The following is a text of the “State of HIV/AIDS in Black America delivered by C. Virginia Fields, President and CEO of NBLCA, on National Black HIV/AIDS Awaremess Day 2009:

THE STATE OF HIV/AIDS IN BLACK AMERICA

C. Virginia Fields

President/CEO, National Black Leadership Commission on AIDS

GOOD EVENING.  THE SEGMENTS OF THE DOCUMENTARY YOU JUST VIEWED, OUT OF CONTROL, WERE AIRED BACK IN 2006.  YET TODAY…ALMOST THREE YEARS LATER AND ALMOST THREE DECADES INTO THE STRUGGLE…WE STILL ENGAGE THE HIV/AIDS EPIDEMIC FACING MANY OF THE SAME DEEPLY TROUBLING AND UNRESOLVED ISSUES.

LADIES AND GENTLEMEN…THE HIV/AIDS CRISIS IS FAR FROM OVER.

FORTUNATELY, 2009 HAS USHERED IN A NEW AND HISTORIC ERA OF HOPE AND CHANGE.  PRESIDENT BARACK OBAMA, WITHIN A WEEK OF TAKING OFFICE, BECAME THE FIRST AMERICAN PRESIDENT TO ANNOUNCE THE DEVELOPMENT OF A NATIONAL HIV/AIDS STRATEGY IN HIS CIVIL RIGHTS AGENDA.

THIS IS A FITTING TIME TO TAKE STOCK OF THE STATE OF HIV/AIDS IN BLACK AMERICA AND THE STATE OF OUR EFFORTS TO COMBAT IT.

SATURDAY, FEBRUARY 7^TH, WILL MARK THE NINTH ANNUAL OBSERVANCE OF NATIONAL BLACK HIV/AIDS AWARENESS DAY. THIS OBSERVANCE IS A NATIONWIDE EFFORT TO MOBILIZE PEOPLE AND CALL UPON THEM TO:

• GET EDUCATED
• GET TESTED
• GET TREATED
• AND GET INVOLVED IN MEETING THE CHALLENGES OF FIGHTING HIV/AIDS, AS IT CONTINUES TO DEVASTATE BLACK COMMUNITIES.

SO… I WELCOME YOU HERE THIS EVENING.

(ACKNOWLEDGEMENTS)

WHEN FINALLY DEVELOPED, PRESIDENT OBAMA’S NATIONAL HIV/AIDS STRATEGY – A PLAN THE NATIONAL BLACK LEADERSHIP COMMISSION ON AIDS AND OTHERS HAVE BEEN CALLING FOR A LONG TIME – MUST ADDRESS, HEAD ON, THE DRAMATIC AND DISPROPORTIONATE MIGRATION OF THE EPIDEMIC INTO AFRICAN-AMERICAN COMMUNITIES.  UNTIL NOW, THAT CHANGE HAS NOT BEEN ADEQUATELY RECOGNIZED OR EFFECTIVELY ADDRESSED.

LOCALLY, AFRICAN-AMERICANS REPRESENT 26% OF NEW YORK CITY’S TOTAL POPULATION, BUT ACCOUNT FOR 51% OF ALL NEWLY-DIAGNOSED HIV INFECTION CASES IN 2006.

NATIONALLY, AFRICAN-AMERICANS REPRESENT APPROXIMATELY 13% OF THE NATION’S TOTAL POPULATION, BUT ACCOUNT FOR AN ESTIMATED 45% OF ALL NEWLY-DIAGNOSED HIV INFECTION CASES AND 50% OF ALL NEWLY-DIAGNOSED AIDS CASES IN 2006.

ACCORDING TO A RECENT REPORT BY THE BLACK AIDS INSTITUTE, IF BLACK AMERICA WERE ITS OWN COUNTRY, IT WOULD HAVE A LARGER HIV POSITIVE POPULATION THAN HALF OF THE FIFTEEN COUNTRIES RECEIVING FUNDS FROM THE UNITED STATES PRESIDENT’S EMERGENCY PLAN FOR AIDS RELIEF.  THIS MEANS THAT BLACK AMERICA HAS MORE HIV POSITIVE CITIZENS THAN ETHIOPIA, BOTSWANA, VIETNAM, NAMIBIA, HAITI, RWANDA, AND GUYANA.

FURTHER EVIDENCE OF THE DISPROPORTIONATE IMPACT OF HIV/AIDS ON AFRICAN-AMERICANS WAS PROVIDED BY THE NATIONAL CENTERS FOR DISEASE CONTROL AND PREVENTION IN THEIR REPORT OF AUGUST, 2008.

• THE REPORT PROVIDED A MORE ACCURATE PICTURE OF THE NUMBER OF NEW HIV CASES NATIONALLY.  IT INDICATES THAT APPROXIMATELY 56,300 NEW INFECTIONS OCCURRED IN THE UNITED STATES IN 2006.  ALMOST HALF– 25,000–WERE IN AFRICAN-AMERICANS.
• THE REPORT CLEARLY CONFIRMED THE MASSIVE MIGRATION OF THE EPIDEMIC INTO COMMUNITIES OF COLOR AND STATED UNEQUIVOCABLY THAT THE COMMUNITIES HIT HARDEST AND MOST DRAMATICALLY ARE AFRICAN-AMERICAN.
• THE REPORT ALSO REITERATED THAT A QUARTER OF A MILLION AMERICANS ARE HIV-POSITIVE AND DON’T KNOW IT.  AS A RESULT, THEY PUT THEMSELVES AND THEIR COMMUNITIES AT UNNECESSARY RISK, CAUSING AS MANY AS THREE-QUARTERS OF ALL NEW INFECTIONS.
• TO PUT THIS IN PERSPECTIVE:

• THE RATE OF AIDS DIAGNOSES FOR BLACK ADULTS AND ADOLESCENTS IS TEN TIMES THAT OF WHITE AMERICANS … AND NEARLY THREE TIMES THAT OF HISPANICS.
• THE RATE OF AIDS DIAGNOSES FOR BLACK WOMEN IS NEARLY 23 TIMES THAT OF WHITE WOMEN.
• AIDS IS THE LEADING CAUSE OF DEATH FOR BLACK WOMEN BETWEEN THE AGES OF 25 AND 34.  AS YOU HEARD IN THE DOCUMENTARY, THIS HAS BEEN THE CASE FOR WELL OVER A DECADE.
• AIDS IS THE SECOND LEADING CAUSE OF DEATH FOR BLACK MEN – AGES 35 TO 44.

THE STATISTICS ARE HEARTRENDING.  THEY SPEAK TO THE IMPACT OF HIV/AIDS ON NEWBORNS AND SENIORS, MOTHERS AND FATHERS, YOUNG ADULTS, TEENS AND THE MIDDLE AGED.  AFRICAN-AMERICANS OF ALL AGE GROUPS ARE ENDANGERED BY THE STUNNINGLY RAPID SPREAD OF INFECTION IN OUR COMMUNITIES.

IN 2006, THE NATIONAL MEDICAL ASSOCIATION REPORTED THE STATE OF HIV/AIDS IN THE BLACK COMMUNITY TO BE OF CRISIS PROPORTIONS…TANTAMOUNT TO A STATE OF EMERGENCY FOR AFRICAN-AMERICANS.

NUMBERS AND CONCLUSIONS GIVE US ONE PICTURE OF HIV/AIDS IN BLACK AMERICA, BUT I’D LIKE TO SHARE WITH YOU A HUMAN PICTURE OF ITS IMPACT, TOO.  MARVELYN BROWN IS A REMARKABLE YOUNG WOMAN I’VE HAD THE PLEASURE OF WORKING WITH RECENTLY.  HER STORY IS AT ONCE SAD, SHOCKING AND INSPIRING.  A BEAUTIFUL, ACCOMPLISHED, POPULAR 19-YEAR OLD, MARVELYN HAD UNPROTECTED SEX ONE NIGHT WITH HER BOYFRIEND, AN EQUALLY ACCOMPLISHED, POPULAR AND – THOUGH HE NEVER TOLD HER – HIV POSITIVE YOUNG MAN.

ONE DAY, SHE BECAME VERY ILL AND WAS TAKEN TO THE HOSPITAL INTENSIVE CARE UNIT.  SHE LAY THERE FOR TWO WEEKS WITHOUT ANYONE – HERSELF INCLUDED – THINKING SHE MIGHT HAVE HIV.  IT WAS NOT DIAGNOSED UNTIL AFTER A CRISIS THE DOCTORS THOUGHT MIGHT KILL HER.

SHE FACED REJECTION AND STIGMA FROM MANY OF HER ACQUAINTANCES.  HER MOTHER TOLD HER TO SAY THAT SHE HAD CANCER.

BUT SHE IS IN TRUTH A VERY REMARKABLE YOUNG WOMAN.  SHE HAS SINCE WRITTEN WELL-RECEIVED BOOKS AND SPOKEN ON TELEVISION ABOUT HER EXPERIENCE, WHILE DEDICATING HER TIME TO REACHING OUT TO OTHER YOUNG WOMEN TO SHARE HER EMPOWERING MESSAGE AND EDUCATE THEM ON HOW TO PROTECT THEMSELVES.  SHE, AS MUCH AS ANYONE, IS THE FACE OF HIV AND AIDS IN THE BLACK COMMUNITY.

IT IS UNNERVING TO THINK THAT EVEN IN THE FACE OF OUR AWARENESS AND KNOWLEDGE TODAY OF THE EPIDEMIC IN THE BLACK COMMUNITY, THERE IS NO OUTCRY; THERE IS NO SENSE OF TOTAL OUTRAGE.

WHY? ……..

UNFORTUNATELY, MANY BELIEVE THAT THE DISEASE HAS BEEN CURED AND THAT IT IS NOW JUST ANOTHER CHRONIC ILLNESS.  THERE ARE NO LONGER FRONT PAGE DAILY STORIES PORTRAYING PEOPLE WHO ARE INFECTED OR DYING FROM AIDS.  IN FACT, THE MEDIA PAYS VERY LITTLE ATTENTION TO HIV/AIDS AT ALL.

THE ADVERTISEMENTS PROMOTING HIV/AIDS MEDICATIONS, WHICH PORTRAY SMILING FACES, GIVE A FALSE IMAGE OF WHAT THIS DISEASE IS ALL ABOUT.

HOWEVER, THERE IS MUCH WE CAN AND MUST DO WITHIN THE BLACK COMMUNITY.

• IT IS PAST TIME TO ADDRESS THE STIGMA AND DISCRIMINATION WHICH HAVE BEEN DIRECTED TOO OFTEN TOWARD PEOPLE LIVING WITH HIV/AIDS.
• WE MUST CONTINUE TO RAISE AWARENESS ABOUT THE DISEASE AND THE PROBLEMS THAT ATTEND IT BY HAVING AUTHENTIC CONVERSATIONS WITHIN OUR COMMUNITIES TO FIGHT COMPLACENCY AND INGRAINED STIGMA
• WE MUST FIND NEW WAYS TO HELP CHANGE PERSONAL BEHAVIORS THAT LEAD TO HIV INFECTION.
• WE MUST HAVE SPECIFIC, CULTURALLY-COMPETENT HIV PREVENTION MESSAGES TARGETED TO AFRICAN-AMERICAN POPULATIONS, INCLUDING WOMEN, YOUTH AND MEN WHO HAVE SEX WITH MEN.
• WE MUST ENGAGE IN A NEW ACTIVISM TO:

• PRESS FOR THE ENACTMENT OF PUBLIC POLICIES AND
• ENSURE THAT BUDGET RESOURCES TARGET CRITICAL AREAS OF PREVENTION, TREATMENT AND CARE,
• AS WELL AS DEMAND RESEARCH TO TURN THIS HEALTH CRISIS IN BLACK AMERICA AROUND.

• WE MUST ALSO ADDRESS A KEY SOURCE OF INFECTION, THE NATION’S CORRECTIONAL SYSTEM.   THE PRISON POPULATION HAS MORE THAN QUADRUPLED SINCE 1980.   AT THE SAME TIME, PRISONS HAVE BECOME INCUBATORS FOR SEXUALLY-TRANSMITTED DISEASES.  YET MOST DO NOT PROVIDE CONDOMS, HIV TESTING, PREVENTION SERVICES, MENTAL HEALTH SERVICES OR APPROPRIATE MEDICAL CARE TO THEIR INMATES.  AS A RESULT OF THIS SYSTEMATIC FAILURE, TOO MANY MEN LEAVE PRISON HIV-POSITIVE WITHOUT KNOWING IT, THEREBY PLACING THE COMMUNITY AT RISK.

ALL OF THESE ISSUES CALL FOR ACTION ON THE PART OF THE PUBLIC AND PRIVATE SECTORS, THE COMMUNITY, ITS LEADERS AND A BROAD SPECTRUM OF CONCERNED INDIVIDUALS.

IT IS BEYOND UNDERSTANDING THAT AMERICA STILL DOESN’T HAVE A COMPREHENSIVE HIV/AIDS STRATEGY THAT CAN TRACK AND RESPOND TO CHANGES IN THE EPIDEMIC.  THIS COUNTRY HAS NO WAY TO KNOW, IN ANY MEANINGFUL TIMEFRAME, WHERE HIV/AIDS IS HAVING ITS GREATEST IMPACT, WHERE IT IS MOVING OR HOW TO ADDRESS IT IN THOSE PLACES.

IN ITS ABSENCE, WE HAVE A DISJOINTED EFFORT THAT DOES NOT ADEQUATELY MOVE RESOURCES TO WHERE THEY CAN DO THE MOST GOOD…THAT DOES NOT PROVIDE ADEQUATE PREVENTION, EDUCATION, HOUSING, ROUTINE TESTING AND TREATMENT WHERE THEY CAN STEM THE TIDE OF THIS DEADLY DISEASE…THAT SERVE TO EXACERBATE THE PAIN IN AFRICAN-AMERICAN COMMUNITIES.

DEEPLY TROUBLED TIMES CALL FOR GREAT LEADERS AND PRESIDENT OBAMA’S COMMITMENT TO A NATIONAL HIV/AIDS STRATEGY PRESENTS US WITH A UNIQUE OPPORTUNITY.  WE CANNOT, WE MUST NOT, LET THIS MOMENT PASS.  WE MUST WORK WITH THE PRESIDENT TO ENSURE A FOCUS ON PRACTICAL MEASURES TO HALT THE SPREAD OF THE EPIDEMIC.  WE MUST DO ALL IN OUR POWER TO ENSURE THAT HIS COMMITMENT MAKES THE LEAP FROM POLICY TO PRACTICE, FROM DISCUSSION TO THE LAW OF THE LAND.

THIS MEANS MAKING OUR SUPPORT AND COMMITMENT KNOWN – IN THE WHITE HOUSE, IN THE DEPARTMENT OF HEALTH AND HUMAN SERVICES AND IN THE HALLS OF CONGRESS.   WE CANNOT BE SATISFIED WITH GOOD INTENTIONS AT THIS JUNCTURE.  WE MUST PRESS FOR ACTIONS AND RESULTS.

WE ARE DELIGHTED THAT, TODAY, THE PRESIDENT TOOK ANOTHER MAJOR STEP FORWARD IN THE FIGHT AGAINST HIV/AIDS BY APPOINTING THE REV. JOSH DUBOIS TO HEAD THE WHITE HOUSE OFFICE FOR FAITH-BASED AND NEIGHBORHOOD PARTNERSHIPS.  THIS APPOINTMENT RECOGNIZES THE IMPORTANT ROLE THAT FAITH LEADERS WILL CONTINUE TO PLAY IN DEVELOPING POLICIES IMPACTING HIV/AIDS, HEALTH PROMOTION AND DISEASE PREVENTION.

THERE ARE SEVERAL PRIORITY ACTIONS FOR WHICH WE MUST ADVOCATE IMMEDIATELY TO STEM THE TIDE OF HIV INFECTION IN THE FORESEEABLE FUTURE.  I LOOK TO ALL OF YOU HERE THIS EVENING TO JOIN US IN THIS NEW, HEIGHTENED ADVOCACY.

CLEARLY, THE FIRST AND FOREMOST IS PRESIDENT OBAMA’S PROPOSED NATIONAL PLAN – THAT MUST INCLUDE ADEQUATE PLANNING, FUNDING AND RESOURCES TO EFFECTIVELY COMBAT HIV/AIDS HERE AT HOME.  ANY SUCH PLAN SHOULD INCORPORATE THE STRATEGIES IDENTIFIED BY THE NATIONAL CONCLAVE ON HIV/AIDS POLICY FOR BLACK CLERGY CONVENED BY THE NATIONAL BLACK LEADERSHIP COMMISSION ON AIDS IN OCTOBER 2007.   THE STRATEGIES CALL FOR

• THE PRESIDENT AND CONGRESS TO DECLARE HIV/AIDS A PUBLIC HEALTH EMERGENCY IN THE AFRICAN-AMERICAN COMMUNITY
• ADDRESSING THE KEY STRUCTURAL DRIVERS OF AMERICA’S AIDS EPIDEMIC, INCLUDING POVERTY, LOW LITERACY, STIGMA, ILLICIT SUBSTANCE USE, UNEMPLOYMENT, DISPROPORTIONATE INCARCERATION, AND THE LACK OF ACCESS TO QUALITY HEALTH CARE TOO OFTEN ROOTED IN RACIAL AND ETHNIC BIAS

THE SECOND CRITICAL PRIORITY IS TO DO A MUCH MORE EFFECTIVE JOB REACHING AFRICAN-AMERICANS WITH EARLY AND EASILY ACCESSIBLE HIV TESTING AND TREATMENT.

IN 2006, THE CDC RECOMMENDED THAT ALL HEALTH CARE FACILITIES ROUTINELY TEST ALL AMERICANS AGES 13 TO 64 FOR HIV—A CRUCIAL STEP, EXPERTS SAY, IN PREVENTING NEW CASES.

THE NATIONAL BLACK LEADERSHIP COMMISSION ON AIDS BELIEVES THAT IT IS TIME THAT THE CDC’S RECOMMENDATIONS FOR ROUTINE TESTING FOR HIV BE UNIFORMLY IMPLEMENTED INTO STATE AND MUNICIPAL PUBLIC HEALTH LAWS.

THE CDC HAS ADDRESSED THE INITIAL FAILURE OF ITS RECOMMENDATION TO MOTIVATE HEALTH CARE PROVIDERS AND THE PUBLIC TO ACCEPT ROUTINE HIV TESTING.  NOW IT IS UP TO THOSE PROVIDERS AND THE PUBLIC TO TAKE ADVANTAGE OF THIS VITAL TOOL.

WHILE TESTING AND TREATMENT CANNOT BE OUR SOLE PREVENTION STRATEGY, WE WILL CLEARLY SEE UNPRECEDENTED AND DRAMATIC RESULTS FROM SCALED UP TESTING AND UNIVERSAL ACCESS TO TREATMENT AND CARE.

WE MUST ALSO URGE CONGRESS – IN THE STRONGEST POSSIBLE TERMS – TO PASS REPRESENTATIVE MAXINE WATER’S GROUNDBREAKING LEGISLATION.  HER BILL REQUIRES ROUTINE HIV TESTING FOR ALL INMATES UPON ENTERING AND LEAVING PRISON AND LINKING THOSE WHO TEST POSITIVE TO HIV TREATMENT, EDUCATION AND SUPPORT.  WE NEED TO PRESS FOR THE SPEEDY RATIFICATION OF THESE MEASURES…AND THE NEW ADMINISTRATION MUST ALSO MAKE THIS A TOP PRIORITY.

THE THIRD CRITICAL PRIORITY MUST BE COMPREHENSIVE HEALTH EDUCATION IN OUR SCHOOLS.  HEALTH EDUCATION FOR OUR CHILDREN SHOULD PROVIDE COMPREHENSIVE INFORMATION ON HIV/AIDS AND ITS PREVENTION.   WE NEED TO FOCUS ESPECIALLY ON YOUNG BLACK WOMEN AND MEN…EMPOWERING THEM WITH THE KNOWLEDGE THEY NEED TO TAKE CONTROL OF THEIR RELATIONSHIPS, THEIR HEALTH, AND THEIR DESTINIES.

IN CONCLUSION, THIS IS TRULY A TIME OF CHANGE IN AMERICA.  THAT CHANGE MUST INCLUDE CHANGES IN HOW WE ADDRESS OUR GROWING, EVOLVING HIV/AIDS EPIDEMIC.

• THE FACE OF THE EPIDEMIC HAS CHANGED.
• THE ECONOMIC STATUS OF ITS VICTIMS HAS CHANGED.
• THE MOST CRITICAL SOURCES OF INFECTION HAVE CHANGED.

AMERICA’S APPROACH TO ADDRESSING HIV/AIDS, TOO, MUST CHANGE.

MY FRIENDS, TOGETHER…LET US WORK TO LIFT THE VEIL OF IGNORANCE….

TOGETHER…LET US FIGHT TO CHANGE POLICIES THAT IMPEDE PROGRESS….

TOGETHER…LET US PROMOTE DIGNITY, RESPECT, AND COMPASSION FOR ALL PEOPLE….

THE NATIONAL BLACK LEADERSHIP COMMISSION ON AIDS INVITES YOU TO JOIN US ON A NEW PATH OF ADVOCACY, POLICY DEVELOPMENT, AND ACTIVISM…WITH PURPOSE IN MIND AND PASSION IN HEART…TO TRULY MAKE A DIFFERENCE IN STEMMING THE RISING TIDE OF HIV/AIDS IN BLACK AMERICA AND BEYOND.

THANK YOU AND GOOD NIGHT.