African American and HIV/AIDS Survey - Kaiser Family Foundation

The Kaiser Family Foundation Survey of African Americans on HIV/AIDS

African Americans Report Need For Information About HIV/AIDS

Almost 3 in 5 African Americans (62 percent) want help talking with their children about AIDS prevention. Many also say they need information about HIV testing (46 percent) and about where to go for help if exposed to HIV (55 percent).

Forty percent of African Americans report the need for information on what to discuss with partners about sex. And slightly more than one in four (27 percent) says they need information about the proper way to use condoms.

Information Sources

Some 46 percent of African Americans cite the media-TV, radio, newspapers or magazines as their leading source of information about HIV/AIDS in the month prior to the survey. Eleven percent names their doctor or health care provider, 6 percent says they got information from work, and 5 percent lists family, friends and acquaintances as the number one source. Two percent says they received the most information from materials distributed by AIDS organizations or advocacy groups.

African Americans report high levels of news consumption related to HIV/AIDS. Four in five (78 percent) have seen or heard a lot or some news coverage of HIV and AIDS on television, radio, in newspapers and other media in the last year or so. Almost one in two African Americans (49 percent) says they have seen a lot or some news specifically about the new combination drug treatments.

In spite of recent advances in the treatment of AIDS which have spurred greater optimism about the AIDS epidemic, only one in five African Americans says today's news coverage about HIV/AIDS gives the impression that AIDS is a less urgent problem now than it was a few years ago. Eight in ten say coverage portrays the problem of AIDS as more urgent (39 percent) or about the same (39 percent).

African Americans support using T V and film to educate people about HIV prevention. Most African Americans believe that the major television networks should accept advertising from condom manufacturers (74 percent) and that when movies and TV shows deal with sexual relationships, there ought to be more references to condom use (69 percent). This reflects slightly higher support than is voiced by the national sample of all Americans: 62 percent supports condom advertising and 55 percent says there should be more condom-references in movies and on TV.

Attitudes of African American parents toward HIV/AIDS are similar to those of African Americans in general and to parents overall. African American parents represented 46 percent of the African Americans surveyed.

Almost 7 out of every 10 African American parents (68 percent) are very concerned about their son or daughter becoming infected with HIV.
Half (49 percent) are more concerned today than they were a few years ago.
More than 3 out of 5 African American parents (65 percent) say they need information about discussing AIDS prevention with children. Parents rate this as the most important information need (43 percent), more so than the African American sample overall (36 percent).
Seventy-two percent of African American parents believe that the federal government is spending too little money on AIDS.
Almost all African American parents believe that the federal government should spend money on HIV and AIDS education and other prevention efforts (96 percent).
Most parents think that major television networks should accept advertising from condom manufacture r s for broadcast (76 percent).
African American pare n t's a re also very supportive of including more references to condom use in movies and television shows which deal with sexual relationships (75 percent). Their support is slightly higher than African Americans overall (69 percent ).

Talking With Providers: Health Professionals As Information Sources

Half of African Americans (52 percent) have never talked to a doctor or health care provider about any aspect of HIV or AIDS, including the risks of being infected with HIV and getting tested for HIV. Only one in three African Americans has talked to a health care provider specifically about getting tested for HIV (33 percent), or their personal risk of being infected (35 percent).

When it comes to the actual conversations about testing for HIV, a majority of African Americans (58 percent) says they raised the subject with their doctor or health care provider as opposed to waiting until the provider brought it up. However, when talking about risks of being infected with HIV, the majority of African Americans says a doctor brought it up (51 percent).

On a related topic, African Americans who have tested for HIV we 're more likely to discuss the results with a health professional than the subset of all Americans who have been tested. In fact, more than two-thirds of African Americans say they discussed their results with a doctor, medical professional, or counselor, compared to half of all Americans. Still, 31 percent did not.

Implications Of The Survey Findings

The Kaiser Family Foundation National Survey of African Americans on HIV/AIDS reveals important findings about the perceptions of African Americans which can help pave the way for future efforts to address HIV/AIDS within the African American community. First, African Americans express a great sense of urgency about HIV/AIDS as a national public health concern, a community concern, and personally. Their sense of urgency exceeds that of the national sample of all Americans and continues to grow in spite of mounting optimism about declining death rates and better treatments. Heightened urgency is consistent across all African American subgroups but is particularly striking among younger African Americans, who express greater worry about HIV/AIDS and personal risk than African Americans overall. Concern among African Americans may reflect personal experience: African Americans are more likely to know someone with HIV or with AIDS, or who has died from AIDS. This is certainly borne out by the epidemiological data, which indicate the increasing impact of HIV/AIDS on the African American community.

Our survey findings also suggest a relatively high level of general knowledge about HIV/AIDS among African Americans when compared to all Americans although there is still a need for information. Importantly, African Americans express a greater desire for information about HIV/AIDS in all areas including talking with kids about HIV/AIDS, where to go for help if exposed to HIV, and testing. The overall appetite for information suggests both a climate of receptivity toward education campaigns and a desire to be involved in reducing personal risk and risk to children.

We know that knowledge does not always translate into behavior change, but this national survey does start to highlight information needs as well as venues for targeted prevention programs and information campaigns. Information sources cited by African Americans differ from those of all Americans, as do their experiences talking with health care providers about HIV/AIDS. This is also true for subgroups of African Americans, including women, young adults, and those with lower incomes and less education.

Finally, there is strong support among African Americans for more local and national efforts in AIDS education, research, and prevention programs. African Americans see a role for national, state, and local initiatives in the fight against AIDS and support strongly prevention education. While African Americans say community groups do care about the fight against AIDS, few believe that these groups are actually doing that a lot in the fight against AIDS. The impressions of local, state and national governments are even less favorable, with fewer than one in five African Americans saying governments are doing a lot to combat AIDS. There is room for further action.

Methodology

The Kaiser Family Foundation National Survey of African Americans on HIV/AIDS was designed by the Kaiser Family Foundation and conducted for the Foundation by Princeton Survey Research Associates. The data were collected in conjunction with a larger study of Americans' knowledge and opinions about HIV/AIDS, which followed a similar survey conducted in 1995. Participants in the African American survey were interviewed by telephone between September 19 and October 26, 1997. Respondents were selected if they self-identified as black or African American and not of Hispanic or Latino background. The responses from a total of 811 interviews of African American adults, age 18 or older, are reported here. Data were weighted to match U.S. Census Bureau estimates of age, sex, education and regional distributions of African American adults living in telephone households in the continental United States. The margin of sampling error for results based on the total sample is plus or minus 4 percentage points although the margin of error is larger for some subgroups.

End Notes

1. Centers for Disease Control and Prevention. (1997). HIV/AIDS Surveillance Report, Midyear Edition Vol. 9, No.1.

2. Karon, J.M. et. al. (1996). "Prevalence of HIV Infection in the United States, 1984 to 1992", Journal of the American Medical Association, Vol. 276, No. 2.

3.Throughout this report, the term African American is applied to the survey sample and epidemiological data to represent non Hispanic Blacks, unless otherwise noted.

4. Centers for Disease Control and Prevention. (1982). Kaposi's Sarcoma (KS), Pneumocystis Carinii Pneumonia (PCP), and Other Opportunistic Infections (OI): Cases Reported to CDC as of June 15, 1982. First Report.

5. U.S. Bureau of the Census. Current Population Reports, Population Estimates and objections, Series P-25. Note that data were reported by race only, not by race and ethnicity.

6.Centers for Disease Control and Prevention. (1997). HIV/AIDS Surveillance Report, Midyear Edition Vol. 9, No.1.

7. U.S. Bureau of the Census. United States Population Estimates, by Age, Sex, Race, and Hispanic Origin, 1990-1996. Release PPL-57.

8. National Center for Health Statistics. (1997). Health, United States, 1996-97 and Injury Chartbook. Hyattsville, Maryland. Cases per 100,000 population for 12 month period ending June 30, 1996.

9. Centers for Disease Control and Prevention. (1997). HIV/AIDS Surveillance Report, Midyear Edition Vol. 9, No.1. Pediatric cases represent those under 13 years of age.

10. Centers for Disease Control and Prevention. (1997). HIV/AIDS Surveillance Report, Midyear Edition Vol. 9, No. 1.

11. Centers for Disease Control and Prevention. (1997). "Update: Trends in AIDS Incidence - United States, 1996."

12. Morbidity and Mortality Weekly Report, Vol. 46, No. 37. Centers for Disease Control and Prevention. Office of the Associate Director of Minority Health.

13. Centers for Disease Control and Prevention. (1997). "Update: ends in AIDS Incidence United States, 1996". Morbidity and Mortality Weekly Report, Vol. 46, No. 37.

14. Personal communication, Drs. Martin Shapiro and Samuel Bozzette, February 1998.

15. Others include the National Center for Health Statistics, National Health Interview Survey (NHIS) from 1988- 1990 and Blendon et.al. (1992), "Public Opinion and AIDS: Lessons for the Second Decade", Journal of the American Medical Association, Vol. 267, No. 7. The NHIS, a lon gitudinal survey, discontinued surveying Americans about HIV/AIDS after 1990.

16.Refers to the Kaiser Family Foundation 1997 National Survey of Americans on AIDS/HIV, a nationally representative sample of American adults, including representative proportions of minority respondents. This sample is herein referred to as "all Americans."

17. Centers for Disease Control and Prevention. (1997). HIV/AIDS Surveillance Report, Midyear Edition Vol. 9, No.1.

18. National Center for Health Statistics. (1997). Health, United States, 1996-97 and Injury Chartbook. Hyattsville, Maryland. Cases per 100,000 population for 12 month period ending June 30, 1996.

19. AIDS Research Institute/The Center for AIDS Prevention Studies, University of California and the Harvard AIDS Institute. (1997). Dangerous Inhibitions: How America is Letting AIDS Become an Epidemic of the Young.

20. Centers for Disease Control and Prevention, 1995 Youth Risk Behavior Surveillance System.

21.Preliminary data from the HIV Cost and Services Utilization Study. Personal communication, Drs. Martin Shapiro and Samuel Bozzette, February 1998.

22. Thirty-five percent of those earning less than $20,000 have less than a high school education.

23. De Zousa. (1995). "The Role of HIV Counseling and Testing in Changing Risk Behavior in Developing Countries," AIDS, ol. 9, Suppl. A; Donovan, C. et.al. (1994). "A Review of the HIV-Related Sexual Behavior of Gay Men and Men Who Have Sex With Men," AIDS Care, Vol. 6, No. 5; Hospers, H.J. and Kolk, G. (1995). "Determinants of Safe and Risk-Taking Sexual Behavior Among Gay Men: A Review," AIDS Education and prevention, Vol. 7, No. 1.