Black America: A Neglected Priority in the Global AIDS Epidemic

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According to a new report by the Black AIDS Institute, if blacks in the United States constituted their own country, that nation would rank sixteenth in the world in the number of people living with HIV. Two percent of adult black Americans are infected with the virus, and only four countries outside Africa have a higher HIV prevalence. [includes rush transcript]

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This is a rush transcript. Copy may not be in its final form.

JUAN GONZALEZ: President Bush is expected to sign a bill today that will extend the administration’s global AIDS initiative, which has spent about $19 billion overseas in the past five years. The bill would extend the AIDS program and authorize the spending of an additional $48 billion over the next five years in fifteen counties around the world, most of them in Africa.

This comes as a new report from a prominent AIDS organization accuses the federal government of doing too little to fight AIDS among African Americans. The fifty-five-page report by the Black AIDS Institute is titled “Left Behind: Black America: A Neglected Priority in the Global AIDS Epidemic.” It finds that the number of African Americans infected with HIV exceeds the number of people with the virus in seven of the fifteen countries served by the President’s Emergency Plan for AIDS Relief, known as PEPFAR.

According to the report, if blacks in the United States constituted their own country, that nation would rank sixteenth in the world in the number of people living with HIV. Two percent of adult black Americans are infected with the virus, and only four countries outside of Africa have a higher HIV prevalence.

Kai Wright is a freelance journalist based in Brooklyn and is the publications editor of the Black AIDS Institute. He helped compile the report. He also has an article in the July issue of The American Prospect titled “America’s AIDS Apartheid.” Kai Wright joins me in the firehouse studio. Welcome to Democracy Now!

KAI WRIGHT: Thanks for having me.

JUAN GONZALEZ: Well, Kai, can you — some of the key findings of the report, and especially the amazing contradiction of President Bush earmarking all this extra money for Africa while the administration appears to be ignoring the situation right here at home.

KAI WRIGHT: Right. I mean, it should be clear that the point of the report isn’t to say that we shouldn’t be involved in the global epidemic. And, you know, the reality is that the United States was asleep at the wheel on that end of things for far too long, as well. And so, as a nation, we should in fact be applauded for what we’re doing globally with PEPFAR and before PEPFAR, PEPFAR being the President’s plan. We should be applauded for that work.

The problem is that at the same time that we’ve begun to scale up this investment globally, we have, in some cases, scaled down our investment domestically and, in all cases, held it flat. That’s since 2001. It’s now 2008. And as that’s been happening, the US epidemic has been growing by at a minimum of 40,000 new infections a year, and we have every reason to believe the number is higher than that.

JUAN GONZALEZ: And what is the extent of government support for AIDS treatment in the African American community? Are there clear figures on that, as opposed to the general society?

KAI WRIGHT: Well, it’s hard to break out the money to say, you know, what goes here — it’s hard to break out the money by race. We can say a few things. We can say that the overall domestic epidemic, even if you don’t break out the numbers by race, we’re not spending on par with the growth of the epidemic. You know, again, if the epidemic is growing by 40,000 a year, at least, according to the CDC, the money — the budget for treatment for people who are uninsured or people who are low-income has not grown at all in that time period.

There’s — at the same time, we see some of the infrastructure, that we built that —- to deal with the domestic epidemic, falling apart. You know, so the program we have that helps folks who are not insured get meds has a waiting list every year. It’s a state-level program. The waiting lists develop at the state level every year, hundreds deep. People have died on the waiting list in South Carolina. That’s the only state that at least has acknowledged it. So we see the apparatus falling apart, and we know that the overall epidemic is disproportionately African American.

JUAN GONZALEZ: And also, within the African American community, the increasing numbers of women that are affected, as well, right? That’s -—

KAI WRIGHT: Yeah. I mean, both women and gay men are the hardest-hit areas. I believe the number stands at two-thirds of cases amongst women in the United States are black. There was — and that’s at all different age groups. It’s — I’m going to get the stat wrong now, but it remains a leading cause of death for African American women who are, I believe, twenty-five to forty-four. So, it’s disproportionately hitting black women. It’s disproportionately hitting black gay men. We’ve seen, in some cases — in one study that the CDC did a couple years ago looking at HIV infection amongst gay men in seven cities, they tested a bunch of gay men, gay and bisexual men, and 46 percent of the black men they tested were already HIV-positive. 46 percent.

JUAN GONZALEZ: The report makes clear that if black America were a separate nation, it would rank among the nations with the highest incidence of AIDS in the world. Could you expand on that?

KAI WRIGHT: Well, I mean, that’s one of the striking things that we realized as we started figuring out how to talk about this sort of — this domestic epidemic that we assume is — that everyone assumes is under control. If you look at the United States and if you look at the West in general, you can make a good case about what we’ve done, about what we’ve accomplished, you know, with the dramatic dropping of the infection rates, the dramatic dropping of the death rates.

But if you break out black people, by all of these measures that we look at globally, black people are doing — have an epidemic that reflects the one in the developing world. When you look at the levels of infection, when you look at things like how long it takes before people get into treatment, if you look at the way the epidemic — way infection spreads in the black community versus in the generalized population, by all of these different measures, the black epidemic looks like the one in the developing world. And it’s time that we start thinking about it that way, as we start saying, well, we have to target our funds for this. It’s a long multi-year battle. We’ve got — multi-generation battle. We’ve got to target our funds. We need to start thinking about, both as a government and as private funders, about targeting the black community as the way — as a part of the global epidemic.

JUAN GONZALEZ: And we’ve mentioned the failures of the federal government overall. What about the elected officials within the African American community, the Congressional Black Caucus and others? Where have they been as this epidemic has been accelerating?

KAI WRIGHT: I mean, interestingly, the Congressional Black Caucus, not just those elected officials, but also at the state and local level, and then outside of elected officials, in some of the black leadership, have really in the last four or five years started stepping up to the plate. Black community — the black leadership has been rightly faulted throughout the course of this epidemic for taking too long to get involved, taking too long to realize that black people were disproportionately impacted. But we have seen a real turn in that in the last four or five years, where a number of CBC leaders — Barbara Lee, Maxine Waters, and there’s a good long list — are really out front. Barbara Lee is one of the folks who signed on to this report; she has an introduction. So we’re starting to see some real leadership from the Black Caucus, and we’ll see where it goes.

JUAN GONZALEZ: Well, I want to thank you, and you’re going to stay with us for our next segment, because we want to talk about the vast majority of African American and Latino middle-class families that are at risk of falling out of the middle class altogether.

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