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HIV/AIDS and Social Disparities

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The transmission of HIV and the HIV/AIDs epidemic remains a top public health concern for the country and for the world. It is clear that these are conditions that disproportionally affect certain social groups within the population. The following is a discussion of these divides and a discussion of initiatives to address the issue.

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Influences and Determinants of Health and Socioeconomic Status
According to an article by Dean and Fenton (2010), efforts have been made to address the social determinants of health in cases of HIV and AIDS, as well as, other sexually transmitted diseases. They note that among American Indians, alcohol abuse, a history of incarceration, and the use of traditional medicine and healers are important social factors to consider when working with an American Indian who is HIV positive. More specifically, providers must be aware of the cultural worldview of those from this social background and the importance of working in collaboration while maintaining patient safety. The article also mentions that there is research to support that the mode of HIV transmission differs for people from different countries. In particular, Dean and Fenton (2010) note that past research has found that for foreign-born black individuals, most HIV is spread through heterosexual contact, compared to it being spread mostly by male-to-male contact for native-born black individuals. Dean and Fenton (2010) also reported that for foreign-born black women, the rates of HIV diagnosis are significantly higher than for native-born black women. In terms of other social determinants of health in HIV and AIDS cases, Dean and Fenton (2010) report that income and social status play a role. In Africa, there is an inverse relationship between poverty and HIV acquisition such that those who are in poverty have higher likelihoods of acquiring HIV and AIDS.

Past and Present Initiatives
To address this disease, the Centers for Disease Control (2016) implemented a program to expand testing. They wanted to focus on prevention by conducting 1.5million tests each year. They indicated that this specific initiative began due to the large number of individuals who are thought to be unaware of their status as being HIV-positive. In particular, the Centers for Disease Control (2016) stated that there were likely 168,300 individuals living in an HIV-positive status without knowing their disease status. The goals of their new initiative was two-fold and it was carried out through three separate programs. The goals of the program were to increase the number of individuals tested for HIV in those areas of the country in which there are disproportionally affected populations, and to support the implementation of a new set of recommendations for HIV testing in healthcare settings. A past public health initiative was released by Obama in 2010 (Department of Health and Human Services, 2010) and this initiative set out to identify priorities and an action plan that could be linked to observable outcomes to address HIV within the United States. In addition to past and present public initiatives, there are also private programs aimed at addressing HIV/AIDS like the Bill & Melinda Gates foundation (2016) which focuses on Sub-Saharan Africa. The foundation works with multiple partners including private industry and academic institutions to improve diagnosis and expand treatment coverage.

Outcomes and Progress
The primary outcome measure is the number of individuals who underwent screening and the number of individuals newly diagnosed with the condition. The Centers for Disease Control (2016) indicated that over the three-year implementation of the program, 2.7 million tests were conducted and 0.7% were newly identified as HIV-positive. Of those who were confirmed as newly diagnosed HIV-positive individuals, 74.3% of these individuals were linked to HIV-appropriate medical care. The testing specifically assisted black individuals as they accounted for 57.4% of the total new HIV tests that were conducted, and they also accounted for 66% of newly-identified HIV cases. Overall, this indicates that the Centers for Disease Controls’ (2016) HIV/AIDS initiative reached many of its intended aims, at least in terms of increasing testing among vulnerable populations in need.

Current Status of the Health Issue
In terms of the current state of the health issue based on the number of newly-diagnosed cases, it is important to look outside of this specific initiative, since this is simple a small subset of the initiatives that are being undertaken to combat HIV/AIDs. Recent research by Pellowski, Kalichman, Matthews, and Adler (2014) asserted that the HIV epidemic is now concentrated on those vulnerable populations within our society. According to these researchers, the HIV/AIDs epidemic is nowhere near being over, and it will be important for researchers and politicians to focus on those members of social and cultural minority groups such as those of racial and gender minority status.

Overall, this research suggests that HIV/AIDS remains a large concern, especially for minority populations. In particular, it appears that although the Centers for Disease Control has taken initiatives in order to address the health disparity, particularly for African American men and women. It is clear that these initiatives have been helpful in addressing the problem, but more needs to be done. There are efforts underway to address this problem; however, it is clear that more needs to be done to help these vulnerable populations. In order to continue the efforts to resolve the epidemic of HIV/AIDS infections, researchers and epidemiologists will need to work in collaboration with government agencies to help address the social disparities.

  • Bill & Melinda Gates Foundation. (2016). Strategy overview. Retrieved from:
  • Centers for Disease Control. (2016). Expanded testing initiative. Retrieved from:
  • Dean, H.D., & Fenton, K.A. (2010. Addressing social determinants of health in the prevention and control of HIV/AIDS, viral hepatitis, sexually transmitted infections, and tuberculosis. Public Health Reports, 125, 1-5.
  • Department of Health and Human Services. (2016). Initiatives. Retrieved from:
  • Pellowski, J.A., Kalichman, S.C., Matthews, K.A., & Adler, N. (2014). A pandemic of the poor: social disadvantage and the U.S. HIV epidemic. American Psychologist, 68(4), 197-209.