Sex and AIDS in Young Adults

Attitudes and Beliefs of Young African-Americans

Distrust and Conspiracy

Educational Concerns

Late Testing

Young Adults: Sex and AIDS -- a Literature Review

According to the Center for Disease Control and Prevention, acquired immunodeficiency syndrome (AIDS) is the leading cause of death among young African-Americans (Hossain, 2003). While African-Americans make up only about 13% of the United States' population, they make up 57% of all new Human immunodeficiency virus (HIV) cases. These statistics suggest that HIV and AIDS are affecting Black America in disproportionate numbers. If education is key to success, African-Americans are respectively defeated on the issue of HIV. Researchers believe that a lack of knowledge is responsible for the crisis. For African-American young adults, lack of education is only the root of the problem, as a lack of knowledge is largely responsible for the rate at which the virus is spread. Since many infected African-Americans do not know that they are infected, they continue to put others at risk. Thus, the problem continues.

More African-Americans are infected with HIV or already dead from AIDS than any other single racial or ethnic group in the United States -- a crisis one black AIDS activist labels "a state of emergency" for the African-American community (Andriote, 2005). More than 40% of Americans who have been diagnosed with HIV since 1981 have been African-American.

This literature reviews aims to examine the factors that cause high infection and mortality rates among African-Americans (Andriote, 2005). Experts believe that a broad range of factors -- including socioeconomic factors, poor health care, late HIV testing, high rates of sexually transmitted infections, and limited knowledge of treatment and prevention options -- are contributory to the HIV / AIDS crisis among blacks.

Attitudes and Beliefs of Young African-Americans

Given the disproportionate impact of AIDS on African-Americans, examining African-American perceptions of the epidemic is crucial (the Kaiser Family Foundation, 1998). By understanding what African-Americans think about HIV / AIDS, and their attitudes toward and knowledge of the epidemic, researchers can help improve the situation in the future.

From its inception, the AIDS epidemic has evolved in an environment of strong public opinion. Attitudes and perceptions shape both national and local policy priorities (such as public health endeavors, federal spending decisions and the roles of institutions) but also the experiences of individuals confronting HIV and AIDS (the Kaiser Family Foundation, 1998).

Research has been done over time to capture public opinion and to measure HIV and AIDS related knowledge and information among Americans in general (the Kaiser Family Foundation, 1998). Surveys have aimed to characterize personal perceptions and concerns about HIV and AIDS; understanding of the transmission, course and treatment of HIV and AIDS; attitudes towards testing for HIV; impressions of community and government efforts in fighting the epidemic; and sources of information about HIV / AIDS. Researchers have attempted to determine the role of public opinion and knowledge in shaping the nation's response to the epidemic.

There have been fewer studies on public opinion and knowledge among minority groups, whose views are often undermined in surveys of the population at large (the Kaiser Family Foundation, 1998). Racial and ethnic minorities, for example, are typically sampled in proportion to their numbers with respect to the entire American population. While these surveys provide important information about African-Americans, they rarely have sample sizes that allow for detailed analysis. The importance of monitoring and understanding public opinion and knowledge in the African-American community is undermined by the disproportionate impact of the epidemic on this population.

The Kaiser Family Foundation pioneered a nationwide effort to examine African-Americans' views and concerns about HIV and AIDS (the Kaiser Family Foundation, 1998). The Kaiser Family Foundation National Survey of African-Americans on HIV / AIDS provides information on the knowledge, values and beliefs of a large sample of African-American adults with respect to HIV and AIDS in the United States. It describes the beliefs and attitudes of African-Americans.

According to the Kaiser Family Foundation (1998): "There is a strong sense of urgency about AIDS among African-Americans. Over half of African-Americans rate AIDS as the most urgent health problem facing the nation today (52%), rating it well above cancer (36%), heart disease (13%) and problems related to health care costs and health care coverage (11%). By comparison, 38% of the national sample of all Americans 16 say that AIDS is the most urgent health problem today, tying it with cancer (also 38%) and ahead of heart disease (16%). The disparity in impressions may reflect reality; among African-Americans, AIDS is a more acute health problem. Two in five new cases of AIDS among adults and one in three new pediatric cases are African-American."

Three in five African-Americans (58%) view AIDS as a more urgent problem for the United States than it was in the near past (the Kaiser Family Foundation, 1998). While many African-Americans believe that the country is making progress in addressing the problem of AIDS African-Americans are more likely than all Americans to believe the country is losing ground.

Distrust and Conspiracy

2005 study suggests that many African-Americans are distrustful of the government's role in the origin and treatment of HIV / AIDS - and that African-American men who hold these beliefs also have more negative attitudes toward condoms and are more likely to resist using them (Floyd, 2005). The study, which was funded by the National Institutes of Child Health and Human Development, is considered the first study to examine a broad range of HIV / AIDS conspiracy beliefs and their relationship with the usage of condoms.

These 'conspiracy theories' have been out there for a while and are part of a larger distrust of government, as well as of medical and public health institutions, by many African-Americans," said Sheryl Thorburn, an associate professor of public health at Oregon State University (Floyd, 2005). "But this is one of the first studies to show that these beliefs about HIV / AIDS may be affecting behavior."

The study consisted of a national telephone survey with 500 randomly selected African-Americans, between the ages 15-44 (Floyd, 2005). Participants were asked a series of questions about HIV / AIDS beliefs, attitudes toward condoms, and condom use.

More than half stated that they believe that there is a cure for AIDS, but that it is being withheld by the government from poor people (Floyd, 2005). Only 37% believed that the government was telling the truth about AIDS. Other findings include:

43.6% of African-Americans surveyed believe that people who take new medicines for HIV are human guinea pigs for the government;

26.6% said AIDS was produced in a government laboratory;

48.2% believed that HIV is a man-made virus;

15.2% said AIDS is a form of genocide against blacks.

The study revealed that conspiracy beliefs were associated with negative attitudes toward condom usage. The researchers did not find similar results for women in the survey.

According to researchers, HIV and AIDS conspiracy beliefs are rooted in well-documented racial discrimination and disparities in health care, in addition to historical examples of unethical research, including the Tuskegee Syphilis Study in the mid-20th century (Floyd, 2005).

In the Tuskegee study, which took place from 1932-72, the U.S. Public Health Service studied the effects of untreated syphilis in 400 low-income African-American males from rural Alabama. The men believed that they were being treated for "bad blood" and were denied treatment for the disease. Distrust of the government's role in HIV may translate into distrust of public health prevention messages about HIV and condoms, researchers wrote.

Educational Concerns

Eissen et al. (2205) recently conducted six focus groups with thirty young African-American men to determine their perceptions of AIDS as a threat to the African-American community, characteristics of past situations that have placed African-Americans at risk for HIV infection, and their personal high risk behaviors.

The results revealed that young African-American men perceive HIV and AIDS as a threat to their community and they have placed themselves at risk of HIV infection based on unsafe sexual behavior, substance abuse, and lack of education about the issue (Essien, 2005).

They describe lack of money to purchase condoms as a barrier to safe sex practice. They believe that HIV educational programs should address these risk factors. They further believe that programs should be held in African-American communities and should include condoms to encourage reduction of risk behaviors.

In addition, respondents stated that many young African-American men are having sex without condoms when having sex with women often when they are under the influence of alcohol or drugs (Essien, 2005). According to the men, substance abuse is a crucial part of the problem of HIV in the African-American community.

It is difficult to ignore the fact that as the HIV / AIDS epidemic continues to spread, it is particularly predominant in poor, urban communities of color (Messina, 1994). African-Americans experience higher rates of unemployment, poor housing, poor health, early death and inadequate medical insurance than other populations. It is argued that the greatest problems facing many African-American communities areā€¦