National HIV Testing Day in Atlanta was a great success! Over 1,000 people were tested in four metro locations, including street outreach at Five Points MARTA Station (151 tested); Lindbergh MARTA Station (167 tested); American Red Cross (211 tested); on-site at AID Atlanta (194 tested).

At Our Common Welfare, we tested 394 individuals with an effort that included several AIDS and Community Service Organizations including: AIDS Survival Project, Positive Impact, Absolute Wellness, AID Atlanta, AIDS Research Consortium of Atlanta, Alpha and Omega AIDS Foundation, American Red Cross -- Metropolitan Atlanta Chapter, ANIZ, Genesis Network and Counseling Center, National Council of Negro Women, Saint Joseph's Mercy Care Services, and many others.

In the two decades since AIDS was first recognized, great strides have been made in treating HIV and preventing or treating the infections that can accompany it. While there is still no cure, people living with HIV have better health care options than ever before. Thanks to these advances, many are living longer and healthier lives than seemed possible even a few years ago.

These encouraging developments mean little to someone who is unaware that they are infected with HIV. Far too many people still learn that they have HIV late in their infection -- when illness has appeared, thus missing years of opportunity for early care and treatment.

Unfortunately, those who are infected but don't know it are most likely to come from the communities in our country where the HIV/AIDS epidemic is growing fastest, and where access to health care is most limited. Unless this changes, African-Americans and Latinos (especially young people, gay and bisexual men, women at risk, and substance users) will continue to get treatment later and die sooner than others with HIV.

African-Americans and HIV and AIDS

The impact of the AIDS epidemic on African-Americans continues to grow disproportionately. Despite declines in AIDS deaths among all racial/ethnic groups between 1995 and 1998, AIDS mortality rates remain nearly ten times higher among African-Americans than among whites. As reported through June 1999:

• African-Americans accounted for 37 percent of total AIDS cases, and 41 percent of new AIDS cases.

• Among men, African-Americans represented 33 percent of total reported AIDS cases.

• Among women, African-Americans represented 57 percent of total reported AIDS cases.

The numbers are even more alarming for HIV infections as reported from the 33 areas with confidential HIV-infection reporting. Through June 1999, African-Americans accounted for 52 percent of total reported HIV cases.

• African-American men accounted for 65 percent of the HIV cases among African-Americans, and 47 percent of HIV cases among all men.

• Of the total cases of HIV infection among women, African-American women accounted for 68 percent.

• Estimates of infection trends in the early 1990s indicate that half of all young adults ages 18-22 infected during these years were African-American.

• Researchers estimate that 240,000-325,000 African-Americans are infected with HIV and more than 106,000 of these individuals are currently living with AIDS.

• AIDS related illnesses remains the leading cause of death for African-Americans between the ages of 25 and 44.

For African-American men, the most common method of getting infected is having sex with other men, followed by injection drug use. Prevention, education and outreach efforts need to continue and increase within the African-American community. These efforts should include messages that stress the importance of participating in HIV counseling and testing programs, and the benefits of knowing your HIV status.

Latinos and HIV and AIDS

Latinos are one of the fastest growing ethnic minorities in the United States, representing a variety of ethnic, social, economic and cultural backgrounds. At nearly 30 million people, Latinos represent approximately 12 percent of the total population. However, they account for nearly 20 percent of all new AIDS cases reported through June of 1999. The Latino community is disproportionately affected and impacted by the AIDS epidemic.

• Latinos represent 105,660 of all AIDS cases reported among men.

• Latinas (Latino women) account for 23,895 reported AIDS cases among women.

• For Latino men, the current AIDS case rate is nearly three times that of non-Hispanic white men.

• From 1986 to 1996, the number of Latinas infected heterosexually increased from 30 percent to 60 percent.

For Latino men, the most common method of getting infected is having sex with other men, followed by injection drug use. Injection drug use and heterosexual contact with men are the major ways Latinas become infected.

Through 1997, HIV infection was the fourth leading cause of death for Latinos. Although the deaths associated with HIV disease have declined in recent years, the number of new HIV infection cases remains level or is increasing among specific populations, including the Latino community. Increased culturally sensitive outreach efforts in the Latino community are imperative. Efforts should continue to include the benefits of knowing their HIV status and taking control of their lives.

Youth and HIV/AIDS

Despite the gains being made by current AIDS therapies, the HIV/AIDS epidemic is far from over -- especially among young people and racial and ethnic minorities. The Centers for Disease Control and Prevention (CDC) estimates that 650,000 to 900,000 Americans are living with HIV, and roughly one in three of these people do not know they are infected. Up to half of all new infections in this country are among those under age 25. Every hour, two Americans under the age of 20 become infected with HIV. Through June of 1999, 132,933 cases of AIDS were reported in people under age 30. Of those cases, 37,370 were among people under age 25. There have been 95,573 cases of AIDS reported in people between 25 and 29 years old. Many of these young adults likely were infected as teenagers.

Each year 640,000 youth between the ages of 9 to 20 are admitted into the juvenile justice system in the United States, with an average daily population of over 53,000. The majority of these youth are between the ages of 15 and 17. Youth living in correctional care facilities represent a high-risk, under-served and vulnerable population in need of effective risk reduction intervention. These same youth are likely to be disproportionately at risk for HIV, STDs and other health problems linked to substance abuse, unprotected sex and poor access to health care.

Although the number of AIDS incidence diagnosed each year is declining, there has not been a comparable decline in the number of newly diagnosed HIV cases among youth.

The HIV/AIDS pandemic continues to disproportionately affect specific populations of teenagers and adolescents. These specific groups, especially those at risk for becoming infected, include young men who have sex with men (MSM), African-Americans and Latino teenagers and young adults, and young women between the ages of 15 and 24.

Men and HIV and AIDS

The face of AIDS among gay and bisexual men is changing. Significant strides have been made to reduce high-risk behaviors and HIV infection of men who have sex with men (MSM) in many communities. Researchers estimate that MSM still account for 40 percent of the overall 40,000 new HIV infections in the U.S. each year, and 60 percent of all new HIV infections among men. There are currently an estimated 325,000-475,000 gay and bisexual men living with HIV in the U.S. An estimated 356,000 AIDS cases have been diagnosed among MSM since the beginning of the epidemic through June, 1999. Men who have sex with men (MSM) are the single highest-risk population group for HIV infection in the United States.

Young MSM account for estimated three out of four HIV infections among young men. Although the number of HIV infected gay white men has been on a decline, the number of HIV infected gay men of color is increasing at an alarming rate. In fact, for the first time in the two-decade epidemic of HIV and AIDS, more minority MSM are infected with HIV than white MSM.

Women and HIV and AIDS

The AIDS epidemic is far from over. In fact, the epidemic has increased most dramatically among women, especially during the last decade. In nine cities, Chicago, Houston, Los Angeles, Miami, New York, Newark, Philadelphia, San Francisco and Washington, DC, it is the leading cause of death for women between the ages of 22 and 44.

African-American women and Latinas together represent less than one-fourth of all U.S. women, yet they account for more than three-fourths (77 percent) of AIDS cases reported to date among women in the U.S. Though the epidemic initially spread mainly through men who have sex with men (MSM) and intravenous drug use (IV), from 1993 to 1998 the number of women infected by men (heterosexual contact) increased by 243 percent.

Many HIV/AIDS cases among women in the U.S. are initially reported without risk information, suggesting that women may be unaware of their partners' risk factors or that health care providers are not documenting their risk. Historically, more than two-thirds of AIDS cases among women initially reported without identified risk were later reclassified as heterosexual transmission, and just over one-fourth were attributed to injection drug use.

A recent study reports the results of a multi-site CDC survey of HIV positive MSM. Of those surveyed, 24 percent were African-American and 15 percent were Latino MSM who identified themselves as being heterosexual. Researchers believe the stigma of homosexuality in communities of color may inhibit men of color from identifying themselves as gay or bisexual, despite having sex with other men. Additionally, by not identifying as gay or bisexual, these men may not accept their risk for HIV, and therefore, may unintentionally put their female partners at risk.

Although women who have sex with women (WSW) transmission of HIV appears to be rare, female sexual contact should be considered a possible means of transmission among WSW.

Women need to know:

• Exposure of a mucous membrane (e.g., the mouth) to semen, vaginal secretions and/or menstrual blood is potentially infectious.

• Condoms or dental dams should be used consistently and correctly each and every time for sexual contact or during oral/anal sex.

• Their own and their partners' HIV status.

Two reasons women with HIV are dying are that many women are misdiagnosed, or learn of their HIV status in the latter stages of the disease; thereby making it harder but not too late to take control of their own health. It is important women and others at risk for HIV infection learn the benefits of knowing if they are infected or not.

At AIDS Survival Project, we know from first hand experience that knowing one's HIV status is an essential step in taking control of one's life. This project helped make it possible for more people to have that life-saving knowledge. Thank you to all of my friends and well-wishers in the struggle and to all of my community partners across the State of Georgia in this important project. In this collective effort, your participation has made a real difference in our community.