Black Men and HIV, Research Paper Example

Introduction

The AIDS (Acquired Immunodeficiency Syndrome) pandemic is the greatest battle that American has had to fight. Across the world, more than 33 million people have been infected with the virus HIV (Human Immunodeficiency Virus). In 2008, twenty million people died from ailments related to the virus (Fauci, 2008). HIV/AIDS is a disease that has disrupted the lives of millions both directly and indirectly. Consequently, millions are living in fear of what they future may hold for them and their families. This disease causes many debilitating effects on its victims. Often, persons suffering from the virus are unable maintain employment. Mental despair is an understatement when considering the mounting medical debts they will acquire while trying to fight the disease. Unfortunately, many victims die from the disease leaving behind small children who are afraid and alone. Society places such a social stigma on HIV victims and their children that the children are often orphaned. The children are often isolated from other members of society; often even relatives abandon them. The virus can be transmitted several ways: sexual intercourse, blood transfusions, from mother to child, or sharing needles can pass the disease on to the next person. Most that contract the virus are just not knowledgeable about the disease; they just do not understand how the disease is spread. People from poverty situations, those with limited education, and no health care coverage make up the greatest percentage of people living with the disease. According to the Center for Disease and Control Prevention there is an estimated 1,148,200 people aged 13 years and older living with the disease in the United States. This number includes 207, 600 people who unknowingly infected. The United States reported it first known case of AIDS in 1981. Early on, many believed that the virus would only affect the gay community or that it was a disease that only gays could contract. Research proved that this disease is not limited to any one group or community; anyone is vulnerable. Because this disease is so devastating and prominent among black males, much research has been completed to understand why incidence of the virus is so prevalent among this group.

Review of Literature

The incidence of HIV in heterosexual Black men has been rising at an increasingly high number. Researchers are trying to determine if behavioral factors influence their HIV risk. A study was conducted to determine if low, medium, or high HIV category risks could be established within the group. One link they found in the group was spirituality. Members of the African American groups that identified with spiritual denominations were less likely to participate in high risk behaviors (O’Sullivan, et al, 2010   ). Those high risk behaviors included: non-use of condoms, multiple sexual partners, and not being tested for the disease. Consequently, it is believed that implementing spirituality may be a means of lowering risky behaviors among the group. Accordingly, a study was conducted that concluded:

“HIV/AIDS is currently the leading cause of death for African American men ages 25-34. As heterosexual behavior is the major mode of HIV transmission among this population, it is important to further understand the factors which may influence risky sexual behaviors and promote HIV testing behaviors. The target population for this study represents the convergence of two groups disproportionately at-risk for contracting HIV: African American men and college students. Specifically, the purpose of the study was to investigate HIV knowledge among young African American male students attending community college and its relationship to self-reported HIV testing behavior and condom use…”( O’Sullivan, et al, 2010)

Many equate this risky behavior with the age factor. Often young people feel invincible.

Not much research has been committed to the study of HIV and other STD testing among African American men who are heterosexual. The characteristics of heterosexual men are very different from those of gay men. A study was conducted on African American men between the ages of 18-44 to determine how this group felt about HIV testing, how they decided when, where, and how often to be tested, and how often they visited a primary doctor. The results concluded that about 74 percent of these men were tested for HIV during their lifetime and about 31 percent had been tested as recently as the previous year (Haile, Chambers, & Garrison, 2007   ). The study also found that black men between the ages of 25-34 who were widowed or divorced, lived by themselves, had higher incomes, and received annual check-ups were more likely to be HIV tested.

Sadly, African American men are more likely to have inadequate education, higher rates of unemployment, and jobs that pay less than members from other ethnic groups. These factors lead to numerous barriers to health care. Consequently, members of this group do not receive preventive care and appropriate care after a diagnosis of HIV. Black men who are uninsured were nearly ten times as likely to go to the emergency room for their usual mode of care as having a primary physician (Haile, Chambers, & Garrison, 2007). Black men were more likely than black women to not have health insurance. “African Americans represent over 19% of those without healthinsurance coverage, totaling over 7 million peopleuninsured African Americans, 3 million people, are working-age males .Thus, a considerable proportion of African American males 18 – 64 years old, 29%, do not have health insurance coverage. The statistic is greatly above the national average (20%) and over twice that of White men in the same age group (13%)” (Haile, Chambers, & Garrison, 2007).

A study was conducted in California from 1995- 2003 on how vaccines are tested and used. Vaccines must go through three phases of testing before they can be used on humans. Phase I can last duration of 18 months, but the final phase can last as long as 4 years. Volunteers help researchers adjust dosing in phase I by agreeing to test the effectiveness of the drug. During phase II, hundreds of volunteers test the drug and doctors record its effectiveness and possible side effects.  The final phase may involve thousands of volunteers who continue to test and record side effects. Researchers normally have an equal number of volunteers who are both positive and negative for the virus to get results of how the medication affects the body. Scientists are trying to determine if certain drugs will delay the progression of the virus or if certain lifestyles may affect the progression of the disease.  The international HIV Vaccine Initiative reported that in March 2013, there were three vaccines being tested in phase II, one phase I/II, and thirty-four in Phase I. The first vaccine to undergo phase III trials was called AIDSVAX. These trials ran from 1998-1999. Two studies were conducted on the effectiveness of this vaccine. There study consisted of 5400 participants, which consisted of gay and IV drug users. At the end of the study, the drug did not prove beneficial in fighting the disease (Blower, Schwartz, et al., 2003).

Social Actions

The stigma that society places on HIV infected person is just one form of discrimination that victims to the virus face. Researchers say that these stigmas only add to social inequalities that African American are already faced with. These stigmas can actually lead to the lack of some interventions and treatments. About 35 percent of black men who were infected with HIV revealed that they had experienced some degree of discrimination about their sexual behaviors. Many were assumed to be homosexual, prostitutes, or drug users (Fauci, 2008). Society needs to be educated on how the disease is transmitted and these programs must ensure confidentiality.

Intervention

Several studies have been conducted to address the effectiveness of intervention programs in African American communities. Cultural and health views seem to have a prolific affect on the behaviors of African Americans. One noted change that positively affected and improved the prevalence of African American men been tested was educational level (Burton, Desrosiers, et al., 2004). There seemed to be a link between social and health perception among African Americans in this community. Many believe that the environment that black men live in directly affect their behaviors.

DNA Vaccines

DNA vaccines are small portions of DNA that contain genes from HIV which are grown in bacteria. Using purified plasmid DNA as a vaccination includes injecting the plasmid into the subjects in hopes of eliciting an immune response from the subject. These DNA vaccines are intended to boost the immune system of the person with HIV in efforts to fight off the diseased HIV/AIDS cells. Fauci says,” Our immune system has an impressive arsenal at its disposal designed to keep the various bacteria, viruses and other pathogens in our environment at bay. Because there are fundamental differences between our chemistry and that of bacteria and viruses, we have successfully evolved immune mechanisms that recognize and exploit these differences to identify and eliminate such foreign invaders” (Fauci, 2008).  This type of vaccine is one of the safest methods with limited side effects. Following the DNA immunization, viral antigens mimic antigen during a natural infection.  Scientists are using several strategies to modulate response to DNA vaccines.

Therapeutic Approach Showing Promise

In 2013, scientist reported that an experimental therapeutic vaccine temporarily lowered the level of HIV in the blood of infected persons. The Vacc-4x used modified antigen-presenting dendritic cells that lowered the viral blood count in victims for several months. Although the effect did not continue, it gave scientist hope that the concept would work. A vaccine of this type could eventually lead to a functional cure by controlling HIV replication without the use of antiretroviral drugs. Normal vaccines are designed to prevent the HIV infection, but to date none have worked. In contrast, therapeutic vaccines are intended to treat people infected with the virus by boosting the immune system. “In around 80% of patients receiving treatment, the virus was suppressed and CD4⁺ levels were maintained two years after therapy began” (Fauci, 2008). Studies have shown that therapeutic strategies in conjunction with antiviral drugs have been shown to slow the progression of AIDS. Yet, there are still problems with viral drug resistance and toxicity “because there are fundamental differences between our chemistry and that of bacteria and viruses, we have successfully evolved immune mechanisms that recognize and exploit these differences to identify and eliminate such foreign invaders” (Burton, Desrosiers, et al., 2004).

Conclusion

HIV is a chronic disorder that can have devastating effects, but it is preventable. Proper knowledge and precautions are imperative to eradicating the disease. African Americans are particularly prone to the disease because of the many barriers they face. In recent years there has been a great increase in the prevalence of the disease in African American men who are heterosexual. In order to eradicate this disease, families, communities, and cultures must share information and assist each other in the battle to longer, healthy lives. Many successes have been made in the fight to find a cure for the HIV/AIDS pandemic. To date, about forty vaccines are currently being tested in hopes of curing or slowing the progression of the disease. Therapeutic methods seem to have the most promising research data.  Although the prevalence is high in Blacks, HIV/AIDS is not a discriminatory disease. Anyone from any ethnic or racial background can be affected. Therefore, efforts must be made to inform the people about this disease, how it is transmitted, and how one can protect himself from contracting it.

References

Blower, S., E. J. Schwartz, et al. (2003). Forecasting the future of HIV epidemics: the Impact of antiretroviral therapies & imperfect vaccines. AIDS Rev 5(2): 113-25.

Burton, D. R., R. C. Desrosiers, et al. (2004). HIV vaccine design and the neutralizing antibody problem.Nat Immunol 5(3): 233-6

Fauci, A., (2008).  25 Years of HIV. Nature 453(1): 289-90.

O’Sullivan LF, Udell W, Montrose VA, Antoniello P, Hoffman S (2010)A cognitive analysis of college students’ explanations for engaging in unprotected sexual intercourse. Arch Sex Behav 39: 1121-1131.

Haile BJ, ChambersJW, Garrison J L (2007) Correlated of HIV knowledge and testing: Results of a 2003 South African survey. Journal of  Black Studies 38: 194-208.