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HIV rates are higher in southern states, which are home to around 45% of all people living with HIV, and account for around half of the new diagnoses annually in the USA, despite making up roughly one-third (37%) of the population.3 Since the beginning of the HIV epidemic, 692,790 people have died of AIDS-related illnesses in the USA.4 President Obama created the USA’s first National HIV/AIDS Strategy in 2010.

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Transgender people who took an HIV test in 2013 were 3 times more likely to have received a new HIV diagnosis than the rest of the population who tested.

More than half of the transgender people testing positive for HIV between 20 were African American/black (58% of transgender men and 51% of transgender women).25 The USA has the largest incarcerated population in the world, with 2.2 million people in prison or other closed settings.26 HIV prevalence is estimated to be 1.5% among prisoners, compared to 0.5% among the general population.

Heterosexual African American/black women and transgender women of all ethnicities are also disproportionately affected.

The USA is the greatest funder of the global response to HIV, but also has an ongoing HIV epidemic itself, with around 37,600 new infections a year.2 Stigma and discrimination continue to hamper people's access to HIV prevention as well as testing and treatment services, which fuels a cycle of new infections.

Throughout 2017, the post of Director of National AIDS Policy, which exists to coordinate efforts to implement the National HIV/AIDS Strategy, has been vacant.

By the end of 2017, all members of the Presidential Advisory Council on HIV/AIDS (PACHA), which provides advice on the National HIV/AIDS Strategy, had either resigned or been fired.

New diagnoses fell by 20% among African American/black women, however rates of new diagnoses are still high compared to women from other ethnic groups, with 4,560 new diagnoses in 2016.19 New infections have also fallen by 16% among heterosexual African American/black men and by 39% among African American/black people who inject drugs.20 HIV also disproportionately affects the Hispanic/Latino community.

In 2015, Hispanic/Latino people accounted for 24% of new diagnoses of HIV in the USA, despite only representing around 18% of the population.21 Men account for approximately 87% of new annual HIV infections among Hispanic/Latino people, the vast majority (85%) of these were the result of condomless sex with men.

Language, cultural factors and fear of being deported are all key barriers.24 Around 1 million adults identify as transgender in the USA.

From 2009 to 2014, 2,351 transgender people were diagnosed with HIV in the country, the vast majority of whom (84%) were transgender women.

When analysed on ethnicity, 38% were among African American/black people, 40% were among white people, and 19% were among Hispanics/Latino people.35 Young people (aged 13-24) accounted for one in five (22%) new HIV infections in 2015.

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