Statement of Anthony S. Fauci, M.D.
Director, National Institute of Allergy and Infectious Diseases
National Institutes of Health on National Black HIV/AIDS Awareness and Information Day
February 7, 2008
The grossly disproportionate impact of HIV/AIDS on African Americans
is a public health crisis that we at the National Institutes of
Health (NIH) and as a nation must address boldly. Nearly 27 years
into the AIDS epidemic, approximately half of the new HIV infections
that occur each year in the United States are among African Americans,
even though they represent only 13 percent of the U.S. population.1
The virus plagues every segment of the African American community:
in 2005, black women accounted for two-thirds of newly diagnosed
HIV/AIDS cases among U.S. women, and black men accounted for half
of new diagnoses among U.S. men.2 A recent study in five large
U.S. cities found that 46 percent of black men who have sex with
men were infected with HIV.3 Only dramatic action will reverse
this calamity.
Today, on the eighth annual National Black HIV/AIDS Awareness
and Information Day, I call upon public health officials and leaders
in the African American community to jointly marshal their efforts
against the AIDS epidemic. In particular, black leaders — religious,
secular and political — have a key role to play in reducing
the stigma often associated with HIV/AIDS and influencing African
Americans to get tested, counseled and treated.
The national toll of HIV/AIDS among African Americans is shocking,
and nowhere is that more evident than in our nation’s capital.
African Americans make up 57 percent of the population of Washington,
D.C., yet they accounted for more than 80 percent of recent HIV/AIDS
cases in that city.4 One in 20 Washingtonians is living with HIV
infection; one in 50 has AIDS. These statistics are staggering
and unacceptable in a modern society.
NIAID strongly endorses testing for HIV during routine medical
care for adolescents, adults and pregnant women, as the Centers
for Disease Control and Prevention recommends. An estimated one-quarter
of Americans who are infected with HIV do not know it, and a disproportionate
number of those people are African Americans. In fact, a recent
study found that 64 percent of HIV-infected black gay men did not
know they were HIV-infected.3 That means a significant number of
African Americans with HIV are not receiving proper counseling
and care, placing them at risk for becoming extremely sick and
for spreading the virus further.
But HIV testing alone is not enough to win the battle against
HIV/AIDS in the African American community, because many lack ready
access to basic health care services. Recent studies have found
that many HIV-infected African Americans are first diagnosed with
HIV late in the course of their disease, often when they are hospitalized
with serious HIV-related illness.5 This is unacceptable in our
society, where antiretroviral drugs for controlling the virus and
prolonging life are widely available and best used earlier in the
course of disease. A delay in getting tested or starting treatment
also may increase the risk of ongoing transmission, as untreated
patients with high levels of the virus are more likely than treated
patients to infect others.
To curb the HIV/AIDS epidemic among African Americans, we need
to bring basic health care services that include HIV testing and
timely treatment into the communities where African Americans live.
All of us at the National Institute of Allergy and Infectious
Diseases, a part of NIH, are committed to basic and clinical research
on HIV/AIDS to help people of all races live healthier, longer
lives. Our research has led to extraordinary advances in understanding
the biology of HIV/AIDS, creating HIV therapies and treatment guidelines,
advancing the development of AIDS vaccines, and developing strategies
to prevent HIV transmission. We continue to strongly encourage
African Americans to participate in clinical research on HIV/AIDS.
Despite significant scientific progress, the deplorably high rates
of HIV/AIDS in the African American community loom large. We as
a nation must act immediately and decisively to end the HIV/AIDS
crisis among black Americans. History will judge us harshly if
we fail in this mission.
Information about National Black HIV/AIDS Awareness and Information
Day is available at http://blackaidsday.org/.
Visit AIDS.gov for
comprehensive government-wide information on HIV/AIDS. Information
about prevention, treatment and clinical trials is available at http://www.aidsinfo.nih.gov/.
Dr. Fauci is director of the National Institute of Allergy
and Infectious Diseases at the National Institutes of Health
in Bethesda, Maryland. Media
inquiries can be directed to the NIAID Office of Communications
at 301-402-1663, niaidnews@niaid.nih.gov. NIAID
is a component of the National Institutes of Health. NIAID supports
basic and applied research to prevent, diagnose and treat infectious
diseases such as HIV/AIDS and other sexually transmitted infections,
influenza, tuberculosis, malaria and illness from potential agents
of bioterrorism. NIAID also supports research on basic immunology,
transplantation and immune-related disorders, including autoimmune
diseases, asthma and allergies. News releases, fact sheets and other
NIAID-related materials are available on the NIAID Web site at http://www.niaid.nih.gov. The
National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.
References:
- CDC. 2007. Fact Sheet: HIV/AIDS
among African Americans.
- CDC. 2007. MMWR 56(09):
189 — 193. Table 1.
- CDC. 2005. MMWR 54(24):
597 — 601.
- Government of the District of
Columbia Department of Health. 2007. District of Columbia HIV/AIDS
Epidemiology Annual Report 2007. Page 2.
- Examples of recent
discussions of late diagnosis of HIV infection
- Keruly JC and Moore
RD. 2007. Immune status at presentation to care did not improve
among antiretroviral-naive persons from 1990 to 2006. Clinical
Infectious Diseases 45(10):1369 — 1374.
- Valdiserri
RO. 2007. Late HIV diagnosis: bad medicine and worse public
health. PLoS Medicine 4(6):e200.
- Schwarcz S et al. 2006.
Late diagnosis of HIV infection: trends, prevalence, and characteristics
of persons whose HIV diagnosis occurred within 12 months of developing
AIDS. Journal of Acquired Immune Deficiency Syndromes 43(4):491 — 494.
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