CDC: Disparities Account for Outsized HIV Infection Rate Among Black Women

How bad are racial disparities in HIV? Enough that the rate of new HIV infections among black women was 93% higher than it would have been if the rate was the same as white women, according to a study appearing May 10, 2019, in CDC’s Morbidity and Mortality Weekly Report.

Researchers conducted the study to examine how HIV continues to disproportionately affect black women and to determine the number of new infections that could have been prevented if racial disparities between black and white women didn't exist.

“In 2016, although black women accounted for 13% of the US female population, 60% of new HIV infections among women were in black women, indicating persisting disparities,” researchers said.

HIV incidence and prevalence estimates for women and adolescent females 13 or more years old were gathered from a CDC HIV Surveillance Supplemental Report, which demographically categorized and estimated rates of HIV infections in the United States between 2010 to 2016, to compare rates of new HIV infections among women of different races.

CDC used population attributable proportion (PAP) disparity measure analysis to assess trends in HIV infection disparities. The PAP calculated the proportional decrease in HIV infections among black women that would've occured if rates of new infections were equal to those of white women.

The PAP disparity measure was the number of excess incident infections among black women divided by the total number of estimated incident infections among all women. Excess incident infections were the estimated number of incident infections among black women subtracted by the hypothetical number of incident infections, which was calculated by dividing the HIV incidence rate in white women by 100,000 and then multiplying by the number of HIV-negative black women.

From 2010 to 2016, the estimated incidence of HIV infection among black women 13 or more years old fell from 32.5 to 24.4 per 100,000 persons. The rate among white women 13 or more years old, which was 1.6 per 100,000 persons, didn’t change from 2010 to 2016. Researchers determined the PAP disparity measure fell from 0.75 in 2010 to 0.70 in 2016, suggesting that if incidence rates for all women were the same, the total annual number of incident HIV infections among black and white women would have been 75% lower in 2010 and 70% lower in 2016.

The 7% decrease in the PAP disparity measure from 2010 to 2016 indicated the percentage of incident HIV infections caused by racial disparities fell by 7% over the time period. Therefore, researchers concluded an estimated 3900 of 4200, or 93%, of incident HIV infections among black women could have been avoided if there were no racial disparities between black and white women.

The study’s findings highlight the extent to which racial disparities have led to disproportionate HIV infections among black women and emphasize the importance of eliminating these differences. Researchers stressed that reduction of racial disparities among women is required to achieve broader HIV control goals. Researchers said that efforts to identify and address social and structural determinants associated with HIV-related disparities, such as increasing access to healthcare, eliminating HIV-related stigma, and spreading awareness of pre-exposure prophylaxis, are needed to decrease rates of new HIV infections among black women.

“Findings from the PAP disparity measure analyses enhance the measurement of HIV disparities among women and adolescent females by quantifying the number of incident HIV infections that might have been prevented in the absence of racial disparities. This information lends support for strengthening HIV prevention and care efforts for heterosexual black females and males to continue progress toward closing the gap in racial disparities in HIV infection among women,” researchers concluded.

Reference

Bradley ELP, Williams AM, Green S, et al. Disparities in incidence of human immunodeficiency virus infection among black and white women — United States, 2010—2016. MMWR Morb Mortal Wkly Rep. 2019;68:416—418. doi: 10.15585/mmwr.mm6818a3.