How HIV and AIDS Affect African-Americans, and Why

Medically Reviewed by Neha Pathak, MD on April 28, 2021

In many ways, African-Americans have been hit harder by HIV than any other racial or ethnic group in the United States. A larger portion of this community gets AIDS diagnoses and has HIV-related deaths. On average, African-Americans with AIDS don't live as long as the other groups.

AIDS is a leading cause of death in African-Americans, especially in young women. The CDC says that as of 2018, Black women were 14 times more likely to be diagnosed with HIV than white women and 5 times more likely than Hispanic women.

Why are the numbers so high?

Lack of Awareness, and Distrust and Fear

Many black people may be HIV-positive and not know it, so they continue to spread the virus while also getting sicker. In 2018, only about half of every 100 Black people with HIV were virally suppressed.

Some African-Americans still mistakenly believe that HIV is a white, gay disease. That makes it hard to teach them about HIV or get them to talk about their HIV status.

Part of the problem may be a lingering distrust in the black community of government sources of information and research. The historic Tuskegee Syphilis Study did harmful medical testing on African-Americans, without their knowledge, for 40 years.

Stigma around homosexuality may also silence men who have sex with men. Black men "on the down low" have sex with men but may not tell their women sex partners.

Unprotected Sex and STDs

Most African-American men and women get HIV when they don't use a condom or other protection when they have sex with a man. It's less likely for a black man to get HIV from a woman. And it's more likely for a black man than a white man to get HIV by having sex with men.

It's easier for someone who has another sexually transmitted disease (STD), like gonorrhea, to get or pass HIV, and the infection rates for STDs are higher for African-Americans.


As a group, African-Americans are more likely to be uninsured or publicly insured than whites. They may not have access to information or as many options for HIV testing and treatment. It may be harder to find support and services to help live with HIV or AIDS and related illnesses.

Women may feel that they can't protect themselves in a sexual relationship when they depend on their partner financially.

Injecting Drugs

Sharing drug needles or syringes with someone who is infected with HIV is the second-most common way African-American men and women get HIV. It spreads HIV through blood contact. Being high may also lead to risky sexual behavior.

Drug dependence or addiction can make money problems worse. And people may be willing to trade unsafe sex for drugs.

How to Lower the Impact

Raising awareness about what HIV is and what it's doing to the African-American community is a start. The CDC and other organizations are trying to shift ideas about HIV and AIDS so more black people feel safe talking about it and will get tested and treated.

To avoid HIV infections, practice safe sex. Ask your partner about their HIV status. Use a latex condom and water-based lubricant each time you have sex. If you think you may have an STD, see your doctor and get treatment.

Think about whether you should get tested for HIV whenever you get a medical checkup. Make it a part of staying healthy. Don't be afraid to ask your doctor for an HIV test.

Always use clean needles and syringes for injected drugs; don't reuse one after someone else. Try counseling or treatment to help you stop using drugs.

WebMD Medical Reference



CDC: "HIV Among African Americans," "Prevention Challenges," "Questions and Answers: Men on the Down Low," "What African Americans Can Do,” “HIV and African American People.”

Kaiser Family Foundation: "African Americans and HIV/AIDS,” “Black Americans and HIV/AIDS: The Basics.”

Journal of Acquired Immunodeficiency Syndrome: “Heterosexually transmitted HIV infection among African Americans in North Carolina.”

Journal of Health Communication: “HIV/AIDS coverage in Black newspapers, 1991-1996: implications for health communication and health education.”


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