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The first cases of what would later be known as AIDS were first identified in the United States in June of 1981 (CDC, 1981). Since this recognition of the HIV/AIDS epidemic in the United States, patterns of morbidity and mortality have been altered, sexual practices scrutinized, and healthcare institutions overwhelmed. Today there are an estimated 1.1 million adults and adolescents living with HIV infection (CDC, 2008), and approximately 56,000 new HIV infections are occurring in the U.S. every year (CDC, 2010; Hall et al., 2008). Current HIV incidence rates have been stagnant since 2000 and are considerably lower than the mid 1980’s peak of new HIV infections (see figure 1). Incident rates during the 1980’s reached 130,000. The advent of highly active antiretroviral therapy (HAART) has helped to slow the progression of HIV to AIDS. However, antiretroviral drug resistant HIV-1 has been noted since 1993 (Eshleman et al., 2007). Today it is possible for people to contract a strain of HIV-1 that is resistant to up to three antiretroviral drug classes (Eshleman et al., 2007). Despite stagnant rates of new HIV infections, and modern biomedical convention that indicates equal susceptibility to contraction of HIV, the epidemic still disproportionately impacts specific subpopulations in the United States and some specific groups show increased incidence of HIV when compared to the general population. These groups often experience political and economic subordination, disenfranchisement, and stigmatization. The most frequently researched of these subpopulations include; persons who are substance abusers (specifically injection drug users), men who have sex with men (MSM), Latino and African American women, older adults (over the age of 50), and adolescents (ages 13-24). What factors contribute to increase prevalence of HIV among these groups? Access and utilization of health services in the early stages of HIV infection can positively impact survival time (Andersen et al., 2000; Bozzette et al., 2003; Montgomery et al., 2002). The use of HAART is credited with declining rates of HIV associated morbidity, hospitalizations and mortality (Bozzette et al., 2003; Montgomery et al., 2002). Interventions for modifying risk behavior and providing current, appropriate health education and medical care have been tested and proven effective in subpopulations. However, in order to develop and fund effective interventions, an understanding of the social determinants of illness within these groups proves advantageous.

Impact of Socio-Medical Factors on the Prevention and Treatment of HIV/AIDS Among Specific Subpopulations