Top 5 Takeaways

1. High HIV Diagnosis Rates: In 2018, Black persons accounted for nearly half of all new HIV diagnoses in the U.S., with a diagnosis rate four times higher than other racial or ethnic groups combined.
2. Social Vulnerability Impact: New HIV diagnosis rates among Black adults were higher in communities with the highest social vulnerability.
3. Geographic Concentration: Approximately half of Black adults with diagnosed HIV resided in the upper quartile of socially vulnerable U.S. Census tracts.
4. Need for Intensified Prevention: There is a critical need for intensified prevention efforts to reduce HIV transmission among Black persons in highly vulnerable communities.
5. Challenges in Accessing Services: Black adults in high social vulnerability areas face multiple barriers to obtaining HIV prevention and care services, including poverty, limited healthcare access, and stigma.

Original Article Author and Citation

Corresponding Author

André F. Dailey, hgu7@cdc.gov, 614-377-6564

Suggested Citation

Dailey AF, Gant Z, Hu X, Johnson Lyons S, Okello A, Satcher Johnson A. Association Between Social Vulnerability and Rates of HIV Diagnoses Among Black Adults, by Selected Characteristics and Region of Residence — United States, 2018. MMWR Morb Mortal Wkly Rep 2022;71:167–170. DOI: http://dx.doi.org/10.15585/mmwr.mm7105a2

Summary

In 2018, Black persons accounted for nearly half of all new HIV diagnoses in the United States, with a diagnosis rate four times higher than other racial or ethnic groups combined. This report highlights that new HIV diagnosis rates among Black adults were significantly higher in communities with the highest social vulnerability. Approximately half of Black adults with diagnosed HIV resided in the upper quartile of socially vulnerable U.S. Census tracts. The findings underscore the need for intensified prevention efforts to reduce HIV transmission among Black persons in these highly vulnerable communities.

Methods

The study analyzed data from the National HIV Surveillance System to assess the association between social vulnerability and HIV diagnosis rates among Black adults in the U.S. Social vulnerability was measured using the Social Vulnerability Index (SVI), which considers factors such as socioeconomic status, household composition, minority status, and housing type. The analysis focused on the rate of new HIV diagnoses per 100,000 population among Black adults across different SVI quartiles.

Discussion

The report found that the rate of new HIV diagnoses among Black adults was higher in communities with the highest SVI (52.1 per 100,000) compared to those with the lowest SVI (33.7 per 100,000). Social and economic marginalization, including residential segregation, contributes to higher social vulnerability and higher rates of HIV diagnosis. Factors such as poverty, limited access to healthcare, substance use disorder, and housing insecurity further exacerbate the challenges faced by Black adults in obtaining HIV prevention and care services.

Conclusion

To address the higher risk of HIV infection among Black adults living in communities with high social vulnerability, it is essential to develop and prioritize interventions that address social determinants of health. These interventions could help prevent HIV transmission and reduce disparities among Black adults. Intensified prevention efforts and targeted strategies are crucial to improving health outcomes and reducing the burden of HIV in these vulnerable communities.

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