SAN FRANCISCO - The United States is at the forefront of a global response to HIV and AIDS but lacks a sense of urgency when it comes to the crisis facing African-Americans, according to a report released yesterday by the Black AIDS Institute.
The report, "Left Behind! Black America: A Neglected Priority in the Global AIDS Epidemic," says that the number of African-Americans infected with HIV exceeds the number of people with the virus in seven of the 15 countries served by the President's Emergency Plan for AIDS Relief.
"When we give aid to foreign countries, we demand that they have a national AIDS plan - but we don't have a plan in the United States," Phill Wilson, founder and CEO of the Black AIDS Institute, said yesterday during a telephone news conference on the report.
In some U.S. cities, the HIV rates among African-Americans are close to those of developing African countries.
If blacks in the United States constituted their own country, that nation would rank 16th in people living with HIV, 105th in life expectancy and 88th in infant mortality worldwide, according to the report.
The report calls for national actions such as HIV testing and prevention in black communities, urges that global AIDS leaders speak out on the neglect in the United States, and says black communities need to work to fight stigma and prejudice.
During the news conference, the Rev. Al Sharpton said the disproportionate and critical levels of AIDS among blacks should be a priority in this country.
"We must have a policy that strictly deals with the racial imbalance," Sharpton said. "To not deal with the disproportionate way it hits black America is doing a disservice to the issue and a disservice to black America."
The report's authors said that they are not criticizing the aid given to countries in Africa and the Caribbean but that there must also be prevention strategies designed specifically for black Americans.
Surveys show that African-Americans regard AIDS as the country's most serious health threat. But the federal government apparently doesn't share that view, the report says.
"The U.S. government's response to what is perhaps the most serious health crisis facing black America remains timid and lethargic," it says. "They act as if AIDS has been solved here, and have no strategy for the epidemic."
People with HIV are doing much better with recently developed drug combinations, and that may have contributed to the idea that the problem is solved, the report says. But there is a continuing need for prevention, it says.
Contributing to the disparity in African-Americans is the high poverty rate, because poor people have less access to health information, care and treatment; higher rates of sexually transmitted diseases among black people, which make them more likely to contract HIV; and the continuing reluctance of African-Americans to address the disease at all because of its association with homosexuality, which carries a heavy stigma in the black community.
"The issue of fighting AIDS in black America is more complicated than fighting [the disease] among white gay men," Wilson said.
AIDS is the leading cause of death among black women ages 25 to 34 and the second-leading cause of death of black men ages 35 to 44. Although only one in eight Americans is black, 50 percent of those infected with HIV in the U.S. are black, says the report.
Wilson said that African-Americans need an honest governmental partner to work with. His institute has reached out to the campaigns of both presidential nominees, he said.
Sen. Barack Obama, the Democrat, has endorsed the concept of a national AIDS strategy and has been tested publicly to bring awareness to the epidemic, while Sen. John McCain, the Republican, has not responded, Wilson said.
Wilson also said foundations should get more involved in a domestic response.
"The Gates Foundation is doing remarkable work in developing countries and has made a huge investment in sub-Saharan Africa, but has absolutely no AIDS program in the U.S. The Rockefeller Foundation also does no AIDS work in the United States," he said.