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There are many health problems facing the urban communities of the United States of America today. These include the lack of clean water, food and other necessities to the population. Other problems involve the transport of human excreta and waste products away from human dwelling. The major potential for problems in urban centers is the increased exposure to many individuals who can spread infectious diseases, the availability of pollutants, increase in stress levels, as well as a concentration of serious mental health problems.

The main health issues of Central Harlem are tobacco smoking, HIV/AIDS, and other sexually transmitted diseases (Fanelli 15). More than one in four adults in the town smoke. Besides, Central Harlem has a double number of HIV/AIDS cases when compared to other urban areas in the United States of America, for instance New York City and Manhattan. Moreover, Central Harlem has elevated cases of sexually transmitted diseases, for example, Chlamydia and gonorrhea. HIV/ AIDS and other sexually transmitted diseases go hand in hand because of the mode of transmission.

This paper will analyze the factors that make HIV/AIDS more prevalent in Central Harlem than in other neighboring urban centers. Studies involving Central Harlem indicate that the region has unusually high prevalence of HIV/AIDS (HIV/ AIDS Policy Fact Sheet 1). There is the need to establish the high prevalence in order to suggest interventions to manage the situation.

Central Harlem town is in the eastern side of St. Nicholas Avenue, northern side of 110th Street, Southern side of 155th Street, and western side of the 5th Avenue. As of 2006, Central Harlem had a population of 151, 100. The town is home to various races, which include Black (67%), Hispanics (19%), White (8%), Asian (3%), and other races (3%). In a period of approximately 10 years, about 10,000 new residents migrated to Central Harlem. This enabled a 9% increase in the population. In that period of ten years, there was an increase of 9,000 whites, which was a 400% increase. Hispanics increased by 8,000, which was about a 40% increase. This means that Central Harlem has a significant immigrant population. The immigrants are mostly American Citizens. However, there is a significant portion of people from other countries (Fanelli 15). Blacks remain the majority in Central Harlem, making 60% of the population. It is crucial to notice that, in the ten-year period, the blacks experienced a drop of 9,500 people. This was an 11% loss. The decline resulted from the migration of the aging blacks who decided to retire down south, and the young generation, who were struggling to secure places in the neighborhood towns (HIV/AIDS Fact Sheet 2).

The HIV/AIDS Fact Sheet notes that residents of Central Harlem having 25 years and above underwent fewer years of education than those in other urban towns like Manhattan. 11% of the population of Central Harlem went up to eighth grade. 22% went up to high school but does not have diplomas. 25% has a high school diploma, while 22% went to college, but does not have degrees. 20% of the population has college degrees.

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The most outstanding aspect of the physical environment of Central Harlem is the presence of drugs and alcohol. In the town, 12% of adults report that they have engaged in more than one incident of binge drinking in the past month (HIV/ AIDS Policy Fact Sheet 2). Binge drinking is the consumption of more than five drinks in an occasion. This leads to a high rate of alcohol related hospitalization. Besides, the high number of drug cartels in the town has resulted to high numbers of drug-related problems.

The social environment of Central Harlem consists of high crime rates. Partly, this arises from the alcohol and drug abuse. Besides, poverty is widespread in the population. This is a result of the high unemployment rate. It is no wonder that some residents turn to crime in order to make a living. However, what is most outstanding in Central Harlem’s social environment are health related issues, especially HIV/AIDS. As already noted, Central Harlem has a double number of HIV/AIDS cases when compared to other urban areas in the United States of America, for instance New York City and Manhattan.

The Case of HIV/AIDS in Central Harlem

There exist wide disparities in HIV/AIDS across the New York communities. The disparities stand out in the case of Central Harlem as “the rate of HIV diagnoses and the rate of people with HIV in the community are more than twice the rates in NYC overall” (HIV/AIDS Fact Sheet 2). This is despite the fact that the death rate due to HIV related complications in the town dropped by 75% as compared to the past decade. In 2003-2004, the death rate was 47/100,000, which was double that of Manhattan (22/100,000), and that of New York Center (18/100, 000).

The population of Central Harlem consists of more young people than old people (Roberts 16). HIV/IDS is more prevalent in the younger generation than in the old because the young generation has high rates of sexual activity. Besides, the most likely way of contracting HIV/AIDS is through sexual contact. Keeping multiple sex partners raises the risk of acquiring HIV/AIDS. The use of condoms offers protection from the virus. However, fewer than four in ten adults from Central Harlem who have more than one sex partner use condoms (U.S. Department of Health and Human Services 433).

The high prevalence of HIV/AIDS attributes to same sex sexual relations. HIV transmission in Central Harlem is high among same sex sexual partners. According to the U.S Department of Health and Human Services, male to male sex is the most common way of exposure to HIV/AIDS (431). Heterosexual exposure contributes to only 11% of the infections. This arises from the high probability of wear and tear during anal sex. In addition, there are no condoms designed for anal sex and, as a result, the available ones may not be efficient in prevention. This translates to high risk of exposure among same sex sexual partners. According to U.S. Department of Health and Human Services, the town of Central Harlem has an approximately 10% of same-sex sexual partners (436).

In addition, the high rates of drug and alcohol abuse in Central Harlem influence the large number of HIV infections. Drugs and alcohol alter reasoning and, as a result, can make an individual engage in risky sexually behaviors. Besides, sharing of the paraphernalia used to administer the drugs leads to the spreading of HIV. The HIV/AIDS Policy Fact Sheet posits that approximately 10% of HIV transmissions in Central Harlem are a result of sharing injections used to administer drugs (2).

Poverty and unemployment in Central Harlem leads the residents to pursue activities that can spread HIV/AIDS, for instance prostitution. The Department of Health and Human Services established that prostitution is a main cause of the spread of HIV/AIDS (435). In Central Harlem, there is wide spread prostitution (Roberts 16). This is because of unemployment and idleness of the youth. In fact, the Department of Health and Human Services established that the majority of the people who indulge in prostitution are people having a high possibility of sexual transmitted diseases and HIV/AIDS. These diseases then trickle down to the entire population of Central Harlem.

Moreover, the high number of immigrants in Central Harlem negatively affects the fight against HIV AIDS. This is because new immigrants may bring new cases of HIV/AIDS to the town. This is especially significant given that the last ten years have seen an increase in the population of Central Harlem because of an influx of immigrants. It is likely that this new population adds to the statistics of HIV/AIDS cases in Central Harlem.

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The above factors combined with a high population density expose Central Harlem to HIV/AIDS. Though other towns of the United States of America might have similar problems, research has revealed that Central Harlem stands out. Let us look at Central Harlem basing on the reports of some studies on HIV/AIDS done in the United States of America.

Two studies are crucial in analyzing the HIV/AIDS trends of Central Harlem.  These are the 2001 study by the U.S. Department of Health and Human Services and the study that led to the HIV/AIDS policy Fact Sheet of 2012.

According to the Department of Health and Human Services, HIV infection in the United States of America is high among urban centers. This is especially so among African Americans. Surveys in Baltimore, Dallas, Los Angeles, Miami, San Francisco and Seattle established that African Americans are prone to infection than other races (U.S department of Health and Human Services 441). As already noted, Central Harlem has a majority black population. This trend might explain the high prevalence of HIV/AIDS in the town. The African Americans have high rates of unemployment and poverty. The drug culture and alcohol abuse are also deeply enshrined in African Americans than in other races. This fosters transmission of HIV through dangerous sexual exposures and sharing of drug paraphernalia (U.S department of Health and Human Services 430).

According to the HIV/AIDS Policy Fact Sheet, early screening is crucial to make room for early intervention (1). However, the fact Sheet estimates that a quarter of the residents of Central Harlem living with HIV/AIDS does not know their status. This delays the treatment and increases the possibility that the victims will spread the disease to others. Roberts notes that, in Central Harlem, one in five positive HIV results is a late diagnosis (16). The HIV/AIDS Policy Fact Sheet posits that 33% of HIV diagnoses in the United States of America are late Diagnoses (1). This echoes the situation in Central Harlem.

The fact sheet established that HIV transmission was high among young people. This involved people of less than 30 years. Those betweeen 13 and 29 years accounted for 39% of new HIV infections in 2009. Most of these young people got the disease through sexual exposure (HIV/AIDS Fact Sheet 2). Central Harlem has mostly young people. This explains why Central Harlem has a high prevalence of HIV/AIDS. The elderly population retires to other regions (Roberts 16).      

The findings of the HIV/AIDS Policy Fact Sheet and the Department of Health and Human Services echo the propositions for the high prevalence of HIV in Central Harlem.

Mitigation against HIV/AIDS in Central Harlem

Advocacy and awareness campaigns in the community of Central Harlem will control the high prevalence of HIV/AIDS. Awareness and advocacy campaigns are especially crucial to enable early diagnosis of the disease. Early intervention is significant in preventing the spread of HIV/AIDS. It also helps in managing complications and deaths related to HIV (U.S. Department of Health and Human Services 440). As a result, the government, non-governmental organizations and other stakeholders should begin awareness and advocacy campaigns about HIV/AIDS in Central Harlem. These campaigns should inform the public of Central Harlem of the dangers of having multiple sexual partners. Besides, it is crucial to inform the public about the advantages of condoms. Awareness and advocacy campaigns should demystify condom use so that many residents can take up the practice.

HIV/AIDS is prevalent in people engaging in male to male sexual relationships. To stop this trend, there is the need to explain the various risks involved with male to male sex. Awareness campaigns are crucial to foster safe sex practices like being faithful to one partner.

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Besides, there is the need to provide employment opportunities and other poverty eradication programs in Central Harlem. Poverty is the principal cause of indulgence in prostitution, drugs and alcohol. These activities foster the spread of HIV/AIDS. If the population finds alternative means of income generation, it is likely that incidences of prostitution will reduce. Moreover, alternative forms of employment will reduce idleness which leads to drug abuse and alcoholism. The government and other stakeholders should explore ways of directing the youth away from these activities. This could be through the establishment of industries that can employ the youth.

Moreover, there is the need to continue giving antiretroviral therapy to the already infected. This will help reduce human suffering and in Central Harlem.

This paper has identified the factors that lead to the high prevalence of HIV/AIDS in Central Harlem. These include the high population of young people in the town. The world wide trends of HIV infection indicate that young people are at high risk of HIV infection because of their sexual activity. Another factor that leads to the high prevalence of HIV/ AIDS in Central Harlem is the wide spread drug and alcohol abuse. Drugs and alcohol impair consciousness and, as a result, expose people to sexual practices that can transmit HIV. Besides, Central Harlem has high rates of unemployment and poverty. This leads the youth to prostitution and drug use. Prostitution directly exposes the individual to HIV. On the other hand, the paraphernalia used to administer drugs can transmit HIV. Having multiple sexual partners, same sex sexual relationships, not using condoms and a high immigrant population are other factors that lead to the high prevalence of HIV/AIDS in Central Harlem.

It is crucial to note that the prevalence of HIV/AIDS is high in towns that have a large population of African Americans, such as Central Harlem. The town, which has a 60% black population, has double the number of HIV/AIDS cases when compared to other neighboring towns. The case is the same to other urban centers like Baltimore, Dallas, Los Angeles, Miami, San Francisco and Seattle. Studies have attributed this fact to poverty, unemployment, and drug and alcohol use among the black population (U.S. Department of Health and Human Services 450). As a result, HIV/AIDS mitigation drives should target urban centers that have high populations of African Americans.

Central Harlem has unusually high rates of HIV/AIDS. This trend is likely to increase if collective effort does take control. Many people in the town have the disease, yet they do not know their status. The risk here is that these people will spread the virus further. There is the need to create awareness and advocacy in Central Harlem to foster early screening and intervention. The awareness and advocacy campaigns should mainly target the Central Harlem's black population as it has a high risk of infection. In addition, continued availability of antiretroviral drugs to the already infected population of Central Harlem will ease human suffering and reduce deaths. These measures are crucial to aid in the realization of the millennium development goal of combating HIV/AIDS.

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