HIV/AIDS in the Black Community

            The cumulative AIDS rate in the black community is fourteen times higher than it is for whites. This huge racial disparity indicates that public health messages are not reaching this community and more needs to be done on the side of education and prevention. Blacks make up 0.7% of New Hampshire’s population and account for 9% of the cumulative AIDS cases.

            Individuals who are black are more likely to live in the cities, especially Nashua and Manchester, than the predominately white suburban and rural areas. The cumulative AIDS rate is highly correlated with urban areas, population density, and distance from Manchester (14). These factors, combined with other socioeconomic factors, put this group at an even higher risk of contracting HIV. Compounding the problem is black community’s general distrust of the US healthcare system, and white clinicians especially. Also, there is a widespread urban myth in the African-American community that HIV was created in a United States laboratory as a way to harm the black community (15). Given the history of unethical medical experimentation in the black population until around the 1960s, it's understandable why this population doesn't trust the medical institutions.

            Public health officials have tried following the model used by the white gay community in addressing the HIV crisis in the black community, and it failed. Public health officials need to work within the trusted establishments in the black community in order for their message to reach this disproportionately affected population (15).

            One of the institutions that public health officials are partnering with is the black church (15). Although about three-quarters of the ministers recognize that HIV prevention programs are needed within their community and their congregation, they don't identify with having a high risk congregation. Few reported having any MSM or IDU within their congregation. However, given the stigma attached to these groups (16 and 17), ministers may be compelled to underreport these populations, even if they are aware of their presence in their congregation. Due to the lack of reporting the numbers provided are therefore not indicative of the actually lack of risk within the church community.

            The two most common reasons given by ministers of black congregations for not providing services are a lack of financial resources and not feeling qualified to discuss HIV/AIDS in church (18). Interestingly, ideological reasons were not cited by many as reason for not providing HIV/AIDS prevention programs. This is encouraging because the two most commonly cited barriers, economic limitations and lack of trained staff, can be overcome. Programs can be funded and ministers and staff educated making this a viable institution to help with the prevention efforts in the black community.

            Philadelphia is partnering with the black churches in the area and some pharmaceutical companies to promote HIV testing, prevention, and education. This program, Project New Covenant, is run through the 400 black churches in Philadelphia (15).

            New Hampshire needs to adapt this program to work within it's black community. There are two black churches in the areas most impacted by HIV/AIDS in New Hampshire,  the New Fellowship Baptist Church in Nashua and the New Hope Baptist Church in Portsmouth. Running programs through the church, an institution well trusted by the black community, would help bridge cultural differences and foster a trusting environment. Also, the nature of the community feel in the church allows the programs to be specifically tailored to the issues central to each specific community. In addition, the black churches studied tended to have large female populations. Since black females accounted for 69% of the new HIV cases among women in 2003, the black church is an ideal way to help reach this at risk population (18).