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doi:10.1093/ije/dyq057Ĭenters for Disease Control and Prevention. HIV transmission risk through anal intercourse: Systematic review, meta-analysis and implications for HIV prevention. HIV-related stigma within communities of gay men: A literature review. Conference on Retroviruses and Opportunistic Infections. doi:10.1016/j.annepidem.2017.02.003Ĭenters for Disease Control and Prevention. Lifetime risk of a diagnosis of HIV infection in the United States. Hess KL, Hu X, Lansky A, Mermin J, Hall HI. Compounding this is the stigmatization of gay black men on both the individual and community level, which further drives at-risk individuals away from accessing care. Stigma, both perceived and real, fuels HIV rates among black Americans who may fear disclosure of their status.According to a study from Harvard Medical School in 2011, such beliefs contribute to decreased survival time in black men by discouraging appropriate treatment behavior, including the consistent use of condoms and linkage to HIV-specific care.
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Distrust of public health authorities can often reinforce negative attitudes about HIV prevention and treatment, increasing denialism and even conspiracy beliefs.Only 59% of those treated for HIV remain in care. Failures of social, police, judicial, and public health services within lower-income communities tend to fuel a general distrust in government programs, including those aimed at HIV testing and prevention.As older men are more likely to have HIV, gay black men tend to get infected at a far younger age than their heterosexual male counterparts. Gay men of color often have sex with older men as a result of these smaller sexual networks.As such, the likelihood of transmission increases simply because there is an inherently higher rate of HIV already within the network. Gay men of color tend to have sex with their own race, according to the CDC, meaning that their sexual networks are smaller and more exclusive.
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Southern states can regularly exceed these figures, such as in Louisiana, where 30% of the black population lives in poverty. In 2018, the poverty rate among black Americans was 22% versus 9% in whites. High rates of poverty, unemployment, and incarceration in black communities are inherently linked to higher rates of HIV.The CDC reports that syphilis, chlamydia, and gonorrhea in black men occur at 4.5, 6.6, and 8.9 times the rate, respectively, of white men in the U.S. Higher rates of co-occurring sexually transmitted diseases only increase the risk. Anal sex remains among the highest risk factors associated with HIV infection, carrying an 18-fold greater risk of transmission when compared to vaginal sex.