Last month President Barack Obama proclaimed in his State of the Union address, “Right now, we are on track to end the scourge of HIV/AIDS. That’s within our grasp.” Given all that he had to cover in his speech before Congress and the nation that night, he moved on from that statement without elaboration.
However, here’s the context of that pronouncement: There is a concrete plan to end the epidemic by 2020 on the federal level, as laid out in the National HIV/AIDS Strategy Updated to 2020. States such as New York also have similar plans. Meanwhile, increased testing and recent medical advances have been driving down infection rates and improving quality of life in some U.S. demographic groups. The result is that between 2005 and 2014 the annual number of HIV diagnoses in the United States declined by 19 percent, according to the CDC.
That’s great news. Yet despite that progress, African Americans are infected with HIV at eight times the rate of white Americans and accounted for 44 percent of HIV diagnoses in 2014, according to the Centers for Disease Control. The particularly high burden of HIV is borne by Black gay men and bisexual men; Black transgender women; and Black women and men, in general. So here is the state of the HIV epidemic among Black Americans as we face another National Black HIV/AIDS Awareness Day today: It can improve if we have the will and take a holistic approach toward getting more Black people educated, tested, treated, and armed with the tools to prevent new infections. On February 4, the National Black Leadership Commission on AIDS (NBLCA), of which I am president and CEO, convened hundreds of members of the HIV/AIDS community, including stakeholders, providers, funders, and consumers those who receive care, to share insights during the second annual State of HIV in Black America conference at Harlem's Schomburg Center.
Speakers included Gail Wyatt, Ph.D., a clinical psychologist, sex therapist and professor in the Department of Psychiatry and Biobehavioral Sciences at UCLA, whose rousing presentation laid bare the roles of stigma, cultural stereotypes and institutional racism in the disproportionately high rates of HIV among black people. She acknowledged the role of HIV prevention strategies like PrEP (Pre-Exposure Prophylaxis), through which people take the medication Truvada on a daily basis, in lowering new HIV infection rates in the general population. She then pointed out how getting Black people to use PrEP is complicated by poverty and the mistrust that many African Americans have of the medical community due to historic mistreatment, as exemplified by the Tuskegee syphilis study. “"You can't bring in a pill and expect that to pull someone out of their reality," she explained.
Darryl Wheeler, Ph. D, Vice Provost for Public Engagement at University of Albany and Dean at the university’s School of Social Welfare, addressed the impact of the HIV infection epidemic on Black men who have sex with men (MSM). In order to be effective in lowering infection rates among them, “We must be willing to take on systems which create the environment in which Black MSM live,” he observed. Like Wyatt, he stressed the importance of establishing trust and urged members of the HIV advocacy community to consider their own experiences with sex, stigma and racism as they attempt to educate and deliver HIV/AIDS-related services to others. “If you can't be honest with yourself, then how can you expect someone else to be honest with you?” he asked.
Meanwhile, Daniel O’Connell, director of the New York State Department of Health AIDS Institute, addressed New York State’s efforts to end the epidemic by 2020, as laid out in its blueprint released last year. "We have a moral responsibility to do this,” he said.
Ronald Johnson, vice president of policy and advocacy for AIDS United, addressing federal efforts to end the epidemic within the same time period. He also reminded those gathered of the link between health care policy and voting, given that America is in the midst of an election season.
Meanwhile, during a Town Hall-style discussion, audience members brought up the importance of faith-based institutions in spreading information about HIV testing and education, and the challenges they sometimes face working with individual institutions. At NBLCA we recognize how critical their participation is, and in fact our board includes clergy. Among them are our board chair, Dr. W. James Favorite, senior pastor of Beulah Baptist Institutional in Tampa, FL; and our chairman emeritus Dr. Calvin O. Butts, III, pastor of Abyssinian Baptist Church in New York City.
Coming out of the State of HIV in Black America forum, NBLCA plans to issue an annual report card as a tool that reports accountability. Later this month, our organization will release a report coming out of last year’s State of HIV in the Black LGBTQ Community forum in Tampa Bay, FL.
However, at the core of our mission is empowering local leadership and community groups to address HIV/AIDS at the grassroots level. This is where you come in. Get tested. Educate yourself about HIV/AIDS and how it affects the black community. Get treatment if you need it, and know that there are options for getting the costs covered. Vote in the upcoming elections and make sure your elected officials are creating and enacting policies to close health disparities and end the epidemic for all Americans, regardless of race. Get involved in the fight against HIV/AIDS in your own community. Together, we can end the epidemic.
C. Virginia Fields, MSW is the President and CEO of the National Black Leadership Commission on AIDS, Inc. and a member of New York State’s Ending the Epidemic Task Force.