Transmission of HIV/AIDS among African American intravenous drug users: implication for public health policy.

Abstract: According to recent research, Baltimore City has one of the highest HIV/AIDS (Human Immunodeficiency Virus), (Acquired Immunodeficiency Syndrome) infection rates in the state of Maryland. Intravenous drug use (IDU) in persons who are infected with HIV, is identified as the critical link to the spread of this disease in Baltimore. Substance abuse programs are insufficient to aid the cit\ in helping to fight the warfare on HIV/AIDS. The City Council, citizens and community based organizations must play a non-judgmental role in obtaining legislation to address the issues. Adequate substance abuse programs will greatly enhance educational and prevention strategies among African Americans who are already disproportionately affected by HIV/AIDS and IDU. Efficient, effective, equal, legal, political acceptance, and improvement would be included in the criteria of policy options. Key Words: HIV/AIDS, Intravenous Drug Use, Health Policy, African Americans, The Maryland HIV/AIDS Epidemiological Profile (2002) has published that intravenous drug user (IDU) accounts for approximately 80% of all new HIV cases reported in the state. According to the Maryland Taskforce (2000), it is unclear as to whether there are sufficient substance abuse treatment programs available in Baltimore City. It follows, therefore, that if there are not sufficient treatment programs, the city will be unable to effectively treat intravenous drug users, whose sexual behavior is associated with the transmission of HIV. While Caucasians account for only for 7.2% of all cases of HIV/AIDS in Baltimore City, African Americans make up a large part of the underserved group of people who are also disproportionately reported as using illegal intravenous drugs and being HIV positive. A recent report indicates that among new HIV cases through 2002, 89% were among African Americans, while only 9.6% were among Whites. The Kaiser Family Foundation State Facts Online (2001), reports alarming data that African Americans represent only 28% of the Maryland State population, however, 137 African American males compared to 18 Caucasian males are intravenous drug users (IDUers). The data also show that 50 African American females use intravenous drugs as compared to 15 Caucasian females. As reported by the Maryland HIV/AIDS Epidemiological Profile (2002), intravenous drug use is an epidemic in the northeast and southeast corridors of the United States, where many underserved African Americans reside. This group of people is often victimized and subject to isolation and social injustice, and are vulnerable to the HIV infection because of unhealthy sexual behaviors. Over the last two decades, intravenous drug use has been documented as being associated with the direct spread of HIV infection among users with heroin being noted as the drug of choice. If sufficient substance abuse programs were available, perhaps IDUers would seek treatment. On global and national levels, the sharing of needles is the link of infecting many people with the HIV virus, making the users unaware of their HIV status (Fenando et al., 2003); Tyndall et al., 2003; Eicher et al., 2000; and Wodak, 2000). As a serious public health threat, unprotected sex is attributed to HIV infection in partners of IDUers. A Mortality Morbidity Weekly Report (2003), made public the results of a six-year study which includes 25 states regarding an HIV diagnosis among IDUers. The Centers for Disease Control and Prevention (CDC) published that 25% of the cases were related to intravenous drug use, and partners of these users make up approximately 30% of persons infected with HIV. Similar studies revealed similar findings that reported cases of HIV diagnoses attributed to intravenous drug use are on the rise (Norden & Lidman, 2003). Other studies that have documented unhealthy sexual behavior associated with intravenous drug use include those of Miller et al., 2002; Drucker, 1995; Booth & Watters, 1994; Des Jarlais et al. …