New reports highlight increasing rates of HIV/AIDS among minorities, the South

The 17th International AIDS Conference opened this week in Mexico City, with appeals for the international community not to slow down its fight against a disease that has claimed more than 25 million lives. While HIV/AIDS is often touted as a crisis for the developing world, new statistics released last month here in the United States continue to prove that the HIV/AIDS epidemic is far from over in the United States.

HIV/AIDS rates in Black American rival some African nations

The epidemic among African-Americans in some parts of the United States is as severe as in parts of Africa, according to "Left Behind - Black America: A Neglected Priority in the Global AIDS" published by the Black AIDS Institute last week.

The report highlights these sobering figures:

• Nearly 600,000 African-Americans are living with HIV, and up to 30,000 are becoming infected each year.
• AIDS is the leading cause of death among black women between ages 25 and 34
• In Washington, D.C., more than 80 percent of HIV cases are among blacks
• Although African-Americans represent only about one in eight Americans, one in every two people living with HIV in the United States is black
• If black America were a country, it would rank 16th in the world in the number of people living with the virus. More black Americans are living with the AIDS virus than the infected populations in Botswana, Ethiopia, Guyana, Haiti, Namibia, Rwanda or Vietnam -- 7 of the 15 countries receiving funds from the President's Emergency Plan For Aids Relief.

HIV/AIDS rates among Latinos represent a growing health crisis

The Washington Post reported last month that AIDS rates in the U.S. Latino population have quietly reached what experts are calling "a simmering public health crisis."

"Even with the United States embroiled in a fierce debate over immigration policy, the problem of AIDS in Latinos had received scant attention from political and public health officials," the Post reported, underscoring that Hispanics have gone rather unnoticed in terms of HIV infection rates. They account for 14 percent of the United States population, yet represent 22 percent of new HIV/AIDS diagnoses in 2006.

According to the Post:

Language difficulties, cultural barriers and, in many cases, issues of legal status make the threat in the Hispanic community unique. For those who arrived illegally, in particular, fear of arrest and deportation presents a daunting obstacle to seeking diagnosis and treatment.

The Deep South continues to lead the nation in HIV/AIDS rates

In another report released last month, researchers found that in the South, more adults and youth live with and die from AIDS than elsewhere in the nation. A new report, "Southern States Manifesto Update 2008: HIV/AIDS and Sexually Transmitted Diseases in the South" released by the Southern AIDS Coalition, a nonprofit partnership of government and private-sector programs based in Birmingham, concluded that AIDS is creating a health disaster in the South. "Rising infection rates coupled with inadequate funding, resources and infrastructure have resulted in a catastrophic situation in our public health care systems in the South," the report says.

Among the findings:

• The South has the highest number of adults and adolescents living with and dying from AIDS in the United States.
• AIDS deaths declined or were steady in other parts of the country from 2001 to 2005, but increased almost 14 percent in the South. Through 2006, 52% of the reported, estimated living HIV cases, and 41% of the reported, estimated living AIDS cases were from the South.
• Although the region is home to only 36 percent of the nation's population, the South accounted for half of all U.S. AIDS deaths in 2005, and more than half of persons living with HIV in 2006.
• Of the 15 states with the highest rates of new HIV infections, nine (60%) are in the South.
• More than 40 percent of new infections are in the South.
• Of the 20 metropolitan areas with the highest AIDS case rates in 2006, 16 (80%) are in the South. The South leads the nation in AIDS cases and rates in cities of all sizes.
• Over half (52%) of African-Americans living with AIDS and 58% of new AIDS cases reported among blacks in 2006 occurred in the South.

(Bar graph: New AIDS Cases in 2005 occurring among African Americans. Source: Ford Foundation.)But while the epidemic continues to grow in the Deep South, federal funding has not followed and has instead been channeled to wealthier parts of the nation with fewer cases and death rates, according to the report. "The South is faced with a crisis of having to provide medical and support care for increasing numbers of infected individuals without adequate funding," especially among the young and among minority Southern communities, the report concluded.

In the South, the HIV/AIDS burden is compounded by high rates of poverty, unemployment, lack of insurance, a health care delivery system in crisis, inadequate transportation systems, translation issues, and social stigma. Moreover, HIV infections seem to be spreading fastest in rural areas where financial, health and social problems often compound. Southern states comprise 65% of all AIDS cases among rural populations, according to the Southern AIDS Coalition.

"The ruralness of the epidemic is what's becoming painfully clear," Kathy Hiers, chief executive officer of AIDS Alabama and co-author of the report, told The Birmingham News.

The need for a new domestic HIV/AIDS policy

There is a lack adequate federal response and funding in dealing with the growing crisis of HIV/AIDS in communities of color and in the South. The Southern AIDS Coalition is calling for a "fundamental rethinking of AIDS policy."

The Black AIDS Institute is also calling for better domestic policies in the United States and for international agencies to hold the U.S. government accountable for failure to address HIV/AIDS epidemic in its own country. They point out that international efforts to combat the epidemic are guided by a strategic plan, clear benchmarks like the prevention of seven million H.I.V. infections by 2010, and annual progress reports to Congress, but in contrast "America itself has no strategic plan to combat its own epidemic."

"We understand the needs of black folk in Johannesburg (South Africa)," Phill Wilson, founder and CEO of the Black Aids Institute, told CNN. "Why can't we understand the needs of them in Jackson, Mississippi?"