The new AIDS medicines and related services have extended life for many thousands of people with HIV/AIDS.  Unfortunately, African American and Latino AIDS patients are not benefiting as much as whites from these new medicines and services.  One study found that the racial/ethnic differences in receipt of treatment could not be explained by other key characteristics of the patients.⁽¹⁾ 

The racial/ethnic differentials in AIDS treatment are reflected in the 1998 AIDS death statistics.  

• The AIDS death rate for African Americans who injected drugs was one-third higher than the rate for whites who injected drugs. 

• The AIDS death rate for Latinos who injected drugs was 10 percent higher than the rate for whites who injected drugs.⁽²⁾

Lack of appropriate care is a personal tragedy for any person with HIV/AIDS, but its consequences extend beyond that person out into the surrounding community.  Patients whose viral load is low are much less likely to transmit HIV to their partners during unprotected sex than AIDS patients whose viral load is high.⁽³⁾   Since sexual partners are often drawn from an individual's own racial/ethnic group, this means it is likely that the suboptimal care received by African American and Latino AIDS patients is translating into more new infections among blacks and Latinos than might be the case if the black and Latino AIDS patients were receiving optimal care.

Latino migration, AIDS care, and new infections

Poor Latino immigrants who have come to the United States without proper documentation are not eligible for financial assistance with their medical care.⁽⁴⁾  This means they are less likely to be tested for HIV and if tested, to get appropriate medical treatment.  The U.S. Immigration and Naturalization Service might eventually find these ill individuals and deport them.  But, in the meantime, they are here.  If they have HIV, they may well have contracted the disease here; but, in any case, they are human beings who need medical help.  They need help both for their own sake, and for the sake of their wives, husbands and lovers who are their uninfected sexual partners. 

Footnotes

(1) This finding comes from a study involving a nationally representative sample of the U.S. population infected with HIV receiving regular medical care and covering the period 1996 to early 1998.  AIDS care improved throughout the study period, but that at the end of the study period, Blacks and Latinos still had less desirable patterns of AIDS care than whites. Women, the uninsured and Medicaid-insured also had less desirable patterns of care. M.F. Shapiro, S.C. Morton, D.F. McCaffrey, J.W. Senterfitt, and others, "Variations in the Care of HIV-Infected Adults in the United States: Results from the HIV Cost and Services Utilization Study, Journal of the American Medical Association, June 23-30, 1999, vol. 281, no. 24, pages 2305-2314.

          A March 2000 General Accounting Office (GAO) study reported that U.S. AIDS funds serve vulnerable groups in higher proportions than their representation in the AIDS population. The apparent conflict between this study and the study by Shapiro and others cited above can be resolved by recognizing that U.S. AIDS funds are a safety net and that many people pay for their AIDS care with private insurance. The GAO study included only government funds. Shapiro's study looked at resources available to AIDS patients from both public and private sources. General Accounting Office, HIV/AIDS: Use of Ryan White CARE Act and Other Assistance Grant Funds, letter report, March 1, 2000, GAO/HEHS-00-54.

(2) AIDS deaths to injecting drug users in 1998, divided by the number of IDUs living with AIDS in 1998 for each racial/ethnic group. Data from a special tabulation from the Centers for Disease Control and Prevention. By definition, people living with AIDS already have the disease, so the genetic protection that whites have from contracting HIV is not a factor here. It is very likely that U.S. statistics on Latino AIDS deaths are low because unknown numbers of legal and illegal immigrants return to their home country to be with family when they die.

(3) Thomas C.Quinn, Maria J. Wawer, Nelson Sewankambo, David Serwadda, and others, "Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1," New England Journal of Medicine, March 30, 2000, vol. 342, no. 13, pages 921-929.

(4) Somini Sengupta, "Law Curtails Help for Illegal Immigrants with AIDS," New York Times, December 29, 1997, page B1.

For a list of other materials used on this website, see References.