San Francisco Chronicle - July 29, 2008
Leslie Fulbright, lfulbright@sfchronicle.com

SAN FRANCISCO -- The United States is at the forefront of a global response to HIV and AIDS but lacks a sense of urgency when it comes to the crisis facing African Americans, according to a report released today by the Black AIDS Institute.

The report, titled " "Left Behind! Black America: A Neglected Priority in the Global AIDS Epidemic,"," shows that the number of African Americans infected with HIV exceeds the number of people with the virus in seven of the 15 countries served by the President's Emergency Plan for AIDS Relief.

The report calls for actions such as HIV testing and prevention in black communities, urges that global AIDS leaders speak out on the neglect in the United States, and says black communities need to work to fight stigma and prejudice.

A press conference today on the findings featured appearances by Al Sharpton, Helene Gayle, president of the global poverty-fighting nonprofit CARE, and Black AIDS Institute CEO Phill Wilson.

In some U.S. cities, the HIV rates among African Americans are close to those of developing African countries. If blacks in the United States constituted their own country, that nation would rank 16th in people living with HIV, 105th in life expectancy and 88th in infant mortality worldwide, according to the report.

While the U.S. government gives billions to help fight the global epidemic, the domestic response is so weak that the country would not qualify for its own emergency AIDS relief program, the report says.

"As America lost interest in its own epidemic over the last decade, the disease became even more firmly implanted in black America," Jesse Milan, chairman of the Black AIDS Institute, wrote in the report. "Nearly 600,000 black Americans are living with HIV, and as many as 30,000 become newly infected each year."

Surveys show that African Americans regard AIDS as the country's most serious health threat. But the federal government apparently doesn't share that view, the report says.

"The U.S. government's response to what is perhaps the most serious health crisis facing black America remains timid and lethargic," the report says. "They act as if AIDS has been solved here, and have no strategy for the epidemic."

People with HIV are doing much better with recently developed drug combinations, and that may have contributed to the idea that the problem is solved, the report says. But there is a continuing need for prevention, it says.

"The issue of fighting AIDS in black America is more complicated than fighting (the disease) among white gay men," Wilson said. "We are dealing with other issues, like drug use, poverty, homelessness and stigma."

AIDS is the leading cause of death among black women ages 25 to 34 and the second-leading cause of death of black men ages 35 to 44. Although only one in eight Americans is black, 50 percent of those infected with HIV in the United States are black, says the report.

Black leaders need to help change a stigma that causes African American men to engage in dangerous behavior patterns - such as unprotected sex - because they don't identify as gay, Wilson said. He called for a sense of urgency among leaders, education on HIV and AIDS prevention and testing, and creating a mass mobilization like the one seen in the early days of AIDS, when it was considered an epidemic among gay white men.

Wilson also said foundations should get more involved in a domestic response.

"The Gates Foundation is doing remarkable work in developing countries and has made a huge investment in sub-Saharan Africa, but has absolutely no AIDS program in the U.S.," Wilson said. "The Rockefeller Foundation also does no AIDS work in the United States."

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