U.S. needs national HIV/AIDS plan, should focus resources on epidemic's trends, opinion piece says

Sep 2 2008

The recent CDC report on new HIV infections "underscore[s] ... the inexorable movement of the HIV/AIDS epidemic into black and other minority communities and the failure of government at all levels to respond to that change," C. Virginia Fields, president and CEO of the National Black Leadership Commission on AIDS, writes in a New York Daily News opinion piece (Fields, New York Daily News, 8/31).

According to the report, there were about 56,300 new HIV infections in 2006, the most recent year for which data are available, about 40% higher than CDC's long-standing estimate of 40,000 for each of the last several years. According to CDC, the number of new infections likely was never as low as the previous estimate of 40,000 and has been relatively stable overall since the late 1990s. The estimate is based on data from a new advanced testing method, which enabled researchers to detect recent HIV infections.

Non-Hispanic blacks accounted for 45% of new infections. HIV incidence in 2006 among blacks was 83.7 infections per 100,000 people, seven times as high as the rate of 11.5 per 100,000 among whites and three times as high as the 29.3 infections per 100,000 people among Hispanics. According to the data, although new infections among blacks are higher than among any other racial or ethnic group, the number has been relatively stable since the early 1990s (Kaiser Health Disparities Report, 8/4).

Fields writes that the U.S. in recent years "has shifted its focus to fighting HIV/AIDS in other countries" and supported expanding the President's Emergency Plan for AIDS Relief. She adds that the number of U.S. blacks with HIV is higher than the number of people living with HIV/AIDS in seven of the 15 PEPFAR countries.

The CDC report, as well as recent data on HIV from the New York City Health Department, show that the U.S. needs a "national plan with strategies to address all of the social and economic factors key to winning the fight against this epidemic," Fields writes. She calls for resources to be allocated following the trends of the epidemic in the U.S., not where the epidemic was. "Until the resources follow the epidemic, this public health emergency will continue to be fueled by the HIV/AIDS risk factors impacting black communities, including poverty, low literacy, stigma, use of illicit substances, unemployment, disproportionate incarceration and the lack of access to quality health care," Fields says.

She also calls on the black community to "address the needs of at-risk communities" and for black leaders to educate, organize and support HIV/AIDS prevention efforts. She concludes that "all American leaders must support a comprehensive National AIDS Plan focused on prevention, treatment, care, research, housing and supportive services to meet the needs of all Americans living with or at risk for HIV/AIDS. Millions of American lives depend on it" (New York Daily News, 8/31).