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HIV Infection in Minority Populations
Overview
The face of AIDS in the United States is changing. Minorities, primarily African Americans and Hispanics, now constitute 57 percent of the more than 600,000 cases of AIDS reported since the epidemic began in 1981.
According to the Centers for Disease Control and Prevention:
- In 1998, African Americans and Hispanics represented 56 percent of AIDS cases reported among men and 78 percent of those in women. Forty-five percent of reported cases were among African Americans, 20 percent among Hispanics.
- In 1998, the rate of new AIDS cases reported per 100,000 population was 28.1 among Hispanics, 6.4 among African Americans, 7.4 among American Indians/Alaska Natives, and 3.8 among Asians/Pacific Islanders. The rate for African Americans is more than eight times higher than for whites (8.2).
- African Americans make up almost 37 percent of all AIDS cases reported in the United States, yet they comprise only 12 percent of the U.S. population.
- Including residents of Puerto Rico, Hispanics represent 13 percent of the population in this country. In 1998, Hispanics represented 20 percent of new AIDS cases.
- Almost 62 percent of all women reported with AIDS are African American.
- African American children represent 62 percent of all pediatric AIDS cases.
- In 1998, Hispanic women represented 19 percent of reported AIDS cases in women.
- In 1998, 254 of 309 (82 percent)pediatric AIDS cases were in African Americans and Hispanics.
- In 1997, most of the deaths due to AIDS were in African Americans at 47.6 percent. Hispanics accounted for 18.6 percent.
- Injection drug use (IDU) is a major factor in the spread of HIV in minority communities. In 1998, injection drug users accounted for 36 percent of all AIDS cases among both African Americans and Hispanics.
NIAID
The National Institute of Allergy and Infectious Diseases (NIAID), the lead component for AIDS research at the National Institutes of Health (NIH), is at the forefront of the war against this continuing health crisis, which disproportionately affects minority populations.
NIAID supports investigations and scientific studies at universities, medical schools, hospitals and research institutions, both in the United States and abroad, aimed at preventing, diagnosing, and treating such infectious diseases as AIDS and tuberculosis, as well as allergies and asthma.
NIAID's AIDS research agenda includes conducting clinical trials that address the specific needs and concerns of minority groups, ensuring that minority patients have access to all clinical trials and communicating AIDS research findings to these communities. In addition, NIAID's Office of Special Populations Research and Training encourages research aimed at improving the health of minority populations. The office also works to increase the effectiveness of outreach and education programs.
Through its Office of Communications and Public Liaison, NIAID works with community-based organizations to disseminate information about AIDS and NIAID research activities to minority communities. AIDS information is available in Spanish and in low-literacy formats.
AIDS Clinical Trials
NIAID programs evaluate promising therapies to fight HIV infection, prevent and treat the opportunistic infections and cancers associated with AIDS, and reconstitute HIV-damaged immune systems.
The programs are the Adult and Pediatric AIDS Clinical Trials Group (AACTG/PACTG), the Terry Beirn Community Programs for Clinical Research on AIDS (CPCRA), the Acute Infection and Early Disease Research Network, and the Division of Intramural Research Clinical Program. In the near future, the HIV Prevention Trials Network will be formed. Together, these programs represent the largest AIDS therapy initiative in the United States. Recruiting minorities into clinical trials is a priority for NIAID to ensure that research results will apply to all populations affected by HIV. With the epidemic moving swiftly into minority communities, inclusion of these patients is particularly urgent.
AACTG sites receive additional funding from the National Institute on Drug Abuse to recruit injection drug users, who are also hard hit by the AIDS epidemic.
During 1999, 12,438 people were enrolled in studies in the AACTG/PACTG -- 38.4 percent were African American, 19.3 percent were Hispanic, and 1.7 percent were Asian/Pacific Islander and Native American.
Established in 1989, the CPCRA supports clinical research in community settings such as health centers and clinics. CPCRA studies examine how to use available therapies more effectively as well as the long-term consequences of different treatments.
Currently, CPCRA trials are under way in 17 cities at 18 units. In 1999, 2,755 patients participated in CPCRA studies. Of these, 39.6 percent were African American, 12.3 percent were Hispanic and 1 percent were Asian/Pacific Islander and Native American.
NIAID is testing several candidate AIDS vaccines. The HIV Vaccine Trials Network will soon coordinate these clinical studies.
NIAID supports two major programs to enhance basic and clinical HIV research performed at minority institutions: Research Centers in Minority Institutions and AIDS Clinical Trials Infrastructures in Minority Institutions.
Epidemiologic Research
NIAID studies explore the nature of HIV transmission and infection in a variety of population groups, including minority populations. Inner-city women, children and injection drug users are the focus of the Women and Infants Transmission Study (WITS/WITS II). Eighty-six percent of the women are from minority populations.
Similar populations of women are the focus of the Women's Interagency HIV Study (WIHS), which NIAID established and awarded funds to six U.S. sites in 1993 to primarily investigate the impact of HIV infection on women. Several other NIH institutes also collaborate on the WIHS and provide funds for various components, e.g., National Cancer Institute, National Institute of Child Health and Human Development, National Institute on Drug Abuse, and National Institute of Dental and Craniofacial Research. Studies of HIV/AIDS in women provide a unique opportunity to test biological and psychosocial hypotheses, and can link basic science findings and laboratory techniques to characterizing epidemiologically well-defined populations. Active community involvement through the WIHS sites and the WIHS National Community Advisory Board (NCAB) eases participation and comprehensive understanding of the research scope and results. More than 80 percent of the women currently enrolled in WIHS are from minority populations.
Resources
For information about Food and Drug Administration-approved HIV-related clinical trials being conducted throughout the United States, call the AIDS Clinical Trials Information Service:
1-800-TRIALS-A
(1-800-874-2572)
1-800-243-7012 (TDD/Deaf Access)
For federally approved treatment guidelines on HIV/AIDS, call the HIV/AIDS Treatment Information Service:
1-800-HIV-0440
(1-800-448-0440)
1-800-243-7012 (TDD/Deaf Access)
Both services operate from 9 a.m. to 7 p.m. Eastern Time, Monday through Friday. Spanish-speaking specialists are available.
To obtain information specifically about clinical trials conducted by the NIAID Intramural AIDS Research Program, call 1-800-243-7644.
To obtain materials for adolescents with HIV, or more information about adolescents and HIV, contact the National Prevention Information Network at 1-800-458-5231 or 1-800-243-7012 (TDD/Deaf Access).
NIAID, a
component of the National Institutes of
Health, supports research on AIDS,
tuberculosis and other infectious diseases as
well as allergies and immunology.
Prepared by:
Office of Communications and Public Liaison
National Institute of Allergy and Infectious
Diseases
National Institutes of Health
Bethesda, MD 20892
Public Health
Service
U.S. Department of Health and Human Services
May 2000
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