America is one of the nations leading the fight against HIV/AIDS across the world, but is failing to address the epidemic among its own Black citizens, says a new report published on 29th July by the Black AIDS Institute.

“America has claimed a leadership role in the fight against the global HIV epidemic,” said Phill Wilson, CEO of the Black AIDS Institute and one of the authors of the report.

“Yet, America’s failure to respond to its own epidemic among its Black citizens undermines its credibility in addressing AIDS epidemic worldwide. For the U.S. to truly be a global AIDS leader, it must put its own house in order, too,” he added.

Figures in the report show that although 1 in 8 Americans is black, 1 in 2 people living with HIV in the US is black. The report indicates that despite enormous strides in HIV treatment improvement, AIDS is the leading cause of death among Black women aged 25 to 34 years, and the second leading cause of death among Black men aged 35 to 44 years.

In the US, Black women are 23 times more likely to be diagnosed with AIDS than White women, and 70 per cent of teenagers newly diagnosed with HIV, and 65 per cent of infected newborns, are Black.

The report suggests there is a “clear and startling gap” between the US government’s appropriate concern for the AIDS crisis around the world, and its denial and neglect of the epidemic at home. This is in spite of figures that show levels of HIV among US Blacks in Detroit, Newark, New York, Washington DC and the Deep South, are on a par with those of some of the severely affected African countries. For example, South Africa has the world’s largest population of people living with HIV, and yet prevalence among middle aged Black males in Manhattan is almost as high.

The report also suggested that if Black America were a separate country:

  • it would be in 35th place for population size, but in 16th place in terms of the number of people living with HIV.
  • It would be in 105th place for life expectancy, and 88th for infant mortality (blacks in the US have a lower life expectancy than people living in Algeria, the Dominican Republic and Sri Lanka).
  • HIV prevalence would be 2 per cent of the population: a figure shared with only four other countries outside of sub-Saharan Africa, and only two of these are in the Western Hemisphere.

One of the leading causes of HIV infection in the US is drug use, said the report, and this is particularly acute among Blacks, who account for over half of drug related HIV transmission in the US. Black America shares the same challenges as other regions in the world when it comes to dealing with HIV prevention: government is reluctant, even hostile, to adopting evidence based harm reduction programmes, and many people are in prisons with no access to HIV prevention or treatment programmes.

Also like many developing countries, the underlying causes of excessive HIV rates and deaths due to HIV/AIDS appear to apply to Black America, such as starting treatment too late, high rates of multiple medical conditions, and problems sticking to treatment schedules.

The report calls for immediate action to:

  • Mobilize communities to combat HIV in Black America, including helping Black America fight stigma, overcome prejudice, and promote solidarity against the epidemic.
  • Increase government support to maximize the impact of community responses to the epidemic in Black America; black organizations, constintuencies and media are currently struggling to do this on their own.
  • Greatly scale up support and funds for HIV prevention, treatment and care services in Black America.
  • Prioritize research on HIV vulnerability and infection patterns that Black America shares with other countries.
  • Break the silence on AIDS in Black America.
  • Call global AIDS leaders to speak out on the neglect of the epidemic in Black America.
  • Applaud the US government’s ability to deal with the global AIDS crisis, but hold it accountable for failure to address the epidemic within its borders.

“Were Black America a separate country, it would elicit major concern and extensive assistance from the US government,” said Wilson.

“Instead, the national response to AIDS among Black Americans has been lethargic and often neglectful,” he added.

“Left Behind! Black America: A Neglected Priority in the Global AIDS Epidemic”
Phill Wilson, Kai Wright and Michael T. Isbell
Black AIDS Institute, August 2008.

Click here for the full Report.

Source: Black AIDS Institute.

Written by: Catharine Paddock, PhD