Already, 40 percent of AIDS cases in the United States are among African Americans. By the year 2005, an estimated 60 percent of people with AIDS in this country will be African American. (Courtesy of Aaron Foster and Marcello Pagano of the Harvard School of Public Health)

The Challenges

Participants in the Leading for Life summit discussed a broad range of strategies to increase AIDS awareness and to encourage people to take action against the epidemic. During the meeting, they focused on four areas of general concern: communications, prevention, public policy, and services and care.

Communications

Participants agreed that the spread of HIV is facilitated by ignorance, denial, and complacency. They identified two principal challenges in the communications arena.

First, multiple communication strategies are needed. Participants agreed that more media attention -- both national and local -- must be devoted to the epidemic among African Americans. In addition, the content of what is written and produced must be monitored to ensure that the information is accurate.

Second, the stigma of AIDS must be mitigated. Too often, people living with HIV and those who care about them bear burdens of isolation, misunderstanding, and intolerance.

Prevention

Comprehensive prevention education is lacking in many African American communities. Participants agreed that in order to be comprehensive, prevention information must also be culturally relevant and pervasive, reaching people -- especially youth -- through radio, television, newspapers, and community programs.

Participants agreed that programs designed by, managed by, and targeted to African American communities must be funded and supported. These efforts will be most successful when based on peer-to-peer communications. Participants also called for prevention programs that target those who practice high-risk behavior, such as unprotected sex and injection drug use.

Participants recognized that the African American church has consistently been the backbone of community advancement, from the time of slavery to the civil rights movement. While many ministers have demonstrated leadership in the face of this epidemic, many others have yet to mount the necessary prevention and care efforts. Participants agreed that it is crucial that more churches become involved in prevention and care. Churches can also play a critical role in moderating attitudes toward people with different lifestyle choices.

Public Policy

Participants noted that public health policy and funding decisions are shaped by a narrow constituency and that African Americans must influence these decisions. Their involvement becomes critically important in Medicaid, welfare, and health care reform, since many African Americans -- and many people living with HIV -- receive basic health care through these programs.

Congressional representatives especially must be willing to push for policies and funding that support the communities they represent. African American state legislators, mayors, and appointed officials must ensure that Medicaid, welfare, and health care reforms protect people with AIDS.

In addition, advocates for HIV prevention and care can work with other groups -- such as African American and women's and children's health organizations -- to create policies that serve all communities.

Services and Care

One hundred people of color in the United States are diagnosed with AIDS each day; many of them live in the most underserved neighborhoods. Despite more than ten years of epidemiologic data showing the spread of HIV in the African American community, government and private sector funders have failed to respond with financial support to stop this growth.

In addition, although a number of corporations and foundations have provided support to AIDS service organizations, African American communities have not fully benefited from these grants.

Summit participants urged African American leaders to demand that government and private sector funders direct an equitable measure of resources to addressing the HIV epidemic in the African American community.

Participants agreed that African American communities must be encouraged and prepared to provide care and other services to those affected. They also urged that services be expanded beyond clinical care to include such assistance as child care and spiritual support.

Finally, participants detailed specific recommendations for action, nationally and locally.

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