After 20 years, HIV/AIDS disproportionately threatens Black populations around the world

New Crisis, The, May/Jun 2001 by Robinson, Lori

upfront

While many diseases strike African Americans disproportionately, few are widely regarded as a "Black" illness, like sickle-cell anemia. Given the stark increase of newly reported cases in the Black community, HIV/AIDS - although it certainly doesn't discriminate - may soon be viewed as such.

"In a very real sense, the HIV/AIDS pandemic is the Black plague," says Salih Booker, executive director of Africa Action, a public education and advocacy organization in Washington, D.C. "The epicenter is Africa. The region with the second highest incidence rate of HIV/AIDS is the Caribbean. And the region with the third highest rate of infection is the United States, largely due to an increase of infection [among] young people of color."

June marks 20 years since the disease now known as AIDS was first mentioned in print. The Centers for Disease Control and Prevention (CDC) published a news brief about what would soon be considered a white, gay male disease. That population's infection rate has declined since then, and the rate for African Americans, particularly women, has skyrocketed.

Through June 2000, 753,907 AIDS cases had been reported to the CDC. The U.S. population is 12.3 percent African American, but Blacks accounted for 38 percent of all cases, 57 percent of the cases among women and 59 percent of the cases among children.

"African Americans have been disproportionately represented since the first year of the epidemic," says medical epidemiologist Dawn K. Smith of the CDC's Division of HIV/AIDS Prevention. "But it's only recently that they've become the actual numerical majority."

According to the CDC, during the 12month period ending last June, new cases of HIV infection in Black men reached 43,258, approximately 3,000 more than white men. And 8,609 new cases of HIVinfected white women were reported, compared to 24,922 Black women. In 1998, for the first time, the estimated number of Black people living with AIDS surpassed the number of whites. Since then, the estimated number Blacks has continued to outpace the number of whites living with AIDS.

More men than women have HIV/AIDS everywhere except sub-Saharan Africa. About 80 percent of the world's AIDS orphans are African children. Of the 20 million people worldwide who have died because of AIDS, 17 million were in Africa. Of 36 million people now living with HIV/AIDS, 25 million of them are in Africa, and less than 1 percent of them can afford AIDS drugs. South Africa alone has an HIVpositive population of 4.7 million, the world's largest.

"The highest priority is to make the anti-- AIDS medications accessible to all," Booker says. He attributes the disease's spread to the failure of wealthy nations to invest in research, forgive debt and provide life-sustaining drugs for impoverished nations. With anti-retroviral drugs, HIV/AIDS may become a chronic illness, not an almost immediate death sentence, he says.

In response to the demands of activists and governments around the world, some pharmaceutical companies began lowering prices last year to make AIDS medicines affordable in poor countries.

The Clinton administration declared HIV/AIDS a national security threat in 2000, an unprecedented move for a health crisis. The action recognized that the continued spread of the disease could destabilize entire governments. In April, the Bush administration announced plans to expand the international focus of the Office of National AIDS Policy, directing it to collaborate with the Department of State on international policy and support a new highlevel AIDS task force co-chaired by Secretary of State Cohn Powell.

Prevention is the key to stemming this health crisis, but the stigma associated with HIV/AIDS hinders successful education and awareness efforts abroad and domestically. Many organizations have grassroots campaigns aimed at combating the stigma among African Americans and other target groups. On June 27, the National Association of People with AIDS is sponsoring a National HIV Testing Day, an awareness campaign to promote prevention education, counseling and testing. The NAACP is encouraging all of its local chapters to participate in the day's efforts.

"The situation is very bad. It's getting worse," the CDC's Smith says. "But we have the resources within our community to stop it in its tracks."