By Julia Park C’22
While approximately 13% of the American population are Black, over 38% of people who are incarcerated are Black and over 40% of people who are living with HIV in the U.S. are Black. The disparity present in these statistics did not occur by chance, and though disheartening, they are not surprising. High rates of HIV in America’s Black population is associated with mass incarceration of Blacks and the limited access to healthcare and lack of prevention programs in America’s correctional facilities.
Rates of HIV/AIDS and incarceration have been steadily increasing for African Americans over the past thirty to forty years. Even by 2011, the incarceration rate for black men was six times that of white men. This horrific trend emerged not by internal moral failings, but through systemic forces (e.g., the war on drugs, mass incarceration, lack of healthcare, politics).
How exactly does HIV/AIDS, race, and space (e.g. the prison system) work together to increase risk?
Let’s take a look at the history of the man made AIDS epidemic in Black Chicago.
At the start of the 2000’s, Blacks made up for only 14% of the population of Illinois, but accounted for half of HIV/AIDS infections. Within one decade, from 2000 to 2010, almost four-thousand Black Chicagoans died of AIDS-related illness, which was approximately three times the rate of white deaths from AIDS. This clearly demonstrated that the geography of HIV/AIDS emanated from the Black community.
Why? It was largely due to the war on drugs, in the early 1980s under Reagan, which created a zero tolerance policy for drug offenses. A direct result of this was that people with greater HIV risk (i.e. intravenous drug users) were placed in prison. In other words, HIV/AIDS migrated from the streets to the prison. Prisons did not create the epidemic, but simply provided a physical location for disease to incubate. Moreover, the war on drugs led to exponentially increased incarceration rates of Blacks, especially Black men. This was not because of their increased drug use compared to whites, but a result of law enforcement’s focus in urban areas, lower income areas, and communities of color. So prisons in their confined spaces, questionable sanitation, and poor ventilation enabled the disease to go undetected. Then, once prisoners, specifically Black Chicagoans, were released back into their communities the disease became easily recirculated back into Black Chicago. This creates, what Penn Nursing Professor Bridgette Brawner calls, “geobehavioral vulnerability.”
The term “geobehavioral vulnerability” offers an explanation as to why, even in Philadelphia, Black communities across the nation have increased exposure to HIV/AIDS. Brawner explains the concept as such: “Geobehavioral vulnerability to HIV suggests that it is not just what you do, but also where you do it, and with whom, that increases your risk of HIV infection. Geosocial spaces—geographic areas where people interact, such as housing developments, census tracts or cities—with high HIV prevalence produce a greater probability of being exposed to HIV.” Therefore, when large portions of the Black population in a neighborhood cycle between the community and prison, it creates increased risk and instability.
Black women, especially, have increased geobehavioral vulnerability. For example, in Philadelphia, there are fewer black men than black women due to factors such as hyperincarceration and early death. Studies have shown that when with such uneven sex ratios, men tend to sleep around, resulting in insular sexual networks with overlapping partners. Hence, heterosexual black women have an increased likelihood of having an infected partner. African American women have increased rates of HIV/AIDS than their white counterparts not because of their behavior. Statistically, black women have fewer sexual partners and are more likely to use condoms than white women from similar economic backgrounds. However, it is their geographic location, their geobehavioral vulnerability, that increases their risk. Unfortunately, many black women who carry the disease live in poverty, having minimal healthcare to help prevent or maintain treatment. They lack education on sex issues, AIDS, or may have sexually transmitted diseases that also go undiagnosed. It is an unfortunate, yet true reality that factors like race, socioeconomic background, and structural forces offer a potent synergy to allow heightened transmission of HIV/AIDS.
So what now? How can we help?
Many commendable researchers have been striving to make conscious decisions and calls to question where funding is being allocated when it comes to HIV/AIDS prevention and research. Undoubtedly, there are many political and institutional changes that must be brought about for national impact. However, if you are a fellow Penn student reading this, even as students there are powerful ways we can help denature the vicious, disparate trend of HIV/AIDS in our black communities. Here are some ways we can help:
1. Volunteer at one of Philadelphia’s many HIV/AIDS targeting nonprofits to increase local access to HIV test and care in various neighborhoods. Some include:
Be on the lookout, as UNAIDS at Penn will be hosting more group volunteering events in the near future..
2. Help design culturally appropriate initiatives that encourage HIV testing and treatment and address stigma,
3. Join us at UNAIDS at Penn in efforts to increase education about HIV/AIDS and address stigma,
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