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World AIDS Day 2009

Addressing the U.S. Epidemic

This World AIDS Day, the Obama administration should begin to seriously address the root causes of the AIDS crisis here at home.

SOURCE: AP/Haraz N. Ghanbari

On this World AIDS Day, as more than 33 million people worldwide live with HIV/AIDS, we want to recognize the impact of the HIV/AIDS crisis in our own country and to call for action that helps the communities and people most in need.

AIDS is the number one killer of black women between the ages of 25 and 34.

Black women are now almost 15 times as likely to be infected with HIV and 23 times more likely to be diagnosed with AIDS as white women.

A total of 44,100 people in the United States were newly diagnosed with HIV in 2007, a 13 percent increase from 2006.

Fifty-four percent of new HIV diagnoses in 2007 occurred in gay and bisexual men of all races and ethnicities.

African Americans, who make up only 12 percent of the U.S. population, now make up more than 49 percent of new infections and nearly 40 percent of all HIV/AIDS deaths in the U.S.

If African Americans in the United States constituted their own country, that country would rank 21 in the world among those with the highest number of individuals living with HIV.

In Washington, D.C., 15,000 people—3 percent of D.C.’s adult population—have HIV or AIDS. A 1 percent population threshold is required for an epidemic to be considered “severe” or “generalized.”

The U.S. Department of Housing and Urban Development has threatened to cut off HIV/AIDS funding for D.C. due to severe and chronic mismanagement of previous grants.

Only 9 percent of U.S. federal discretionary HIV/AIDS spending in 2008 was dedicated to domestic prevention services—down from 14 percent in 2000.

International HIV/AIDS discretionary spending increased from 4 percent in 2000 to 46 percent in 2008.

The United States has increased its PEPFAR commitment for international HIV/AIDS prevention and treatment by $48 billion over the next five years.

The Centers for Disease Control and Prevention would need $4.8 billion over the next five years to reduce the annual number of new HIV infections in the United States.

We are encouraged that the Obama administration’s Office of National AIDS Policy is developing a National HIV/AIDS Strategy, something advocates have long called for.

At the very least, this strategy should focus on the following:

1. Providing health insurance to all people who have HIV or AIDS, regardless of their ability to afford such coverage.

2. Establishing explicit care and prevention guidelines that target people based on their sexual orientation, race/ethnicity, gender, age, immigration status, and/or geography.

3. Appointing a high-level official with the Centers for Medicare and Medicaid Services to oversee (and better leverage) funding for HIV/AIDS-related care.

The United States should continue funding programs that fight HIV/AIDS around the world. But we must also seriously address the root causes of the AIDS crisis here at home. This crisis is fueled by complex factors—poverty, discrimination, violence, homophobia, and stark racial and gender inequities—that most people prefer to ignore or at the very least address in isolation from each other. A new dynamic approach to conquering HIV/AIDS is needed, otherwise the epidemic will only persist and grow here at home.

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