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U.S. AIDS policies neglect blacks, report says

Global attention should be matched with funding, education at home

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updated 5:56 p.m. ET July 29, 2008

WASHINGTON - U.S. policies and cash may be leading the fight against AIDS globally, but they have neglected the epidemic among black Americans, the Black AIDS Institute said in a report released on Tuesday.

While blacks account for one in eight people in the United States, half of all Americans infected with HIV are black, the report found.

“We are 30 percent of the new cases among gay men, 40 percent of the new cases among men in general, 60 percent of the cases among women and 70 percent of the new cases among youth,” Black AIDS Institute CEO Phill Wilson told reporters in a telephone briefing.

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“Yet ... the U.S. response to AIDS in black America stands in sharp contrast to the international response to the epidemic overseas,” he added.

Al Sharpton, a prominent activist and founder of the National Action Network, agreed.

“U.S. policy makers seem to be much more interested in the epidemic in Botswana than the epidemic in Louisiana. This is an unnecessary and deadly choice. Both need urgent attention,” Sharpton said.

Dr. Helene Gayle, former head of AIDS for the U.S. Centers for Disease Control and Prevention and now president of the poverty-fighting charity CARE, said many HIV infected blacks are not in traditional high-risk groups such as men who have sex with men, injecting drug users and sex workers.

“The federal government’s approach to the epidemic in black America is fundamentally flawed,” Gayle said. This includes both a lack of funding and poor targeting of the money, she said.

Empowerment and education
Approaches that would work among black Americans include policies to empower women.

“Black women often cannot insist on abstinence or the use of condoms for fear of violence or other emotional trauma,” Gayle said.

Black American women are 23 times more likely than white women to become infected with the human immunodeficiency virus that causes AIDS, the report found.

A lack of education works against young people, who are often powerless and in sexual relationships with older people, who can infect them, Gayle said. Wider testing for HIV among blacks is also essential, the report stressed.

And better prevention messages that use language that will reach drug users, youths and men who have sex with men are key.

“We have focused on abstinence-only (methods) even though they don’t work in our community,” Wilson said.

Information about condom use is important, Wilson said. “We also need to look at needle exchange,” he said — noting that although needle exchange programs work to reduce HIV transmission while doing nothing to encourage drug use, they are frowned upon by the federal government.

Education campaigns can battle myths about disease transmission, as well as conspiracy theories that cause many blacks to mistrust the medical system, Wilson said.

$48 billion for AIDS treatment overseas
The U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, will spend $48 billion over the next five years to help treat and prevent AIDS, tuberculosis and malaria in 15 targeted countries and is considered a showpiece of George W. Bush’s presidency.

“More black Americans are infected with HIV than the total populations of people living with HIV in seven of the 15 countries served by PEPFAR,” Wilson said.

“Were black America a separate country, it would elicit major concern and extensive assistance from the U.S. government. Instead, the national response to AIDS among black Americans has been lethargic and often neglectful.”

Copyright 2008 Reuters. Click for restrictions.