December 1, 2008
Today is World AIDS day and I'm thinking about President-elect Barack Obama. As a 52-year-old Black gay man with HIV, I have many reasons to welcome the inauguration of Barack Obama. A big one is that an Obama administration has enormous potential to reinvigorate a struggle that has been allowed to flag over the last eight years: our national fight against HIV/AIDS.
With our country facing so many national challenges -- two wars, a financial meltdown, and the growing threat of environmental devastation -- it may be tempting to relegate the AIDS epidemic to the lower rung of national priorities. Yet that would be a grave mistake. Every year, more than 56,000 people in this country contract HIV.
The devastation is worst among Black Americans, who represent nearly half of all new HIV infections, including two-thirds of the new cases among women and 70% of the new cases among adolescents.
AIDS clearly has affected certain groups more than others. But as Senator Obama said in 2006: "We are all sick because of AIDS -- and we are all tested by this crisis. It is a test not only of our willingness to respond, but of our ability to look past the artificial divisions and debates that have often shaped that response."
AIDS, in short, is a sickness at the very heart of the American family. Like any family, America must respond to the sickness in its midst by displaying both solidarity for those who are living with HIV and a determination to make sure no one else gets infected.
We cannot relegate the AIDS fight to the government alone, not even with President Obama at the helm. So, here are several high-priority actions that Americans and our new government, together, should immediately take to reinvigorate our fight against HIV/AIDS:
The U.S. government requires all foreign countries that receive assistance from the President's Emergency Plan for AIDS Relief (PEPFAR) to have a national strategy to respond to HIV/AIDS. Shockingly, America has no national strategy for its own epidemic. No national targets are in place for reducing the number of new HIV infections or lowering the annual number of AIDS deaths. Multiple federal agencies own different pieces of the national AIDS response, yet in the absence of any national coordinating mechanism they stumble over each other, fight for turf, and leave critical priorities unaddressed.
President-elect Obama has committed to put in place a National AIDS Strategy. However, communities affected by AIDS -- not bureaucrats -- must drive the development of this strategy.
HIV prevention accounts for a paltry 4% of total spending by the federal government on domestic HIV/AIDS programs. That's an outrage.
The Obama administration must make good on its campaign promise to strengthen national prevention efforts. Yet when opposition surfaces to needle exchange or school-based HIV prevention programs, we must speak out and persuade decision-makers that true "family values" don't allow more HIV infections to occur when proven methods exist to prevent them.
The disproportionate vulnerability of Black gay men to HIV infection stems in no small part from the prevailing stigma associated with homosexuality. If we are serious about lowering the rate of new HIV infections, we must actively oppose stigma and promote acceptance in our churches, schools, and local communities.
The CDC estimates that more than one in five people living with HIV don't know they are infected. Such people are often diagnosed late in the course of disease, which significantly reduces life expectancy. Late HIV testing also contributes to the spread of HIV, because people who are unaware of their infection are more than three times more likely to expose others to the virus as people who know they are HIV-positive. Here, too, our new President will need our help establish a social norm that every person should know his or her HIV status. We need to urge everyone to get tested, and to explain, again and again, the benefits of getting tested.
In 2006, 15,000 Americans died of HIV-related causes. Yet, while our government's global AIDS efforts enjoyed double-digit increases each year between 2005 and 2008, categorical domestic federal programs for HIV treatment and prevention failed to keep pace with inflation. Especially scandalous is the lack of any funding increase for the Minority AIDS Initiative since 2004, even though nearly 100,000 Black Americans have become newly infected with HIV since that year. We need to insist that Congressional appropriators deliver the funding that is urgently needed to address this national priority.
Throughout much of the HIV/AIDS epidemic, mainstream Black organizations stayed on the sidelines. Thankfully, that has changed. Organizations like the Black AIDS Institute, the Balm in Gilead and the National Black Leadership Commission on AIDS have assisted leading Black organizations and historically Black colleges and universities to develop organizational action plans on AIDS.
Unfortunately, we're still not where we need to be. In 2006, private U.S.-based foundations gave less than a tenth of their HIV-related contributions to activities in this country. Less than a tenth! While we continue to help Africa and other hard-hit regions, we need to put out the fire here at home.
The new administration offers enormous promise for a new day in our nation's long struggle against HIV/AIDS. However, President Obama and his team won't be able to reinvigorate the national AIDS response on their own. Let's roll up our sleeves and get to work.
Yes, we can!
Yours in the Struggle,