vaccinations and boosters, and using masks as appropriate.

Resources for Nurses and Healthcare Providers

Numerous resources are available for nurses seeking to address HIV/AIDS stigma in the Black and African American community and to alleviate barriers to prevention and treatment.
HIV.gov serves as the national hub for information on HIV and AIDS. Nurse resources include news updates, educational programs, data, and insights into awareness days like National Black HIV/AIDS Awareness Day. The American Nurses Association’s position statement on HIV and related conditions offers guidance on treatment and prevention. It also outlines action points for governments and other entities. The foundation provides an extensive fact sheet on Black Americans and HIV/AIDS. The AETC, a component of the Rutgers School of Nursing, presents an array of training materials related to HIV/AIDS and African Americans

Resources for African Americans Impacted by HIV/AIDS

If you or someone you care about is affected by HIV/AIDS or if you’re looking to deepen your understanding, these resources can be invaluable.
Held annually on February 7, this event offers an event planning guide, a social media toolkit, and facts about HIV/AIDS in the African American community. This website imparts information to both community members and healthcare professionals about HIV/AIDS and its impact on African Americans. This CDC page provides resources for accessing and financing care, finding housing, seeking legal assistance, and more. The Black AIDS Institute offers resources and a directory of organizations working to combat stigma and prevent HIV/AIDS in Black and African American communities. HIV/AIDS impacts mental and physical health. NAMI provides resources tailored to Black and African American individuals for locating culturally competent care.