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Boston boasts several of the world’s most renowned hospitals and medical training facilities. The PACT project serves people and communities who do not have access to those facilities – mainly people of color who are almost always poor and usually unemployed and uninsured.

Most of PACT’s patients and most of the community health workers who serve them are African-American or Latino people from inner-city Boston neighborhoods. Many of them speak little English and have limited reading and writing skills in their native languages. More than 90 percent of our patients have experienced long-term unemployment as a result of HIV-related disability, language, or educational obstacles.

The three largest communities we serve – Dorchester, Roxbury and Mattapan – bear the brunt of the HIV pandemic in Boston and have populations made up mainly of minorities. Recent studies have found that minorities contract HIV at two to twelve times the rate of their white counterparts and are much more likely to die from their illness than whites.

According to a June 2006 report from the Massachusetts Department of Public Health, AIDS ranked as the sixth leading cause of death for Hispanics, ninth for non-Hispanic Blacks, but only the twenty-fifth for whites. According to a public health commission report, North Dorchester bears the highest burden with six percent of the city’s total population and 16 percent of Boston’s reported HIV/AIDS cases. It is estimated that between 10 and 15 percent of the overall HIV population in Boston (or 700-800 patients) are eligible for PACT services.

The conditions that PACT has been confronting in Boston for more than a decade are indicative of a pervasive national problem: alarming racial and ethnic disparities in health outcomes in the U.S. Despite wider access to treatment for HIV, a combination of late HIV diagnoses, low access to health care, and poor medication adherence are resulting in growing numbers of patients with AIDS. In 2004, Blacks and Hispanics accounted for about a quarter of the U.S. population but more than 70 percent of those diagnosed with AIDS.