AIDS is the Primary Killer of African-Americans Ages – NOT

By Chris Jennings

Recently, a web page of National Public Radio stated “AIDS is the primary killer of African-Americans ages 19 to 44 [years of age] . . . .”

This misconception is evidently a common one.   For example, Peter Piot, Executive Director of UNAIDS, stated “AIDS remains the leading cause of death in African-American women in the USA” in the article AIDS: Lessons Learnt and Myths Dispelled, published in the scientific journal The Lancet on July 18, 2009.

Neither statement is accurate.  Although, it is no secret that the black Americans (African-Americans), as a group, embody a disproportionately high prevalence of specific medical and societal ills, HIV/AIDS among them.  However, HIV/AIDS is not the principal killer of black Americans of any age group, male or female.

The table below presents the rank of HIV/AIDS among the Top Ten Killers of African-Americans by age group.  The table also lists the actual #1 Cause of Death in each age group.

AIDS Deaths among Blacks in the United States, 2008

All Blacks, Both Sexes

	HIV Disease (AIDS)			#1 Cause of Death
Age Range	Rank	Deaths	% Total	Cause	Deaths	% Total
15 – 19 years	8	22	0.8 %	Homicide	1231	43.1 %
20 – 24 years	6	93	2.1 %	Homicide	1802	41.3 %
25 – 34 years	4	613	6.6 %	Homicide	2471	26.7 %
35 – 44 years	4	1564	9.9 %	Heart Disease	2894	18.3 %
45 – 54 years	4	2048	5.7 %	Cancer	8745	24.3 %

For each age group, the table lists the Rank of HIV/AIDS among the Top Ten Killers of African-Americans.  It also lists the number of deaths caused by HIV/AIDS, and the percent of these HIV/AIDS deaths among all deaths for this age group.  For example, in the 15 – 19 years age bracket, HIV/AIDS was the 8th leading cause of death; 22 people died of HIV/AIDS, and these 22 people represented 0.8% of all deaths among this age bracket.

The same data is presented for the #1 Cause of death for each age bracket.

Regarding Piot’s comment that “AIDS remains the leading cause of death in African-American women in the USA,” HIV/AIDS is not among the Top Ten Killers of for black American women for all ages combined.  However, HIV/AIDS does rank among the Top Ten Killers within certain age brackets, as follows:

AIDS Deaths among Black Females in the United States, 2008

	HIV Disease (AIDS)			#1 Killer in Age Group
Age Range	Rank	Deaths	% Total	Cause	Deaths	% Total
15 – 19 years	9	15	2.2 %	Accidents	171	25.1%
20 – 24 years	6	40	3.9%	Accidents	218	21.3%
25 – 34 years	4	273	9.4%	Heart Disease	414	14.3%
35 – 44 years	3	620	9.4%	Cancer	1440	21.9%
45 – 54 years	5	648	4.2%	Cancer	4418	28.9%

As exemplified by the recent PBS documentary ENDGAME:  AIDS in Black America as well as the recent press coverage from the 2012 International AIDS Conference in Washington, D.C., the story of AIDS among black Americans has reached the value of mainstream media.  (Although back in 2006, ABC News featured the program, Out of Control: AIDS in Black America, so it is not really news.)  According to the latest figures, more black Americans contract HIV infection and die of HIV disease than white Americans.

Yet, typically, the story behind why AIDS persists in the black community (and other communities) is never addressed.  It’s simply not a sound-bite issue.

The high prevalence of HIV infection in the black community is largely due to IV drug use.  (Therefore, as a short-term partial solution, the issue of making clean hypodermic needles available is a vital issue.)  A large proportion of the black (and Latino) females with HIV/AIDS were the sexual partners of black (and Latino) IV drug users.  Overall, heterosexual HIV transmission dwells in the realm of long-term sexual partnerships:  not in the world of one-night stands (although it can and probably has happened).

The story of blood-borne diseases, such as HIV infection and Hepatitis B virus infection, is written in the ills of society.  These two blood-borne diseases share the same transmission vectors and the same high-risk groups.  The Hepatitis B epidemic of the 1970s was a model for the HIV/AIDS epidemic that emerged in the 1980s.

IV drug use is major transmission vector for blood-borne diseases.  A vector historically linked with specific socio-economic issues; notably, joblessness, and the consequent despair and hopelessness.  Other factors likely thrown into the mix are personal histories of physical, emotional, and/or sexual abuse.  The danger of opiates is that they are effective:  they effectively kill both physical and emotional pain.

Black gay men are also, reportedly, now at high risk of contracting HIV infection; reportedly carrying a higher risk of HIV infection than white gay men.  Yet, in truth, the risk persists for specific sub-groups of gay men overall, irregardless of racial flavor.  AIDS prevention is relatively simple.  So why do gay men continue to contract HIV infection?   The risks are known.  Why do junkies (to use the colloquial term) continue to share needles?   The risks are known.  Why do teenagers still start smoking?  The risks are known.

Ultimately, the answer is that oppressed peoples engage in what are termed adverse health behaviors.  Teenagers engage smoking because of emotional insecurity.  Junkies shoot heroin as a short-term solution to overbearing emotional pain.

Gays?  They are an oppressed people.  Yes, there have been a number of hard-fought, hard-won advances in gay rights over the past several decades, seemingly culminating in the advent of gay marriage in a number of U.S. states.  But, during the same time period, the United States has undergone tremendous social polarization.  Opposing the advancement in gay rights has been a growth in malevolent and venomous vitriol — a growing willingness to vocalize proclamations that, in previous years, had been restrained by a simple sense of shame and social decency.

Moreover, gay bashing (assault), murders, and discrimination in housing and employment persist.  Fear and oppression by any other name.  In part, the effects of this oppression are acted out in the risk-taking behavior of gay men.  After the devastation of the 1980s HIV/AIDS epidemic, the annual rates of new HIV infections dropped off significantly for 20 years, but in some gay communities, infections rates have been on the rise again over the last 10 years.  As stated by a gay colleague, at a certain age-break, the young gay men almost seem to embrace HIV infection.  (He also expressed the belief that the high prevalence of sado-masochistic sex among gay men is another manifestation of self-hate.) ]

To repeat, the story of blood-borne diseases – as with many other conditions consequent to adverse health behaviors — is written in the fabric of society.  The answer to HIV/AIDS does not lay in money, science, more effective drugs, or a vaccine.  Behind Hepatitis B and HIV lay some other blood-borne agent waiting to emerge.  To end the era of blood-borne diseases in the Western world, the mandate is the creation of a society enabling the formation of familial, educational, and societal structures (including economic justice!) that grant emotional inoculation against the incidence and consequence of hate, insecurity, despair, and abuse.

The way lies forward.

(Source:  Deaths: Leading Causes for 2008 (National Vital Statistics Reports, Vol. 60, No. 6, June 6, 2012) by Melonie Heron, Ph.D., Division of Vital Statistics:  http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_06.pdf)

Chris Jennings (Harvard, B.A., Biology 1976/77) is a medical writer and author of two recent books that redefine the size, scale, and scope of the HIV/AIDS epidemic:  HIV/AIDS – The Facts and the Fiction & HIV/AIDS in South Africa – The Facts and the Fiction.  Chris Jennings has written and published two prior books on HIV/AIDS adopted as educational texts by world-renowned hospitals; federal, state, and municipal health agencies; and nursing schools, public health schools, and universities.  In addition to conducting investigative research of the scientific and medical literature, Chris Jennings provides writing services to the pharmaceutical, medical, and diagnostic industries.

For more infection, visit Health Alert Communications at:  www.healthalert.net.

Copyright © by Chris Jennings 2012