HIV and AIDS in California: Focus on African American Males - Essay Example

? HIV and AIDS in California: Focus on African American Males Aged 18 years and above. Despite the much publicized fight against HIVand aids, the pandemic continues to create havoc in most communities around the globe. The state of California is not an exception. HIV and aids pose a significant community health problem in this most populous state of the U.S. In fact, the state of California has the second highest HIV prevalence rate after New York (CDPH, 2009). Most importantly, Afro American males of the reproductive age are the most affected. This paper endeavors to find out why Afro American males are the most affected, what is being done to address the issue, and thereafter offer recommendations. HIV/AIDS and California The state of California is ranked second after New York in HIV prevalence rate (CDPH, 2009). Close to 190 000 people had contracted HIV by April 2009 (CDPH, 2009). According to a report by California department of Public health, Blacks have a higher chance of contracting HIV, followed by Hispanics. The report also indicated that HIV prevalence in California is higher in males than in females. Males contribute to 92% of all the people living with HIV in this state. Most of transmission in males occurs via homosexuality (MSM) (64.9%), and of the HIV victims live in Los Angeles and the San Francisco Bay area. In addition, 0.7% of inmates had contracted HIV according to a report released in 2005 by the California department of public health. In summary, the top ten HIV counties are as follows Los Angeles, San Francisco, San Diego, Orange, San Bernardino, Riverside, Alameda, Sacramento, Santa Clara and Costra Rica respectively (CDPH, 2009). On the other hand, the top ten aids counties include Los Angeles, San Francisco, San Diego, Alameda, Orange, River Side, Santa Clara, Santa Bernardino, Sacramento and Costra Rica respectively (CDPH, 2009). HIV/AIDS and California: Focus on males aged 18 years and above According to California department of Pubic Health, by 31st March 2009, African Americans constituted 7% of California’s total population. Amazingly, they represent 19.1% of HIV cases and 17.9% of cumulative aids cases in California. Since the prevalence of HIV/AIDS is high in African Americans, California is not an exception. Most importantly, African American males are the most affected. The most prevalent mode of transmission is through men who have sex with men (MSM) and MSA/Injection Drug users (MSM/IDU) (CDPH, 2009). However, other modes of transmissions like heterosexual contact also contribute significantly to the spread of HIV in males of California. Males in the age groups that range from late teenage to early 50s (sexually active males) are the most vulnerable. This is the most useful age group to any given population. Thus, AIDS pandemic threatens California’s workforce and men of the reproductive age. In 2002, the institute of medicine (IOM, 2006) published a report dubbed “Unequal Treatment” which gave an analysis of racial health disparities in the U.S. The report indicated that African Americans and Hispanics find it more difficult to access healthcare when compared to their White counter parts. In addition, the African American and Hispanic communities (considered as minorities) receive health care of poor quality. The effect is much higher in populous states like California. Thus, marginalized social status and stigma make Afro American males to be vulnerable to HIV infection (IWH, 2006). Transmission is high in non educated Afro American Males and those with low education levels. Low income, poor and inequitable medical access, marginalization, low education and drug abuse are the key factors contributing to the spread of HIV in males of the reproductive age California (IWH, 2006). Community Resources and Partners addressing this Health concern California has a substantial number of organizations and agencies which endeavor to address the challenge of HIV and AIDS in Afro American males. Some of them offer their services to the whole Californian community while others focus specifically on Afro American males. The California department of public health acts as a coordinator of all public health programs. The department cooperates with other organizations and agencies in offering services that aim at preventing HIV transmission and empowering people living with AIDS. The public can access the department’s services by visiting their office. Other educative programs and announcements are posted on the department’s website. Office of Aids in California is another agency that addresses aids related issues. The agency has offices in various states. Office of AIDS (OA) in California notes that Afro Americans encounter immense geographical, cultural and structural barriers that justify the importance of using culturally grounded interventions in preventing HIV (HAAAMC, 2009). OA has established various strategic to HIV and AIDS in Afro American communities. OA has established a dedicated staff specialist position whose main roles include devising projects, programs and policies, and providing leadership and consultation services that concern Afro Americans. OA has led to the creation of The California African American HIV/AIDS Coalition (CAAHAC). OA offers various logistic and technical supports to CAAHAC which focuses on five key regions; the bay area, Los Angeles, Sacramento, Riverside and San Diego (HAAAMC, 2009). OA also oversees regional capacity building trainings on essential behavioral interventions. Amongst the most beneficial capacity building trainings developed so far include SISTA (Sisters informing Sisters on the Topic of AIDS) and African American MSN cultural competency dubbed Facing the Invisible Man (HAAAMC, 2009). In January 2009, OA offered tailored technical assistance to 22 CBOs and coalitions in the vast California state. Most importantly, OA offered planning and development assistance, website designs, marketing, tracking and documentation systems, outreach programs and program evaluation. Other community based organizations involved in addressing this health challenge are BRUTHAS, FeMAALES, HOLLA, and MAALES. Other organizations are Black Gay Men’s Advocacy Coalition, Black AIDS institute, National Medical Association, National Alliance of State and Territorial AIDS Directors, and National Association of Black Social Workers. OA also works in hand with Black Health Infant Program that aims at reducing perinatal HIV transmission. Most importantly, OA and CDPH work in hand with local communities in order to impact positively on public health by partnering with CBOs, Local health jurisdictions and other health service providers (HAAAMC, 2009). Most of these agencies have local offices and websites where relevant information is communicated. Issues not addressed Despite heightened efforts by the above organizations, some fundamental issues are still unresolved. This may be so because they are not within the mandate of the above organizations. Such factors drag behind the effort of stakeholders. They include: Drug Abuse Drug abuse is a significant risk factor for HIV and AIDS. It has been note that a substantial number of male patients living with AIDS or those that have recently contracted HIV got it through Injection Drug Users (IDU). Since drug abuse is prohibited, most addicts inject themselves with abusive substances in secret. Some do it under very unhygienic conditions. There is a possibility of syringe sharing. Consequently, those who have already contracted HIV can transmit the virus to the new drug recruits. It is exceedingly difficult to control IDU HIV infection because addiction forces addicts to inject themselves with abusive substances. Curbing drug addiction is a headache to the federal government. Many stakeholders who fight HIV remain underequipped to handle HIV transmission as a result of drug addiction. Low income Low income is another fundamental factor that contributes to the spread of HIV. As the cost of living continues to rise, many young males in the said age group face different challenges in meeting the demands of life. Eventually, those who get frustrated end up using short cuts in order to meet their daily needs. This drives many young males into social evil activities that make them vulnerable to HIV contraction. Stakeholders come in when the situation is already out of hand; when individuals have already contracted the virus. It is challenging for stakeholders to cater for the needs of everyone in tying to prevent HIV infection. The most they can do is to educate the public and offer consultation services. Gay Relationships Another critical issue is the gay factor. Most males contract HIV through homosexual intercourse. Sex with other men is a leading cause of HIV in males. Stake holders’ efforts to curb HIV infection do not address this issue comprehensively. However, it is understandable because a lot of uncertainties surround gay relationships. Education On the other hand, it has been noted that a substantial number of HIV victims have little education or no education at all. This is another fundamental risk factor that does not directly cause HIV but acts as the breeding ground for other factors. Certainly, those with little or no education find it had to access opportunities. Consequently, they struggle to carter for their lives especially in meeting the daily needs and healthcare needs. Thus, some of them end up engaging in social evil activities. Eventually, most of them end up contracting HIV. The government needs to make education affordable and accessible to all and encourage young people to go to school. Learning does not only give individuals and edge in life, but also equips them with long term problem solving skills. Barriers to solving HIV and AIDS challenge in California In a study conducted in Los Angeles by Myers, Koester and Dufour (2011), 2500 AIDS patients were unaware of their serostatus. Communication barriers were found to prevent the public from accessing HIV testing in publicly funded primary care clinics. Another study conducted by Wohl, et al. (2011) reported that 715 of AIDS patients in Los Angeles need supportive services and 35% have unmet services. The study found that poor dissemination of information and economic situation of the patients contributed to the poor access to the required supportive services. On the other hand, a study conducted by Sale et al. (2011) revealed that there is an urgent need to address the issue of men who have sex with men. The study also indicated that service providers and male homosexuals find it uneasy to discuss the issue. In addition, negative beliefs about the issue pervade the general community. Thus, the researchers called for additional training for service providers so that they can provide appropriate non judgmental prevention and counseling services and education. In addition, Brooks et al. (2011) conducted a study in Los Angeles to identify factors that impede or facilitate adoption of pre-exposure prophylaxis (PrEP) for HIV prevention among gay and bisexual males in HIV-serodiscordant relationships. The study found cost to be amongst the impediments to the implementation of the program. Furthermore, Pollini et al. (2011) aimed at identifying barriers to treatment initiation amongst people living with aids. They found out that stigma and isolation are still key barriers to initiation of care in populations consisting of persons of color. Major stakeholders involved Californian department of public health and Office of Aids (OA) are the key agencies involved in the fight of HIV and Aids in California. OA and CDPH work in hand with local communities in order to impact positively on public health by partnering with CBOs, Local health jurisdictions and other health service providers (HAAAMC, 2009). Recommendations According to the barriers that impede the fight against HIV and aids, the following Recommendations should be implemented. There should be proper communication protocols on services provided so that people living with aids can easily access them. This is based on the evidence provided by Myers et al. study (2011) in which 2500 people living with HIV and aids in Los Angeles were unaware of their serostatus simply because they lacked information on the availability of public HIV testing centers. Wohl, A. et al. (2011) study conducted in Los Angeles also found poor information dissemination to be a barrier to the access of supportive services by people living with Aids. Service providers need to need to be properly trained to handle issue surrounding men who have sex with men (MSM). Because MSM is a leading cause of HIV in California, proper mechanisms should be put in place to address the issue. This is based on the evidence provided by CDPH that the most prevalent mode of transmission of HIV in California is through men who have sex with men (MSM) and MSA/Injection Drug users (MSM/IDU) (CDPH, 2009). Sale et al. (2011) study also indicated that their service providers and male homosexuals find it uneasy to discuss the issue. In addition, negative beliefs about the issue (MSM) pervade the general community. Proper mechanisms should be put in place to reduce stigmatization and isolation of people living with aids. This will enable them seek supportive services. Supportive services should be affordable and accessible. This is based on the study conducted by Pollini R et al. (2011) which found out that stigma and isolation are still key barriers to initiation of care in populations consisting of persons of color. Conclusion Aids pandemic is a serious public health problem in California. Most importantly, African American males seem to be the most vulnerable group. This is due to a high prevalence of MSM in the Afro American community. Thus, proper mechanisms should be devised to address the issue of MSM. On the other hand, poor communication protocols hinder the access of supportive services by people living with HIV and aids. Therefore, proper communication mechanisms should be implemented. Although a good numbers of organizations strive to address the issue of HIV and Aids in Californian Afro Americans, extra effort is required in order to realize considerable success. References Brooks, R. (2011). Motivators, concerns, and barriers to adoption of preexposure prophylaxis for HIV prevention among gay and bisexual men in HIV-serodiscordant male relationships. AIDS Care, 23(9), 88-95. California Departmentof Public Health (CDPH). (2009). California HIV Statistics. Sacrament: California Public Health Department. HIV among African Amertican Males in Carlifonia.(HAAAMC) (2009). Sacramento: Retrieved 9 april 2012 from http:// www. cdph.ca.gov/programs/aids/documents. Minessota Department of Health(MDH). (2001). Public Health Inverntions: Applications for Public Health Nursing Practice. Minessota: Minessota Department of Health. Myers, J., Koester, K., and Dufour, M. (2011). Barriers and Facilitators to Enhancing HIV Testing in Publicly Funded Primary Care Clinics: Findings from San Francisco. Aids and Education Preventio, 85-95. DOI 10.1521/aeap.2011.23.3_supp.84. Pollini R. et al. (2011). A Community-Based Study of Barriers to HIV Care Initiation. AIDS Care and STDS, 25(10), 601-609. Sale L. et al. (2011). We're going to have to cut loose some of our personal beliefs': Barriers and opportunities in providing HIV prevention to African American men who have sex with men and women. Aids Educaton and Prevention, 23(6), 521-532. The Institute for Work and Health(IWH). (2006). Primary, Secondary and Tertiay Prevention. Toronto: The Institute of Work and Health. Wohl A. et al. (2011). Barriers and Unmet Need for Supportive Services for HIV Patients in Care in Los Angeles County, California. Aids Patient Care and STDS, 525-532. Read More