Deeper Look: Health Disparities and HIV

The Centers for Disease Control and Prevention (CDC) defines health disparities as “differences in the incidence, prevalence, and mortality of a disease and the related adverse health conditions that exist among specific population groups. These groups may be characterized by gender, age, race or ethnicity, education, income, social class, disability, geographic location, or sexual orientation.” Addressing disparities in health is important to increase the health outcomes of the broad population, reduce health care costs, and achieve equity (KFF).

If we are going to end the HIV epidemic in the U.S., it is essential to understand why HIV has a disproportionate impact on certain groups over others and the wide array of factors that drive the disparities we see at the local-, state-, and national-level.

To help users better understand the association between HIV and social determinants of health (SDOH), AIDSVu provides interactive maps of SDOH indicators that can be viewed alongside maps of HIV prevalence, new diagnoses, HIV mortality, the HIV Care Continuum, and PrEP utilization. These indicators include:

• Food insecurity (cumulative 2016 to 2019)
• High School Education (2019)
• Housing (2019)
• Income Inequality (2019)
• Median Household Income (2019)
• Medicaid expansion (as of October 2021)
• People Without Health Insurance (2019)
• Poverty (2019)
• Unemployment (2019)

AIDSVu also displays maps of infectious diseases that are closely associated with HIV, including:

• Hepatitis C prevalence (cumulative 2013 to 2016)
• Primary and secondary syphilis prevalence (2019)

HIV-Related Health Disparities Among Racial and Ethnic Minorities

HIV-related health disparities are significant among racial and ethnic minorities. Black Americans represented 42% of all new HIV diagnoses but only 13% of the population in 2019. Not only are Black Americans disproportionately impacted by HIV, but they also experience SDOH that often lead to poorer health outcomes. This is the case with other racial and ethnic minorities as well, including Hispanic/Latinx individuals. In 2019, Hispanic/Latinx people represented 16% of the U.S. population but comprised 29% of those newly diagnosed with HIV.

Language barriers and cultural practices can also pose barriers to accessing HIV education and care. In some cultures, such as in East Asian cultures, it is a taboo to discuss illness—especially when related to sex. Cultural beliefs can contribute to stigmatized beliefs about HIV, fewer instances of seeking essential HIV medical care, significant underreporting of HIV cases, and inequitable intervention resource allocations (CDC). Additionally, concern for immigration status can place pressure on racial/ethnic minorities to avoid health services because they fear the impact that an HIV diagnosis can have on their residential security in the U.S. (CDC).