CDC H IV/A IDS Fact Sheet

HIV/AIDS among

African Americans 1-800-CDC-INFO (232-4636)

In English, en Español

24 Hours/Day

cdcinfo@cdc.gov

http://www.cdc.gov/hiv 

February 2006

In the United States, the HIV/AIDS epidemic is 

a health crisis for African Americans. In 2002, 

HIV/AIDS was among the top 3 causes of death 

for African American men aged 25–54 years 

and among the top 4 causes of death for African 

American women aged 25–54 years. It was the 

number 1 cause of death for African American 

women aged 25–34 years [1].

STATISTICS

HIV/AIDS in 2004

According to the 2000 census, African 

Americans make up 12.3% of the US 

population. However, African Americans 

accounted for 19,206 (50%) of the estimated 

38,730 new HIV/AIDS diagnoses in the 

United States in the 35 areas with long-term, 

confidential name-based HIV reporting [2] 

(see box before the References section for list 

of states and areas).

During 2001–2004, the rate of HIV/AIDS 

diagnoses for African Americans decreased, 

although the rate for African Americans was 

still the highest rate for all racial and ethnic 

groups [3].

The primary mode of HIV transmission among 

African American men was sexual contact with 

other men, followed by heterosexual contact 

and injection drug use [2].

The primary mode of HIV transmission among 

African American women was heterosexual 

contact, followed by injection drug use [2].

Of the estimated 145 infants perinatally 

infected with HIV, 105 (73%) were African 

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American (CDC, HIV/AIDS Reporting 

System, unpublished data, June 2005).

Of the estimated 18,849 people under the age 

of 25 whose diagnosis of HIV/AIDS was 

made during 2001–2004 in the 33 states with 

HIV reporting, 11,554 (61%) were African 

American [4].

Of the estimated 80,187 African Americans 

whose diagnosis of HIV/AIDS was made 

during 2001–2004 in the 33 states with HIV 

reporting, 49,704 (62%) were males, and 

30,483 (38%) were females [4].

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Race/ethnicity of adults and adolescents 

with HIV/AIDS diagnosed during 2004

Note. Based on data from 35 areas with long-term, 

confidential name-based HIV reporting.


H IV/A IDS among Afr ican amer icans

AIDS in 2004

African Americans accounted for 20,965 

(49%) of the 42,514 estimated AIDS cases 

diagnosed in the United States (including US 

dependencies, possessions, and associated 

nations) [2].

The rate of AIDS diagnoses for African 

American adults and adolescents was 10 times 

the rate for whites and almost 3 times the rate 

for Hispanics. The rate of AIDS diagnoses 

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for African American women was 23 times 

the rate for white women. The rate of AIDS 

diagnoses for African American men was 8 

times the rate for white men [2].

The 178,233 African Americans living with 

AIDS in the United States accounted for 43% 

of all people in the United States living with 

AIDS [2].

Of the 48 US children (younger than 13 years 

of age) who had a new AIDS diagnosis, 29 

were African American [2].

Since the beginning of the epidemic, African 

Americans have accounted for 379,278 

(40%) of the estimated 944,306 AIDS cases 

diagnosed [2].

From the beginning of the epidemic through 

December 2004, an estimated 201,045 African 

Americans with AIDS died [2].

Of persons whose diagnosis of AIDS had 

been made since 1996, a smaller proportion 

of African Americans (64%) were alive after 

9 years compared with American Indians 

and Alaska Natives (65%), Hispanics (72%), 

whites (74%), and Asians and Pacific Islanders 

(81%) [2].

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Transmission categories for African 

American adults and adolescents with 

HIV/AIDS diagnosed during 2001–2004

Note. Based on data from 33 states with long-term, 

confidential name-based HIV reporting.

Source. CDC. Trends in HIV/AIDS diagnoses—33 states, 

2001–2004. MMWR 2005;54:1149–1153.

Note. Based on data from 35 areas with long-term, 

confidential name-based reporting.

Race/ethnicity of adults and adolescents 

living with HIV/AIDS, 2004
H IV/A IDS among Afr ican amer icans

RISK Factors AND BARRIERS 

TO PREVENTION

Race and ethnicity, by themselves, are not risk 

factors for HIV infection. Even though HIV 

testing rates are higher for African Americans 

than for other racial and ethnic groups [5], African 

Americans are more likely to face challenges 

associated with risk for HIV infection, including 

the following.

Sexual Risk Factors

African American women are most likely to 

be infected with HIV as a result of sex with 

men [2]. They may not be aware of their male 

partners’ possible risks for HIV infection, such as 

unprotected sex with multiple partners, bisexuality, 

or injection drug use [6,7]. In a study of HIVinfected persons, 34% of African American men 

who have sex with men (MSM) reported having 

had sex with women, even though only 6% of 

African American women reported having had sex 

with a bisexual man [8]. 

Lack of Awareness of HIV Serostatus

Not knowing one’s HIV serostatus is risky for 

African American men and their partners. In a 

recent study of MSM in 5 cities participating in 

CDC’s National HIV Behavioral Surveillance, 

46% of the African Americans were HIV-positive, 

compared with 21% of the whites and 17% of 

the Hispanics. The study also showed that of the 

participating MSM who tested positive for HIV, 

64% of the African American men, 18% of the 

Hispanic men, 11% of the white men, and 6% of 

multiracial/other men were unaware of their HIV 

infection [9].

Substance Use

Injection drug use is the second leading cause of 

HIV infection for African American women and 

the third leading cause of HIV infection for African American men [2]. In addition to being at risk 

from sharing needles, casual and chronic substance 

users are more likely to engage in high-risk behaviors, such as unprotected sex, when they are under 

the influence of drugs or alcohol [10]. Drug use 

can also affect treatment success. A recent study of 

HIV-infected women found that women who used 

drugs, compared with women who did not, were 

less likely to take their antiretroviral medicines 

exactly as prescribed [11].

Sexually Transmitted Diseases

The highest rates of sexually transmitted diseases 

(STDs) are those for African Americans. In 2003, 

African Americans were about 19 times as likely 

as whites to have gonorrhea and about 6 times 

as likely to have syphilis [12]. Partly because of 

physical changes caused by STDs, including genital lesions that can serve as an entry point for HIV, 

the presence of certain STDs can increase one’s 

chances of contracting HIV 3- to 5-fold. Similarly, 

a person who has both HIV and certain STDs has a 

greater chance of spreading HIV to others [13].

Note. Based on data from 35 areas with long-term, 

confidential name-based reporting.

Race/ethnicity of adults and adolescents 

living with HIV/AIDS, 2004 (cont.)
H IV/A IDS among Afr ican amer icans

Denial 

Studies show that a significant number of African 

American MSM identify themselves as heterosexual [14,15]. As a result, they may not relate to 

prevention messages crafted for men who identify 

themselves as homosexual. 

Socioeconomic Issues

In 1999, nearly 1 in 4 African Americans were living in poverty [16]. Studies have found an association between higher AIDS incidence and lower 

income [17]. The socioeconomic problems associated with poverty, including limited access to highquality health care and HIV prevention education, 

directly or indirectly increase HIV risk.

Prevention

In the United States, the annual number of new 

HIV infections has decreased from a peak of more 

than 150,000 in the mid-1980s and has stabilized 

since the late 1990s at approximately 40,000. 

Populations of minority races and ethnicities are 

disproportionately affected by the HIV epidemic. 

To reduce further the incidence of HIV, CDC 

announced a new initiative, Advancing HIV 

Prevention (AHP) (http://www.cdc.gov/hiv/

topics/prev_prog/AHP), in 2003. This initiative 

comprises 4 strategies: making HIV testing a 

routine part of medical care, implementing new 

models for diagnosing HIV infections outside 

medical settings, preventing new infections by 

working with HIV-infected persons and their 

partners, and further decreasing perinatal HIV 

transmission.

CDC has also established the African American 

Working Group to focus on the urgent issue of 

HIV/AIDS in African Americans. The working 

group will develop a comprehensive response to 

guide CDC’s efforts to increase and strengthen 

HIV/AIDS prevention and intervention activities 

directed toward African Americans. Already, CDC 

is engaged in a wide range of activities to involve 

community leaders in the African American 

community and to decrease the incidence of HIV/

AIDS in African Americans. For example, CDC

Funds demonstration projects evaluating rapid 

HIV testing in historically black colleges and 

universities

Conducts epidemiologic research focused on 

African Americans, including the following:

Brothers y Hermanos, a study of black and 

Latino MSM conducted in Los Angeles, 

New York, and Philadelphia that aims to 

identify and understand risk-promoting and 

risk-reducing sexual behaviors

Women’s Study, a study of black and 

Hispanic women in the southeastern United 

States that examines relationship, cultural, 

psychosocial, and behavioral factors 

associated with HIV infection

Addresses, through the Minority AIDS 

Initiative (http://www.cdc.gov/programs/hiv09.

htm), the health disparities experienced in the 

communities of minority races and ethnicities 

at high risk for HIV. These funds are used 

to address the high-priority HIV prevention 

needs in such communities, including funding 

community-based organizations (CBOs) 

to provide services to African Americans. 

Examples of the programs that CBOs carry out 

are as follows:

A program in Washington, DC, that 

provides information to, and conducts HIV 

prevention activities for, MSM who do 

not identify themselves as homosexual. 

The activities include a telephone help 

line; an Internet resource; and a program 

in barbershops that includes risk-reduction 

workshops, condom distribution, and the 

training of barbers to be peer educators.

A program in Chicago that provides social 

support to help difficult-to-reach African 

American men reduce high-risk behaviors. 

This program also provides women at high 

risk for HIV with culturally appropriate, 

gender-specific prevention and riskreduction messages.

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H IV/A IDS among Afr ican amer icans

A program in South Carolina that is 

focused on changing the behaviors 

of adolescents to reduce their risk of 

contracting HIV and other STDs.

Creates social marketing campaigns, including 

those focused on HIV testing, perinatal 

HIV transmission, and the reduction of HIV 

transmission to partners 

Creates and disseminates scientifically based 

interventions, including the following:

POL (Popular Opinion Leader), which 

identifies, enlists, and trains key opinion 

leaders to encourage safer sexual norms 

and behaviors within their social networks. 

POL has been adapted for African 

American MSM and shown to be effective.

SISTA (Sisters Informing Sisters About 

Topics on AIDS), a social-skills training 

intervention in which peer facilitators help 

African American women at highest risk 

reduce their HIV sexual risk behaviors.

Many Men, Many Voices (3MV), an STD/

HIV prevention intervention for gay men 

of color that addresses cultural and social 

norms, sexual relationship dynamics, 

and the social influences of racism and 

homophobia.

ADAPT (Adopting and Demonstrating 

the Adaptation of Prevention Techniques), 

which provides funding to agencies to 

adapt and evaluate interventions shown to 

be effective in communities of color.

In addition, CDC provides intramural training 

for researchers of minority races and ethnicities 

through a program called Research Fellowships 

on HIV Prevention in Communities of Color. 

Additionally, recognizing the importance of 

conducting culturally competent research and 

programs, CDC established the extramural 

Minority HIV/AIDS Research Initiative (MARI) 

in 2002 to create partnerships between CDC 

epidemiologists and researchers who are members 

of minority races and ethnicities and who work in 

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communities of color. MARI funds epidemiologic 

and preventive studies of HIV in communities of 

color and encourages the career development of 

young investigators. CDC invests $2 million per 

year in the program and since 2003 has funded 13 

junior investigators at 12 sites across the country 

[18]. 

Understanding HIV and AIDS Data

AIDS surveillance: Through a uniform system, CDC 

receives reports of AIDS cases from all US states and 

territories. Since the beginning of the epidemic, these 

data have been used to monitor trends because they 

are representative of all areas. The data are statistically 

adjusted for reporting delays and for the redistribution 

of cases initially reported without risk factors. As treatment has become more available, trends in new AIDS 

diagnoses no longer accurately represent trends in new 

HIV infections; these data now represent persons who 

are tested late in the course of HIV infection, who have 

limited access to care, or in whom treatment has failed.

HIV surveillance: Monitoring trends in the HIV 

epidemic today requires collecting information on HIV 

cases that have not progressed to AIDS. Areas with confidential name-based HIV infection reporting requirements use the same uniform system for data collection 

on HIV cases as for AIDS cases. A total of 35 areas—

the US Virgin Islands, Guam, and 33 states (Alabama, 

Alaska, Arizona, Arkansas, Colorado, Florida, Idaho, 

Indiana, Iowa, Kansas, Louisiana, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New 

Jersey, New York, New Mexico, North Carolina, North 

Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, 

Wisconsin, and Wyoming)—have collected these data 

for at least 5 years, providing sufficient data to monitor HIV trends and to estimate risk behaviors for HIV 

infection. Recently, 9 additional areas have begun confidential name-based HIV surveillance, and data from 

these areas will be included in coming years.

HIV/AIDS: This term includes persons with a diagnosis of HIV infection (not AIDS), a diagnosis of HIV 

infection and a later diagnosis of AIDS, or concurrent 

diagnoses of HIV infection and AIDS.


H IV/A IDS among Afr ican amer icans

REFERENCES

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CDC. HIV/AIDS Surveillance Report, 2004. Vol. 16. 

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hiv/topics/surveillance/resources/reports/2004report 

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CDC. Trends in HIV/AIDS diagnoses—33 states, 

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CDC. Disparities in new cases of HIV/AIDS among 

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Leigh B, Stall R. Substance use and risky sexual 

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have sex with men—United States, 1989–1998. MMWR

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CDC. HIV/STD risks in young men who have sex with 

men who do not disclose their sexual orientation—six 

US cities, 1994–2000. MMWR 2003;52:81–85.

US Census Bureau. Poverty status of the population 

in 1999 by age, sex, and race and Hispanic origin. 

March 2000. Available at http://www.census.gov/prod/ 

2003pubs/c2kbr-19.pdf. Accessed January 23, 2005.

Diaz T, Chu S, Buehler J, et al. Socioeconomic 

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For more information . . . 

CDC HIV/AIDS

http://www.cdc.gov/hiv

CDC HIV/AIDS resources

CDC-INFO

1-800-232-4636

Information about personal risk and where to 

get an HIV test

CDC National HIV Testing Resources

http://www.hivtest.org

Location of HIV testing sites

CDC National Prevention Information 

Network (NPIN)

1-800-458-5231

http://www.cdcnpin.org

CDC resources, technical assistance, and 

publications

AIDSinfo

1-800-448-0440

http://www.aidsinfo.nih.gov

Resources on HIV/AIDS treatment and 

clinical trials