Health - Aids

Acquired immune deficiency syndrome (AIDS) is caused by a virus that affects the body's immune system, making it difficult to fight invasions from infection or other foreign substances. As a result, people infected with the AIDS virus are subject to a number of opportunistic infections, primarily Pneumocystis carinii pneumonia and aposi's sarcoma, a form of skin cancer. AIDS, which is caused by the human immunodeficiency virus (HIV), is not transmitted casually, but only through the transfer of bodily fluids such as blood and semen. The CDC reports only four methods of transmission: contaminated blood, sexual transmission, contaminated syringes from intravenous drug use, and perinatal (around the time of birth) transmission from a mother to her child or through breast milk.

Minorities have been especially hard hit by the AIDS epidemic. The CDC notes that of the estimated 462,792 people living with AIDS in 2004, 220,028 (47.5%) were African-Americans, 157,172 (34%) were non-Hispanic whites, and 78,039 (16.9%) were Hispanics. Asians and Pacific Islanders and Native Americans and Alaska Natives were the least likely groups to be living with HIV/AIDS, at less than 1% (2,765 and 1,996, respectively) each. (See Table 6.11.).

Far more AIDS cases have been diagnosed among African-American children than among children of other racial or ethnic backgrounds. Through 2004, 5,590 cases among African-American children, 2,128 among Hispanic children, and 1,612 among white, non-Hispanic children had been diagnosed. Only fifty-three cases had been FIGURE 6.5 Incidence and death rates, prostate cancer, by race/ethnicity, 1975–2002 "Figure XXIII-3. SEER Incidence and U.S. Death Rates: Prostate Cancer," in SEER Cancer Statistics Review, 1975–2002, National Cancer Institute, 2005, http://seer.cancer.gov/csr/1975_2002/results_merged/topic_race_ethnicity.pdf (accessed January 25, 2006)diagnosed among Asian and Pacific Islander children, and only thirty-four had been diagnosed among Native American and Alaska Native children. However, the rate of diagnosis among African-American children dropped the most between 2000 and 2004, from ninety-three cases in 2000 to twenty-nine in 2004%#x2014;a decrease of 68.8%. (See Table 6.12.) Cases among Hispanic children had fallen from eighteen in 2000 to eight in 2004, a decrease of 55.6%, while cases among white, non-Hispanic children had fallen from eleven in 2000 to seven in 2004, a decrease of 36.4%.

Methods of transmission of HIV differ considerably by race. White men with AIDS had overwhelmingly contracted the disease through homosexual contact; 73% had done so, with the next-highest transmission method for this group being intravenous drug use, at 9%. Most Asian and Pacific Islander men with AIDS (69%) and Native American and Alaska Native men with AIDS (55%) also contracted the disease through homosexual contact. While the majority of African-American men with AIDS (37%) and Hispanic men with AIDS (43%) acquired the disease through homosexual activity, a significant proportion of African-American men (31%) and Hispanic men (32%) with AIDS contracted the disease through intravenous drug use. In addition, a sizeable portion of African-American men with AIDS had contracted the disease through heterosexual contact (10%). (See Table 6.13.)

Most women who had contracted AIDS through December 2004 had done so through heterosexual contact or intravenous drug use. White women were about FIGURE 6.6 Incidence and death rates, lung and bronchus cancer, by race/ethnicity, 1975–2002 "Figure XV-4. SEER Incidence and U.S. Death Rates: Lung and Bronchus Cancer, Both Sexes," in SEER Cancer Statistics Review, 1975–2002, National Cancer Institute, 2005, http://seer.cancer.gov/csr/1975_2002/results_merged/topic_race_ethnicity.pdf (accessed January 25, 2006)equally likely to contract AIDS through heterosexual contact (41%) or intravenous drug use (40%) as were Native Americans and Alaska Natives, 41% of whom contracted the disease through heterosexual contact and 43% of whom contracted the disease through intravenous drug use. African-American women were slightly more likely to contract the disease through heterosexual contact (42%) than they were through intravenous drug use (36%). Hispanic women were also slightly more likely to contract AIDS through heterosexual contact (49%) rather than through intravenous drug use (37%). Asian and Pacific Islander women were much more likely to contract AIDS through heterosexual contact (52%) than they were through intravenous drug use (12%). (See Table 6.14.)

Not only are African-Americans extremely over-represented in new diagnoses each year but they also suffer from disparities in care for HIV and AIDS. The 2004 National Healthcare Disparities Report documents that racial and ethnic differences have been shown in the receipt of antiretroviral therapy (to prevent HIV-infected people from developing AIDS) and therapy to prevent Pneumocystis carinii pneumonia.

Sickle-Cell Anemia in African-Americans

Sickle-cell anemia, a hereditary disease that primarily strikes African-American people in the United States, is a blood disorder in which defective hemoglobin causes red blood cells to become sickle shaped, rather than round. This can create blockages in small arteries and can result in many problems, including chronic anemia, episodes of intense pain, strokes, and death. Scientists FIGURE 6.7 Incidence and death rates, colon and rectum cancer, by race/ethnicity, 1975–2002 "Figure VI-2. SEER Incidence and U.S. Death Rates: Colon and Rectum Cancer, Both Sexes," in SEER Cancer Statistics Review, 1975–2002, National Cancer Institute, 2005, http://seer.cancer.gov/csr/1975_2002/results_merged/topic_race_ethnicity.pdf (accessed January 25, 2006)believe the genetic trait arose randomly in Africa and survived as a defense against malaria. The disease can be inherited only when both parents have the sickle-cell trait and the child inherits the defective gene from both parents. One of every twelve African-Americans is a carrier for sickle-cell anemia, and about one of every five hundred African-American infants is born with it. According to the National Institutes of Health (NIH), many non-African-Americans with ancestors from malaria regions—parts of Greece, Italy, the Near East, and India—also have the disease. However, of the seventy-two thousand Americans the NIH estimated had sickle-cell anemia in 2002, most were of African descent. About one thousand babies are born each year in the United States with the disease.