Black America and HIV – US failure to combat problem

Here is the link to the report and whole article.

What If Black America Were Its Own Country?
“Left Behind! Black America: A Neglected Priority in the Global AIDS Epidemic” incorporates a new analysis by the Black AIDS Institute showing how Black America would rank on the global health and HIV scale if it were a separate country. The results put the U.S. government’s neglect of its own citizens’ healthcare into stark relief.According to the report:
• Standing on its own, Black America would constitute the world’s 35th most populous country, but would rank 16th in the world in the number of people living with HIV.
• A free-standing Black America would rank 105th worldwide in life expectancy and 88th in infant mortality. Blacks in the U.S. have a lower life expectancy than do citizens of Algeria, the Dominican Republic or Sri Lanka.
• Outside of sub-Saharan Africa, only four countries – and only two in the Western Hemisphere – have adult HIV prevalence as high as the conservative estimate (2% among adults) for Black America. Blacks represent about one in eight Americans, but account for one in two people living with HIV in the U.S.
• Despite extraordinary improvements in HIV treatment, AIDS remains the leading cause of death among Black women between 25-34 years and the second leading cause of death in Black men between 35-44 years.
• Black women in the U.S. are 23 times more likely than White women to be diagnosed with AIDS.
• Blacks make up 70% of new HIV diagnoses among teenagers and 65% of HIV-infected newborns.

“The AIDS pandemic, including the epidemic right here at home, is a worldwide crisis. That is why we must ensure it is addressed it in a truly global way,” said Barbara Lee, member of Congress from California and a co-author of the legislation that created PEPFAR.

A Misdirected Response
“Left Behind!” posits that the Federal government is taking a fundamentally flawed approach to the epidemic in Black America, applying the prevention paradigm developed for concentrated epidemics, which focuses almost exclusively on so-called “high-risk” groups.

“The ‘concentrated epidemic’ approach reflects a fundamental misunderstanding of the social networks of Blacks in America. We are experiencing an epidemic with significant transmission beyond vulnerable populations. Nothing short of a mass Black mobilization will be sufficient to turn around the AIDS epidemic in Black America,” noted Wilson. “The U.S. should understand from its work in countries with similar epidemiological profiles that a more effective approach for Black America would include a mix of targeted programs for high-risk populations; broad-based initiatives that mobilize entire communities; and efforts to address the role of concurrent partnerships and the rapid spread of HIV transmission in social networks.”

“Black women are particularly affected by the domestic AIDS response and attention to their needs are inadequate. Lives are lost as a result,” said Dr. Helene Gayle, President/CEO of CARE. “As in other parts of the world, Black women in the U.S. often face increased vulnerability to HIV due to lack of a perception of power in sexual relationships and low self-esteem. Many cannot insist on abstinence or the use of condoms because of fear of emotional or physical abuse by their partners. Development of female-initiated prevention methods is not only a critical priority for Black women overseas, but also for Black women here at home.”

The report illustrates that young people in Black America, as in other parts of the world, are often at highest risk of infection because of inadequate knowledge of HIV infection, a high prevalence of inter-generational relationships, and a shortage of youth-tailored HIV prevention programs. And it points out that the silence that masks the particularly high risk of HIV confronting men who have sex with men in Africa and other heavily impacted regions also exacerbates AIDS in Black America. “Among men who have sex with men worldwide, Blacks in the U.S. may have the highest HIV prevalence. In the U.S., Black gay men experience more than twice the rate of infection as their White counterparts,” noted Jesse Milan, Vice President of the non-profit health management consultancy Altarum. “Black men who have sex with men in the U.S. share important attributes related to HIV risk with their peers in other regions, including the experience of severe stigma and discrimination that often impedes HIV prevention efforts.&