More than a million Americans are currently living with HIV/AIDS, and roughly half of them are black. This is one of the most striking disparities in public health, and today is National Black HIV/AIDS Awareness Day, meant to draw attention to it. I’ve written about HIV here and abroad for many years, and there’s much to say on the who, what and why of this disparity. Suffice to say, HIV preys upon poverty worldwide, so no surprise that when a quarter of black Americans are living in poverty, HIV infection rates are so high.
As with many things in public health, the data that’s supposed to help us understand the challenges can be overwhelming. But I’ve long felt there’s one chart that most clearly explains the narrative of the domestic HIV/AIDS epidemic, and says everything about the challenges we now face. It’s below, and it shows AIDS diagnoses over the course of the epidemic. In the late 1990s, right about when taxpayer-developed lifesaving drugs hit the market and America declared victory over HIV, the epidemic split: Black diagnoses continued climbing as a share of overall diagnoses, while white diagnoses plummeted. In other words, in the part of America where people had access to care, the epidemic changed dramatically; elsewhere, it didn’t.
This year marks 30 years since the U.S. Centers for Disease Control first reported cases of the condition scientists would eventually identify as AIDS. Colorlines will be reporting on and talking about that unhappy anniversary all year, and in many cases in partnership with the Black AIDS Institute, an organization I worked with for many years. Today, the Institute released its latest State of AIDS in Black America report, which you can find here. Its take-home: the Obama administration’s crafting of America’s first overarching strategy for dealing with the epidemic was a huge victory last year, but that victory is meaningless if Congress and the administration don’t now fund and implement that strategy.
There are many, complex factors driving the black AIDS epidemic, from the much discussed stigma to the much less discussed basic access to meaningful health care. We’ll be parsing these throughout the year. But in the end, as the graph above suggests, today’s epidemic is also shaped dramatically by one factor: whether our government takes it seriously enough to end it, in all parts of our society.