The AIDS epidemic among African Americans in some parts of the United States is as severe as in parts of Africa. This is shocking for a wealthy, industrialised country that spends more money on health care than any other nation in the world. HIV remains prevalent in the U.S.A. however and, significantly, continues to disproportionately affect African Americans. In fact, nearly half of all HIV and AIDS cases diagnosed in the U.S. over the past ten years have been African American. When you consider that the African American community comprises of less than 13% of the overall population it becomes clear  how out of proportion that is. So, when it comes to HIV infection, why is there still such a huge racial disparity in modern America?

The answer to this may be in the limitations of American health care and its unequal representation with regards to ethnicity, sex and wealth. African American’s are more likely to rely on public funding for their healthcare than their white counterparts. They are therefore more likely to have a late HIV diagnoses, are less likely to recieve antiretroviral treatment and as a result are more likely to die from AIDS. 

It seems likely, however, that the explanation is intertwined with mass incarceration, the high number of African American’s in the prison system and the spread of HIV in such institutions. The percentage of young African American men in prison is nearly seven times that of white men and the rate of HIV cases in such instituions is high. In fact it is six times that of the general population. 

There are many possible reasons for this. One may be prison officials’ apathy towards the health and well being of inmates. The culture of corrections focuses heavily on custody and security, and may give lower priority to healthcare. The failure of many prison officials and correctional institutions to provide condoms and sterile syringes is also important. Stigma surrounding HIV, offset by homophobia, often prevents inmates from being tested. It also undermines the HIV prevention programmes that are already limited by finances and a lack of resources. And this has all been exacerbated by the ‘War on Drugs’ that has led to overcrowded prisons and the consequential transmission of HIV to vast numbers of people.

The racial prejudices of some prison officials may be a further barrier to health care for African American inmates. Evidence has suggested that white inmates receive more favorable responses to ‘sick call requests’ and are often given less strenuous prison work. African American’s are more likely to be infected by injecting drugs than white inmates. One quarter of prisoners have injected drugs and nearly half have shared needles, yet only 20% of prisons provide bleach kits to sanitize such needles. Both racial discrimination and a lack of clean needles have inflamed the HIV epidemic.

The failure of correctional institutions to provide sterilised needles is reflective of widespread American policies regarding needle exchanges. The banning of federal funding for needle exchange programmes in 1988 had a devastating impact on drug users and the rise of HIV in America. Despite this, the ban on federal funding for needle exchange programmes continued for over twenty years and has only recently been overturned.

All of this may have been exacerbated by the ‘War on Drugs’ that author Michelle Alexander remarks to be more a ‘War on Some People’.  And by this she means the black community. It is largely African Americans that have been criminalised, marginalised and incarcerated by the ‘get tough’ drug policies of American politicians. It is also disproportionately African American’s that become infected by HIV and I believe that a correlation exists here. 

High levels of unemployment, homelessness and poverty in the African American community has led to increased IDU, high levels of incarceration and, as a result, HIV. The racial predudices of some official individuals has no doubt inflamed the situation. However, I feel that the disproportionate number of African Americans incarcerated and affected by HIV points to a deeper, more institutional and ingrained problem with American politics and culture and its claim to racial equality. This is something that must be further explored if black America’s HIV epidemic is to be solved.