The FIAAY Project

The year 2020 witnessed the expansion of what became the largest protest movement in the history of man. Across the globe, people of different races, nationalities, and creeds came together to oppose the deaths of unarmed Black people by state actors. Along with this, many are developing a more nuanced understanding of inequities within the criminal justice system. There is greater recognition that these protests were about systemic racism in the criminal justice system and not just police violence.

Biases in the criminal justice system are well documented. A prominent example is the War on Drugs. Although Whites and African Americans sell and use drugs at roughly the same levels, the arrest rate for drugs is nearly three times higher for African Americans.1 Generally, African Americans are policed more heavily, charged more severely, and receive harsher sentences for similar crimes as Whites.2  As a result, African Americans are imprisoned at a rate that is over five times higher than Whites.3 These inequities impact Black communities in multiple areas of life ranging from economics, education, and, of particular interest, health.

One area where health and mass incarceration is receiving increasing attention is HIV. Mass incarceration leads to greater HIV vulnerability for African Americans. Communities with more people who have been to jail tend to have higher HIV rates than others.Among people in jail, African American men are five times more likely to have HIV than White men.5 The same trend is occurring among women.  African American women in jail are more than twice as likely to have HIV compared to jailed White women.5

This is especially concerning given higher HIV rates in African American communities.  It is expected that 1 in 20 African American men will be diagnosed with HIV compared to 1 in 132 White men.6  An estimated 1 in 48 African American women will have HIV compared to 1 in 880 White women.6  Higher HIV rates cannot be fully explained by behavior. For example, African American women use condoms more than White women.7  African American men who have sex with men engage in fewer sexual risks than White men who have sex with men.8  Clearly something outside of behavior is driving differences in HIV rates.  Research indicates that the interactions African Americans have with the criminal justice system may help drive different HIV rates between Black and White communities.9

Despite the negative impacts that incarceration has on HIV in African American communities, there is reason for hope. If HIV is detected early and people are linked to care, they can live longer and help prevent the spread of HIV. HIV medications today are so effective that this disease is not the death sentence that it used to be. Medications can also eliminate enough virus in the blood so that it will not transmit to others. However, to realize maximum benefit, HIV should be found early. Early detection among young African Americans who have been involved in the criminal justice system is therefore critical reducing HIV disparities.

Despite the benefits of testing, there are several barriers that reduce timely HIV diagnosis for people who have a history of incarceration. To gain more information on this and create strategies to reduce HIV vulnerability, researchers at the University of Louisville began the FIAAY (Fighting Injustices among African American Youth) study.  These scientists want to gain information that can address HIV in African American communities by exploring police– community relations, perceptions about HIV, and barriers to HIV testing.  

The project consists of:

-- Online surveys with 300 African American young adults (age 18-24) in Louisville, Kentucky, who have been in jail or prison.
-- Surveys will be completed annually over three years.
-- Participants will receive up to $75.

Beating HIV is a big challenge but it can be done. Everyone can help in their own way. To learn more about this study or to participate, reach out to us:

Call: 502-852-1908
Text: 773-895-5068
Email: fiaayhiv@louisville.edu
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References

1. Alexander M. The new Jim Crow: Mass incarceration in the age of colorblindness. The New Press; 2020

2. Synder, H. (2011). Arrest in the United States, 1980-2009. In. Washington DC: US Department of Justice.

3.Carson EA. Prisoners in 2017. Washington, DC: US Department of Justice, Bureau of Justice Statistics;2019

4.Ojikutu BO, Srinivasan S, Bogart LM, Subramanian SV, Mayer KH. Mass incarceration and the impact of prison release on HIV diagnoses in the US South. PLoS One. 2018;13(6):e0198258.

5.  Centers for Disease Control and Prevention. HIV among Incarcerated Populations. 2017; https://www.cdc.gov/hiv/group/correctional.html.

6.  Centers for Disease Control and Prevention. 2016 Conference on Retroviruses and Opportunistic Infections. 2016; https://www.cdc.gov/nchhstp/newsroom/2016/croi-2016.html. Accessed April 19, 2017.

7. Annang L, Walsemann KM, Maitra D, Kerr JC. Does education matter? Examining racial differences in the association between education and STI diagnosis among black and white young adult females in the US. Public Health Reports. 2010;125(4_suppl):110-121.

8. Millett GA, Flores SA, Peterson JL, Bakeman R. Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. AIDS. 2007; 1;21(15):2083-91.

9. Kerr J, Jackson T. Stigma, sexual risks, and the war on drugs: Examining drug policy and HIV/AIDS inequities among African Americans using the Drug War HIV/AIDS Inequities Model. International Journal of Drug Policy. 2016 ; 1;37:31-41.

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