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Mass. urges more HIV/AIDS testing in minority areas; Over 50% of HIV+ in Mass. Are Minorities
  By Megan Woolhouse
Boston Globe Staff / December 2, 2007
State public health officials have recommended increasing HIV/AIDS testing in minority neighborhoods as a way to combat the "grossly disproportionate" spread of HIV/AIDS among the city's black and Hispanic populations, according to a report issued yesterday.
The report found that while 6 percent of the state's population is black and another 6 percent is Hispanic, those two groups represent more than half of the people living with HIV/AIDS in the state in 2005. An even greater number of all women diagnosed with HIV/AIDS - 83 percent - were black or Hispanic.
"Persons of color are far more likely than white individuals to be living with HIV; black and Hispanic individuals being 11 and 9 times more likely to be HIV positive than white individuals," the report stated. "Behavioral analysis also suggests a tendency not to report same-sex contact or injection drug use among black men, possibly as a result of societal stigma surrounding these behaviors."
Stephen L. Boswell, president and chief executive officer of Fenway Community Health, the largest provider of outpatient HIV services in New England, said patients with HIV/AIDS may hide it or be unaware of it because they haven't been tested. Compounding the problem is what Boswell described as sex "on the down low." Boswell said that is a common way of referring to sex between black males who identify themselves as heterosexual in public health surveys, keeping their gay liaisons secret.
"It's a phenomenon of major concern," Boswell said. "As a consequence of being underground, it becomes a very difficult part of the epidemic to deal with."
The report, "An Added Burden: The Impact of the HIV/AIDS Epidemic on Communities of Color in Massachusetts," was released by Dr. JudyAnn Bigby, the state's secretary of Health and Human Services, at a World AIDS Day event at Healing Our Land, a church-based HIV/AIDS prevention group in Boston. It is the first time the state's Department of Public Health has issued a report specifically addressing the racial disparities associated with HIV/AIDS in the state.
In a phone interview yesterday, Bigby said many factors contribute to the problem, such as high prison incarceration rates among black men. Prison rapes routinely occur among men who do not consider themselves gay, she said, and those men may pass the disease along to subsequent female partners. Bigby added that despite state prevention efforts, some prisons still don't allow condoms to be passed out among inmates.
Rebecca Haag, executive director of the AIDS Action Committee of Massachusetts, said the number of minority women with HIV/AIDS has been steadily climbing for the last five years. She said there is a lack of outreach and information getting to them about HIV/AIDS prevention.
The Centers for Disease Control and Prevention has focused resources on making HIV testing as common as screening for diabetes and colon cancer. The CDC has recommended that all adolescents and adults under age 64 be told during a medical visit that they would be screened for HIV. Patients would have the option to decline.
Haag said those efforts won't succeed without more targeted outreach and testing in minority communities.
"Routine testing without routine healthcare doesn't do us a lot of good," she said. "We need to get the Urban League involved. . . . There is still a lot of stigma related to this disease."
The report highlighted other racial disparities among users of HIV/AIDS services in Massachusetts. It found, for example, that while injection drug use is a significant factor in HIV infection among people of color, those individuals are dramatically underrepresented in the state's HIV testing services and its four programs that offer clean needles to drug users across the state.
The report included a number of recommendations to change that. It asked for expanded investment in AIDS/HIV programs serving communities of color, the creation of more culturally specific information about the risks of HIV transmission, and the importance of routine testing. The report also calls for expanding the availability of clean-needle programs in minority neighborhoods.
Haag said Governor Deval Patrick has indicated that HIV/AIDS prevention is one of his priorities, and she hopes he will increase the budget for those programs. She applauded state officials for issuing the report and recommendations.
"I think we're doing a pretty good job in Massachusetts overall," she said, "but there are pockets of communities where we need more funding for prevention."
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