What is the most critical AIDS issue facing the African-American community and how can it be best addressed?
Despite the many programs, initiatives and advances in medical treatment, the HIV/AIDS epidemic continues to take a devastating toll on the African-American community. We are experiencing the highest rates of new infections and deaths compared to all other groups. Indeed, although African Americans comprise only 12 percent of the U.S. population, we account for 40 percent of the 930,000 estimated AIDS cases diagnosed since the epidemic began.
During 2000-2003, HIV/AIDS rates for African-American females were 19 times the rates for white females; rates for African-American males were seven times those for white males. My home state of Illinois has not been spared -- it ranks ninth out of the top 10 states with the highest numbers of African Americans living with HIV/AIDS.
The irony and the tragedy of these statistics is that HIV/AIDS is a completely preventable disease. As such, I believe that the most critical AIDS issue facing the African-American community is the need for prevention. We have not adequately educated ourselves and each other about this disease, nor have we identified effective ways to empower individuals to change their sexual practices to protect themselves from HIV infection. Obviously I am not an expert in the area of HIV prevention, but I do know that until we have an open and honest dialogue within the African-American community about what we need to do, or do better, we will not be able to stop the silent but deadly spread of this disease.
Where is the least progress being made in combating the epidemic in the black community?
We simply have not identified or implemented effective prevention strategies for reducing the rate of transmission of this disease in the African-American community. Given the continued explosion of HIV infections in the community, it is clear that we have a long way to go before we get a handle on the disease in the black community. However, I would say that our federal agency partners have identified those groups -- especially women, and men who have sex with men -- which are at highest risk for infection, and have taken steps to target these populations with initiatives and funding support to community organizations, including minority organizations that can best outreach to high-risk groups. Support to these organizations remains critical if we are ever to achieve any real success.
What are the top myths you have encountered in the community and how can they be countered?
The most dangerous myth about HIV/AIDS in our community is the misconception that it does not affect African Americans. AIDS has long been stereotyped as a white, specifically gay man's, disease, but the unfortunate reality is that it has impacted all populations, regardless of race, ethnicity or socioeconomic status. In order to counter this myth, I think that the conversation about HIV/AIDS needs to occur more readily, and not just with our families but also in our churches, schools and other community settings. Our grass-roots and community-based groups are trusted brokers of these dialogues, and continued support of these organizations by the federal government and other funders is critical.
How would you rate President Bush and his administration in addressing the many HIV issues facing the African-American community? What about his emphasis on the epidemic in Africa?
The President has publicly acknowledged the critical situation our nation and the world is facing with the HIV/AIDS epidemic. He has discussed it in speeches and has specifically acknowledged the disproportionate burden of the epidemic on women and communities of color. Yet, this public recognition simply has not translated into adequate investment in HIV/AIDS programs such as the Ryan White CARE Act or the Minority AIDS Initiative. Certainly many of these programs have been spared draconian cuts or elimination in the President's budget, which has not been true for other critical programs such as the Healthy Communities Access Program. However, when it comes to HIV/AIDS, to stand in place is to fall further and further behind, and this is what is happening in the African-American community. Without adequate funding the President's words remain empty rhetoric.
With respect to the epidemic in Africa, let me start by saying that the continued spread of HIV/AIDS across the world highlights the critical need for international partnership and strategies. In this day of global trade and commerce, our success in eradicating HIV/AIDS here in the United States will not happen without similar efforts and success in other countries. Our assistance and attention to the epidemic in Africa is not just the smart thing to do -- it is also the right thing to do. In sub-Saharan Africa, where an estimated 26 million people were living with HIV at the end of 2005 and more than 12 million children have been orphaned by AIDS, the devastation is simply incomprehensible, and I commend President Bush for his international efforts.
If you were the President, what would be the top five Executive Orders, policies or other positions you would take to end the epidemic, improve treatment, lower transmission rates and so on?
This is not an easy task, and given that the HIV/AIDS epidemic continues to evolve, what may seem logical today may not be a top priority tomorrow. In addition, successful eradication is unlikely without a comprehensive, large-scale societal investment in improving the educational and economic opportunities of our most vulnerable populations, which are disproportionately affected by this disease. That being said, my top five priorities are the following:
- Strengthening the public health infrastructure.
We know that the federal government's investment in prevention is only a fraction of its investment in medical care and treatment. The HIV/AIDS epidemic is just one example of this administration being "penny-wise and pound-foolish." This nation must increase its investment in the federal and state public health agencies, and equally important, in our community-based organization partners who are truly the foot-soldiers in this prevention war against AIDS.
- Promoting screening for HIV/AIDS.
Studies have indicated that about one-fourth of Americans infected with HIV are unaware of their status, and these individuals will continue to transmit the deadly infection. These individuals need to be identified, educated and treated.
- Expanding coverage for HIV/AIDS treatment and services.
A number of programs, particularly the Ryan White CARE Act, have helped so many individuals get the care they need, allowing them to remain healthy, and live longer and more productive lives. Yet, so many individuals continue to fall through the cracks, and the overall federal investment is inadequate given the scope and magnitude of the epidemic.
- Supporting research for novel drugs and treatments.
HIV has continued to mutate, thwarting vaccine-development efforts and rendering many of our current treatments ineffective. The federal government must continue to support and accelerate research for development of effective medications and treatments, which should include microbicides which hold tremendous promise for HIV prevention for women.
- Providing comprehensive sex education.
Promotion of abstinence from sex outside of monogamous relationships must be part of any successful HIV-prevention strategy, but it cannot be the entire strategy. Information about condoms and other effective tools must be made readily available. We are losing the battle against the HIV/AIDS epidemic, and we cannot allow partisan politics to trump sound, scientific policies.