February 4, 2009
The scourge of HIV/AIDS, which continues to affect the African-American community disproportionately, highlights the importance of a comprehensive strategy to address the U.S. epidemic. African-Americans make up 12 percent of the U.S. population but account for nearly half of all new HIV infections1 and almost half of all Americans living with HIV.2 Recent analyses by the U.S. Centers for Disease Control and Prevention (CDC) reveal that in 2006, more new HIV infections occurred among young black men who have sex with men than in any other segment of the U.S. population. That same year, black women acquired new HIV infections at 15 times the rate of white women.3 If African-Americans were a country, they would form the 35th most populous nation in the world but would rank 16th in the number of people living with the virus.4
One need look no further than our nation's capitol to see the dreadful impact of HIV/AIDS on black Americans. One in 20 residents of Washington, D.C., a majority black city, is living with HIV5 -- approximately the same proportion of people as in the sub-Saharan region of Africa.6 One in 50 D.C. residents has AIDS.7 These shocking statistics would be tragic anywhere but are particularly inexcusable in a wealthy country such as the United States.
Today, on the ninth annual National Black HIV/AIDS Awareness and Information Day, let us unite to address this public health crisis in the black community. Let us promote tolerance and compassion for people infected with HIV and ensure HIV testing, counseling and treatment for all. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, joins the African-American community in mourning those who have succumbed to HIV/AIDS and in committing ourselves to preventing further suffering and death from this terrible scourge.
To win the battle against HIV, it is crucial that African-Americans -- and indeed, all Americans -- get tested for the virus during routine medical care, as the CDC and the American College of Physicians recommend. Of the estimated 1.1 million Americans living with HIV, one-fifth do not know they are infected,8 raising the chances of further spreading the virus and the likelihood of becoming very ill without treatment. Increasingly, scientific evidence indicates that beginning treatment for HIV as early as possible in the course of infection has advantages for infected individuals, their partners and their communities. Early treatment appears to improve the odds of staying healthier longer.9 In addition, treatment can dramatically reduce the amount of HIV in blood and other bodily fluids, decreasing the chances of virus transmission. This is particularly important during the first weeks after infection, when the amount of virus circulating in untreated individuals is extremely high.
Treatment is no substitute for prevention, however. NIAID-funded investigators are working to develop and validate new methods to protect against HIV infection, including microbicides that could be applied vaginally or rectally before sex; antiretroviral drug regimens that could be used to prevent infection in people who are at high risk of becoming infected with HIV; and, of course, vaccines to prevent HIV infection.
NIAID also is conducting HIV/AIDS research specifically designed to benefit African-Americans. For example, NIAID is launching a clinical study (www.hptn.org/research_studies/hptn061.asp) in seven U.S. cities to explore multiple interventions for preventing HIV infection among black men who have sex with men. Studies such as these are designed to make the scientific findings relevant to the patient populations who need them. We strongly encourage African-Americans to join us in the fight against HIV/AIDS by participating in clinical research. To locate NIAID-sponsored HIV/AIDS clinical trials that are seeking volunteers, go to ClinicalTrials.gov.
As a nation, we must focus on the essential measures for curbing the HIV/AIDS epidemic among all communities, including African-Americans. These measures include access to basic health care services; routine HIV testing to ensure that HIV-infected individuals are identified early in their infection and begin treatment when it provides the most benefit; and patient-management strategies to ensure adherence to treatment regimens. Aggressive HIV testing and treatment combined with a well-rounded HIV prevention research program will serve all of us well as we attack the epidemic together.
Information about National Black HIV/AIDS Awareness and Information Day is available at http://blackaidsday.org/.
Each year, the NIH Office of AIDS Research (www.oar.nih.gov/) develops a Trans-NIH Plan for HIV-Related Research that identifies strategic research priorities for all areas of AIDS research. The annual Trans-NIH Plan, developed in collaboration with experts from the NIH institutes and centers, other government agencies, non-governmental organizations and AIDS community representatives, includes a chapter specifically devoted to research addressing AIDS in racial and ethnic populations. The 2010 fiscal year strategic plan can be accessed at www.oar.nih.gov/strategicplan/fy2010/pdf/Chapter5.pdf.
Visit http://AIDS.gov for comprehensive government-wide information on HIV/AIDS; visit www.aidsinfo.nih.gov/ for information about prevention, treatment and clinical trials; and visit www.hhs.gov/ocr/civilrights/resources/specialtopics/hiv/ for information on protecting the civil rights and health information privacy rights of people infected with HIV.
Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.