More than 25,000 people have arrived in Washington D.C. for the 19th International AIDS Conference with a renewed sense of purpose after several significant advances in treatment and prevention. And there has been one narrative emerging since Sunday’s opening session: Black gay and bisexual men have been more affected by HIV/AIDS than any “other population in the world.”

The statistics on HIV in Black America are already sobering. Blacks represent only 12% of the nation’s population but account for nearly half—some 44%—of all new HIV infections, reports the Centers for Disease Control and Prevention.  Black gay men have become the ‘epicenter’ of the domestic and global epidemic. Researchers believe they account for less than one percent of the nation’s population … but nearly one in four of all new HIV infections in the United States.  That’s from a new report from the Black AIDS Institute, “Back of the Line: The State of AIDS Among Black Gay Men in America.”

“This is an emergency. Black gay and bisexual men are being devastated by HIV/AIDS,” Black AIDS Institute President Phill Wilson told EBONY.  The Los Angeles-based organization is the only national HIV/AIDS think tank focusing on African Americans. “It is the worst epidemic in all of the developed world. The epidemic rivals much of the developing world.”

The crisis is so severe in some American cities that “one in two Black men who have sex with other men are HIV positive,” the report adds. The trend has been particularly “alarming” among young Black gay men aged 13 to 19, according to the CDC. New infections have increased by almost half between 2006 and 2009.

“Black gay and bisexual men continue to be first in line when it comes to need—but remain at the back of the line when it comes to assistance,” said Wilson, who addressed the conference in its Monday morning plenary. “That is an outrage. This is completely unacceptable.”

Researchers are unsure why new infections are soaring. Most data show that Black gay men do not practice more unsafe sex than white gay men. “It’s probably behavior plus late testing practices,” said Dr. David J. Malebranche, assistant professor of medicine at Emory University in Atlanta. “We see late testing across the Black community, such as in cancer, diabetes, high blood pressure. Plus the heightened stigma of HIV certainly delays testing.”

Despite the gloomy statistics there is “finally potential that we can have an AIDS-free generation”—even among Black gay and bisexual men—Dr. Kevin Fenton told EBONY from the conference. Fenton—who is also Black and openly gay—is the Director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “Now we have a range of highly effective tools in which we can bring this epidemic to an end.”

Last week the Food and Drug Administration approved the antiretroviral medication Truvada to reduce the risk of HIV infection in uninfected individuals. It’s a controversial strategy known as pre-exposure prophylaxis or PrEP.  Daily use of the cocktail has shown up to 75 percent efficacy in preventing HIV transmission.

PrEP could ultimately become a “powerful” tool to use among Black gay men—but with a major disclaimer, adds Fenton. “PrEP is not going to be effective for everyone. We’re going to have to target men who are at greatest risk for infection and are willing to take the medication as directed. Various studies [found] that adherence to the medication is critical.”

Another strategy making buzz at the conference has been the government’s new testing campaign targeting Black gay men. The CDC launched the ‘Testing Makes Us Stronger’ campaign last September. The program includes transit, magazine and online advertising—as well as outreach across “hookup” websites popular with Black MSM.

“It’s the first time the federal government has targeted Black gay men in this manner and we’re very excited,” Fenton told EBONY. “The campaign was developed by Black gay men. It’s critically important for us to speak for the lives of those who are hardest hit by the epidemic…That’s why this conference is so critical. It’s the shot in the arm that we need to re-double our efforts.”

Rod McCullom has written and produced for ABC News and NBC, and his writing has appeared in EBONY, The Advocate, and many others. Check out his award winning site Rod 2.0. Follow him on Twitter: @RodMcCullom.