Executive Summary: Making Change Real

The 2009 edition of the Black AIDS Institute's annual State of AIDS in Black America report lays out both the promise and the peril of the unique moment at which we've arrived in this epidemic.

On one hand, the historic election of Barack Obama and a congressional majority that has been more supportive of the AIDS fight offers great opportunity. Similarly, Black America is engaged in the struggle to end AIDS like never before. Together, these two realities could create real, lasting change in the course of this epidemic.

At the same time, 2008 witnessed great setbacks, particularly in the effort to prevent the virus's spread. We are seeing the outcome of too many years of neglect, at both the governmental and communal level.

The Challenges We Face

New Infections

In 2008, the U.S. Centers for Disease Control and Prevention released its long-awaited study re-examining the size and depth of the U.S. epidemic. Using new technology that allows researchers to learn more detail about individual HIV infections, the CDC discovered, among other things:

• The U.S. epidemic is at least 40 percent larger than previously believed and growing by between 55,000 and 58,000 infections a year;
• The U.S. has never logged fewer than 50,000 new infections a year, contrary to prior belief that we leveled out at 40,000 new infections a year in the mid-1990s;
• Black Americans represented 45 percent of people newly infected in 2006, despite being just 13 percent of the population;
• Men who have sex with men accounted for 53 percent of all new infections in 2006, and young Black men were particularly hard hit;
• In 2006, Black gay and bisexual men between the ages of 13 and 29 accounted for more new HIV infections among gay and bisexual men than any other race or age group. And more than half, or 52 percent, of all Black gay and bi men infected that year were under 30 years old.

Deaths

The racial disparity in AIDS deaths continued in data released last year:

• In 2006, the latest year for which data is available, 7,426 Black Americans died from AIDS. That number represents a meaningful improvement over the previous year -- a decline of 1,253 deaths.
• But Blacks continue to represent a far outsized proportion of deaths each year. In 2006, Blacks accounted for just over half of all AIDS deaths.

The 2009 State of AIDS in Black America report includes a chart pack -- "The Black Epidemic: By the Numbers" -- which details key data about the Black epidemic.

Resources

The federal commitment to all areas of AIDS work -- prevention, treatment and research -- has all but disappeared.

• The CDC's annual HIV-prevention budget has never topped $800 million -- a fraction of what the U.S. spends on the Iraq war in a week;
• The prevention budget has been cut by 20 percent in the past five years, in real dollar terms;
• The CDC spent just under $369 million on Black-specific prevention and research in fiscal year 2008, or 49 percent of the overall budget.
• Between 2004 and 2008, the discretionary domestic AIDS budget remained virtually flat, while global spending increased by more than 20 percent annually.

The Promise of a New Era

While the challenges are great, Black America is perhaps better poised to meet them today than ever before.

The new Obama administration has vowed to take action on several fronts, including drafting America's first comprehensive strategy to direct our efforts. (See "Call to Action for a National AIDS Strategy" on page 30, and "What Obama Has Promised" on page 21.) But just as crucial, our community is engaged like never before. From individuals on up to our traditional Black organizations, we've accepted the idea that this is our problem and we must find the solution.

In 2006, 16 traditional Black institutions launched the National Black AIDS Mobilization by signing on to the National Call to Action and Declaration of Commitment to End the AIDS Epidemic in Black America (see BlackAIDS.org for text and list of signatories). The 16 institutions are not typical AIDS organizations. These groups, many of which have histories that span generations, were founded to meet a wide range of communal needs and concerns; they have now formally added AIDS to their work.

This report offers an update on the progress each group has made in fulfilling its pledge to act. Many of them have made great strides; others are just beginning their work. In all cases, far more resources and support are required from both public and private funders who seek to impact the AIDS epidemic.

Some highlights from the State of Our Movement section of this report include:

• In 2008, two crucial groups joined the list of those that have completed strategic plans detailing how they will address HIV/AIDS: the National Association for the Advancement of Colored People and the National Urban League;
• 100 Black Men of America partnered with Aetna to create a website that members use as a healthcare management tool focusing on HIV/AIDS as well as prostate cancer/colorectal cancer, depression, cardiovascular disease and sickle cell anemia;
• The National Council of Negro Women hosted a panel discussion at its national convention, a town hall meeting and an online survey that all resulted in a series of recommendations for the next president, including a call for a national strategy to end AIDS;
• In the fall of 2007 the National Newspaper Publishers Association began a 25-week series of HIV/AIDS opinion pieces that were published in 200 Black newspapers each week;
• The Potter's House continued its HIV work with Texas ex-offenders and expanded its AIDS work in southern Africa.

These are just a handful of the many initiatives traditional Black organizations undertook in 2008. A full accounting for each group can be found in the State of Our Movement section of this report, and each of their strategic plans are online at BlackAIDS.org.