Washington Post Full Article – In a 55-page report, the Black AIDS Institute argued that the disease should be viewed as a threat to the entire black population, and not just specific high-risk groups. Unlike in white Americans — and in the citizens of most industrialized nations — HIV in American blacks is increasingly transmitted heterosexually through “networks” where men especially have many sex partners at the same time, the report noted.
The report’s authors asserted that the black AIDS epidemic here is being overlooked as the United States is allocating unprecedented resources to fighting the disease in sub-Saharan Africa.
African Americans with HIV — at least 500,000 — are more numerous than in seven of the 15 “target countries” in the Bush administration’s global AIDS initiative, which has spent about $19 billion overseas in the past five years. Bush is scheduled to sign a bill today that will extend the program and authorize the spending of $48 billion for the next five years. The target countries consist of 12 in Africa and three others: Guyana, Haiti and Vietnam.
The report noted that with 39 million people, “black America” would be the 35th most populous country, and the 28th richest, if it were a separate nation. Two percent of adult black Americans are infected, the government estimates, and only four countries outside Africa have a higher HIV prevalence. It would rank 16th in the world in the number of people living with HIV.
“The U.S. response to the epidemic in black America stands in sharp contrast to our response to the epidemic overseas,” said Phill Wilson, a longtime AIDS activist who is executive director of the Black AIDS Institute.
He added that his purpose in making the comparisons is not to criticize the global program but to urge that more money and attention be directed to the domestic one.
But Kevin A. Fenton, the head of HIV/AIDS prevention at the Centers for Disease Control and Prevention, said the argument that government prevention efforts are not tailored to the black epidemic is mistaken. “CDC prevention efforts have really tried to follow the epidemic,” he said.
The proportion of AIDS-prevention funding devoted to the black community has risen as the epidemic has become more concentrated there and now constitutes about $300 million of the $600 million spent each year, Fenton said.
According to the CDC, 1 million to 1.2 million people in the United States are HIV-positive, although that estimate is now five years old. The CDC on Sunday will release more precise estimates of the HIV incidence, or the number of new infections that occur each year. It is believed to be about 50,000. The 2 percent HIV prevalence in adult African Americans exceeds the 1 percent threshold that defines a “generalized” epidemic, rather than one limited to certain subgroups. Two of the striking features of the epidemic in black Americans is the high rate of infection in women and the frequency of heterosexual transmission, both characteristic of Africa.
The CDC estimates that 38 percent of all new infections in African Americans from 2001 to 2005 were in women. Of new infections in black men and women, 46 percent were the result of heterosexual contact. In the District, about 40 percent of new infections are acquired heterosexually, 30 percent from male homosexual contact, and 15 percent from injected drug use.
Among white Americans during the same period, 16 percent of new infections were in women, and 16 percent of new infections in men and women were attributed to heterosexual transmission.
In sub-Saharan Africa, 60 percent of new infections occur in women, and the vast majority of all infections are acquired through heterosexual contact.