|Young African American Adults At High Risk for
HIV, STDs Even In Absence of High-Risk Behaviors
Results of a new study supported by the National Institute on
Drug Abuse (NIDA), National Institutes of Health, suggest that
young African American adults — but not young white adults — are
at high risk for HIV and other sexually transmitted diseases (STDs)
even when their relative level of risky behaviors is low. The findings
imply that the marked racial disparities in the prevalence of these
diseases are not exclusively affected by individual risk behaviors.
The paper can be viewed online in the American Journal of Public
“Improving our understanding of the factors that contribute to
the health disparities seen in HIV is one of our top priorities,” says
Dr. Elias Zerhouni, director of the National Institutes of Health. “Studies
like this help define the problem, but further research may provide
us with a greater understanding of why this population is at higher
risk and how best to intervene.”
Environmental, institutional, and contextual influences, such
as differences in social and dating patterns, are among the many
factors identified by the researchers that may play a role in one’s
risk for HIV. The authors recognize that research that seeks to
address racial disparities in STD and HIV infection must proceed
with sensitivity and involve dialogue and consensus among all community
“NIDA has conducted many studies that link drug abuse and other
risky behaviors to HIV infection,” says NIDA Director Dr. Nora
D. Volkow. “This study is particularly interesting because it suggests
that given similar patterns of risk behaviors across racial groups,
young African American adults are more likely to become infected.
As a result, we need to look beyond strategies that target individual
risk behaviors and focus on outreach and education for this population
as a group.”
“We found that the most normative category for young African American
adults (almost 38 percent of participants) was one of the lowest-risk
categories, characterized by having few sexual partners and low
alcohol, tobacco, or drug abuse. Yet these same individuals were
more than seven times as likely as young white adults in the same
category to harbor an STD/HIV infection” says lead scientist Dr.
Denise Hallfors of the Pacific Institute for Research and Evaluation
in Chapel Hill, North Carolina.
The scientists stratified the participants into 15 behavioral
patterns ranging in risk level from relatively low (e.g., having
few sexual partners and low alcohol, tobacco, or drug use) to high
(e.g., intravenous drug abusers). The researchers observed that
the STD/HIV prevalence among young African American adults was
high for all 15 defined behavior patterns regardless of risk level,
whereas among young white adults, the STD/HIV infection prevalence
was only high for the four most risky behavior patterns — exchanging
sex for money, intravenous drug abuse, men having sex with men,
and abusing marijuana and other drugs.
The study authors recommend continuing a proactive strategy to
reach all African American young adults, including universal screening
and expanding information, testing and treatment services to non-traditional
venues, such as churches, beauty salons and barber shops, colleges,
prisons and jails.
The researchers analyzed 2001-2002 population-based data from
6,257 young white adults and 2,449 young African American adults
nationwide 18 to 26 years old. They were participants in The National
Longitudinal Study of Adolescent Health and had completed initial
surveys when they were in 7th to 12th grades in 1994-1995. In this
assessment, participants used computer assisted self-interviewing
technology to respond to sensitive questions about sexual and substance
abuse history. Following the interview, participants were tested
for STDs and HIV.
“These surprising new findings suggest that a more comprehensive
research approach is needed to understand the factors that make
young African American adults vulnerable to STD and HIV infection
beyond the commonly known individual risk behaviors,” says Dr.
Volkow. “Most STDs can be cured, the health and lifespan of people
infected with HIV can be significantly increased by available therapies,
and prompt diagnosis and treatment may reduce the spread of these
The National Institute on Drug Abuse is a component of the National
Institutes of Health, U.S. Department of Health and Human Services.
NIDA supports most of the world’s research on the health aspects
of drug abuse and addiction. The Institute carries out a large
variety of programs to ensure the rapid dissemination of research
information and its implementation in policy and practice. NIDA
sponsors the Learn the Link campaign to highlight the
well documented link between non-intravenous drug use and HIV.
Information on the Learn the Link campaign, as well as
fact sheets on the health effects of drugs of abuse and information
on NIDA research and other activities can be found on the NIDA
home page at www.drugabuse.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.