If black America were a country, it would rank 16th in the world in terms of the number of people living with HIV, yet activists say black Americans lack many of the HIV services their government has provided to other nations through the President's Emergency Plan for AIDS Relief (PEPFAR).
A recent analysis by the US Centres for Disease Control revealed that there were about 56,300 new HIV infections in the United States in 2006, about 40 percent higher than previous estimates. According to the report, black Americans accounted for 45 percent of new infections, despite the fact that they make up just 13 percent of the population.
"Enough talk already; it is time for action. We need a clear, aggressive plan to provide HIV education, prevention and treatment to all who need it," Phill Wilson, chief executive officer of the Black AIDS Institute, told a press conference at the International AIDS Conference in Mexico City on Monday.
"This National AIDS Strategy would incorporate many of the same approaches the US recommends for other countries with serious HIV epidemics: we need to set ambitious HIV reduction goals, support efforts to get our people tested, and the government needs to spend at least US$1.3 billion annually to implement a comprehensive national prevention strategy," he said.
A new report by the Black AIDS Institute, Left Behind, which is critical of the government's HIV/AIDS response, says 30,000 black Americans are infected with HIV every year, and AIDS is the leading cause of death among black women aged between 25 and 34.
"America's opinion leaders, policy makers and news media have come to believe that the AIDS challenge is indeed 'elsewhere' – that America's AIDS problem has been solved due to a proliferating array of effective medication," the report commented.
Barbara Lee, a congresswoman from Oakland, California, noted that PEPFAR has brought a sense of urgency to HIV programmes in other countries that is lacking in the US. "Where is our PEPFAR?" she asked.
 Black women are 23 times more likely to be infected with HIV than their white counterparts |
Several speakers urged private foundations that donate time and money to the epidemic in Africa and other parts of the world to turn their attention homeward, and called on local community organisations to put HIV on their agendas.
Helene Gayle, CEO of the non-governmental organisation (NGO), Care USA, said the sexual experiences of black American women often mirrored those of women in less developed parts of the world. Black women in the US infected with HIV also tended to be diagnosed late, leading to higher mortality.
"Because of gender inequality, fear of violence and other physical and emotional abuse, black women often can't insist on methods prescribed by prevention programmes, such as condom use or abstinence," she said. "Black women are 23 times more likely to be infected with HIV than their white counterparts."
Gayle said the US federal government's approach to HIV prevention had been to target high-risk groups such as intravenous drug users, despite the fact that many HIV infections occurred outside such groups. She pointed to the need for more research into the sexual behaviour patterns that led to higher infection rates among blacks.
The speakers also highlighted the need to reach out to young black Americans with sex education and more information about HIV. According to the Left Behind report, blacks make up 70 percent of new HIV infections among teenagers.
"There is a low level of HIV literacy within the black community," said Sheryl Lee Ralph, a black American actress and AIDS activist. "Parents don't talk to their children about HIV because they don't know what to say, so children learn about sex from other children."
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