WASHINGTON (FinalCall.com) – When AIDS first hit America in the ’80s as a White, gay disease, there was a massive media campaign to educate and prevent future transmissions.
Now that it’s a Black disease, with this community leading in new infections, the Black AIDS Institute believes Blacks have been almost abandoned.
In “Left Behind: Black America: a Neglected Priority in the Global AIDS Epidemic,” Jesse Milan, Jr., Black AIDS Institute board chair, writes, “In this report, we point out that Black America is lacking a partner in the federal government when it comes to fighting AIDS, and in many ways has been left behind by most foundations and almost all global health agencies.”
“The point of this report, rather, is that the same zeal, wisdom and courage our government is now showing on global issues must be brought to bear in the fight against AIDS at home,” said Mr. Milan.
The report concludes America is “failing to respond effectively to the AIDS crisis in Black America.”
Dr. Helene D. Gayle, president and chief executive officer of CARE, agrees.
“Essential AIDS programs on which Black Americans rely have barely grown in recent years–in some cases, failing to keep pace with inflation. The country’s failure is especially striking when it comes to programs to prevent new HIV infections, which account for only 4 ¢ of every dollar the U.S. government spends on the domestic AIDS epidemic,” she writes in the report.
“And as the threat posed by the epidemic grows ever more acute in Black communities across the country, overburdened community agencies are struggling to do more with fewer and fewer resources.”
Phil Wilson, executive director of the Black AIDS Institute, also believes the government should do more. “Forty percent of new cases among men are among Blacks, as are 60 percent of new cases among women and 70 percent of new cases among teens. In some Black neighborhoods the incidence of HIV infection is equivalent to nations in sub-Saharan Africa,” he noted.
“The epidemic is so bad that the U.S. of Black America would qualify for the President’s Emergency Plan for AIDS Relief (PEPFAR), the aid the U.S. government offers to countries with the worst AIDS epidemics.” The report was released July 29.
HIV infection rate underestimated
The problem of HIV infections in America is also larger than previously thought. The Centers for Disease Control announced Aug. 3 at the XVII International AIDS Conference in Mexico that previous estimates were off by thousands of cases. It estimated some 56,300 current cases of HIV infection.
“That’s still just an estimate and it’s low. The real numbers aren’t known because not enough people are getting tested. There has to be extensive testing in the Black community. Everyone needs to get tested. It doesn’t matter if you are gay, straight, married or single,” Dr. Jewel Crawford, professor at Morehouse Medical School, told The Final Call.
“These numbers are only guesses. It could be much more than that. The focus has to be on testing. In countries like Cuba where everyone is tested, they have more accurate numbers. We have 50 million people without health care. They’re not getting tested. Most of those are our people. The real numbers aren’t known.”
With more testing, people will know their status and many will change their behavior, said Dr. Crawford. Testing allows those who are HIV positive to get treatment sooner, while those who are HIV negative can be made aware of how to prevent contracting the infection.
The CDC said the undercount came to light with the use of a more precise method for estimating annual HIV incidence based on the number of individuals who become newly infected with HIV in a given year.
The increase wasn’t news to Mr. Wilson. “On the one hand, these higher figures make me feel vindicated. For years, the Black AIDS Institute and other AIDS advocacy organizations have been telling the CDC that their figures were too low, as they insisted they were right,” he said.
“We knew they were wrong because we’re the ones on the ground in the Black community. We’re the ones getting the phone calls from Black young people who have just learned that they’re positive and now realize that they didn’t really believe that they were at risk or that their lives were worth protecting,” Mr. Wilson added, in a prepared statement.
“We’re the ones who listen to Black people admit that they are more afraid of the stigma they’ll face than they are of the disease. After receiving these and other phone calls, we knew that the epidemic was worse in our community than the official numbers were saying,” he said.
The new estimate comes from the first national surveillance system based on direct measurement of new HIV infections and builds on a new laboratory test that can distinguish recent from long-standing HIV infections.
The CDC also suggests the number of new infections was likely never as low as the previous estimate of 40,000 and has been roughly stable overall since the late 1990s.
“Its important to note that the new estimate does not represent an actual increase in the number of new infections, but reflects our ability to more precisely measure HIV incidence and secure a better understanding of the epidemic,” said Dr. Kevin Fenton, director of the CDC’s National Center for HIV/AIDS.
“This new picture reveals that the HIV epidemic is–and has been–worse than previously known and underscores the challenges in confronting this disease.”
Lifestyles, race still impact infection rates
The CDC report confirmed HIV’s greatest impact remains on gay and bisexual men of all races and among Black men and women.
In 2006, men who had sex with men accounted for 53 percent of those with new infections, heterosexuals accounted for 31 percent, and injection drug users accounted for 12 percent of new infections.
Infection rates among Blacks were seven times as high as Whites and almost three times as high as Hispanics, a group also disproportionately affected.
“The CDC’s announcement underscores the allegations we made in our report, ‘Left Behind,’ in which we examine what the AIDS epidemic would look like and how the U.S. government would respond if Black America were its own country,” said Mr. Wilson.
“The United States of Black America would rank 9th on the U.S. government’s list of the 15 countries with the worst AIDS epidemics in the world. While our government’s AIDS policy focuses upon those nations abroad, the epidemic at home continues unabated.”
The importance of prevention
“Prevention can and does work when we apply what we know,” said Richard Wolitski, Ph.D., acting director of CDCs Division of HIV/AIDS Prevention. “While the level of HIV incidence is alarming, stability in recent years suggests that prevention efforts are having an impact.
“In this decade, more people are living with HIV and living longer than ever before due to advances in treatment.Even though this could mean more opportunities for transmission, the number of new infections has not increased overall. ”
The Black AIDS Institute recommendations for combating the AIDS crisis include:
– Invest at least $1.3 billion per year, as identified by Federal AIDS Policy Partnership, to implement a comprehensive national prevention strategy.
– Support efforts such as “Test 1 Million,” a national campaign to raise awareness about the importance of HIV screening and utilization of treatment by providing voluntary testing and counseling to one million people at elevated risk for infection who do not know their HIV status.
“AIDS is not just a health issue. It is a human rights issue. It is an urban renewal issue. It is an economic justice issue. The fight against HIV and AIDS is actually a broader fight against an environment in which poverty; homelessness, unemployment, incarceration, marginalization, homophobia and violence exacerbate the risk Black people face daily, including their risk for HIV and AIDS,” argued authors of the Black AIDS Institute report.
- CDC understated number of new HIV infections (FCN, 08-14-2008)
- Black leaders issue new strategy to stop AIDS crisis (FCN, 11-08-2006)