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Wednesday, August 06, 2008

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?”

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posted by Desiree Evans at 10:31 AM | Email this post

Monday, December 03, 2007

'Shine a Light' on AIDS prevention gaps

Our report on the controversy over CDC's release of its latest AIDS data got the attention of Kenyon Farrow. Citing the "Southern States Manifesto," we noted that among the factors contributing to the region's disproportionate burden of HIV/AIDS/STDs are its relatively poor health infrastructure, higher poverty rates, lack of affordable housing, and racial disparities, which elicited this comment from Farrow:
"It is exactly for those reasons that activists have called for the Prevention Justice Mobilization, which will culminate in a rally and march tomorrow, December 4, 2007 in front of the Hyatt Regency in Atlanta (where the CDC's prevention conference is being held)."
Bringing together more than 325 groups and individuals, the Prevention Justice Mobilization 2007 is holding a series of HIV-prevention events and actions around the United States through Dec. 15 to demand leadership in the fight against HIV/AIDS and justice in prevention policies. Tomorrow's event -- the "'Shine a Light' on U.S. Prevention Gaps" march and rally -- starts at 4:30 p.m. at Atlanta's Hardy Ivy Park (click here for directions). For more information, visit www.preventionjustice.org.

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posted by Sue Sturgis at 8:49 PM | Email this post

CDC comes under fire for delaying release of latest AIDS data

The Centers for Disease Control and Prevention's 2007 National HIV Prevention Conference is underway in Atlanta right now amid controversy over the federal agency's refusal to release the latest HIV incidence estimates for the United States.

AIDS activists say annual HIV infections may be as much as 50 percent higher than what the U.S. government has been estimating since 2001, and they complain that health officials are improperly delaying release of the new data, which is essential to drawing up the 2008 federal budget for HIV/AIDS-related programs. Among the groups demanding immediate release of the updated numbers is the Los Angeles-based AIDS Healthcare Foundation (AHF), the nation's largest nonprofit HIV/AIDS health care, research, prevention and education provider.

On Dec. 1 (which also happened to be World AIDS Day), AHF issued a statement demanding that the data be released after the Wall Street Journal reported that an upward revision of AIDS incidence figures was likely. The New York Times and Washington Post also say they have sources confirming the revised estimate, Reuters reports. The new estimate is based on 2005 data and may be as high as 60,000 annual infections, compared with the 2001 estimate of about 40,000 new cases, according to a former CDC adviser.

In a letter dated Nov. 26, 2007 and sent to the National Alliance of State and Territorial AIDS Directors and others, the CDC said it would release the 2005 HIV incidence estimates "in the coming months." AHF surmises that the agency sent the letter in response to widespread speculation that the latest incidence numbers will reveal an "astronomical rise" in the estimate of new cases. That speculation intensified after the National Minority AIDS Council-sponsored U.S. Conference on AIDS held last month in Palm Springs, Calif.

The CDC's letter says that the new figures currently exist in the form of a manuscript that the agency is submitting to an academic journal for peer review. In a statement issued yesterday in response to advocates' demands that it release the unreviewed data immediately, the agency says that it "would not be responsible" to discuss specific data before it's certain the estimates are reliable. But that claim is disputed by AHF President Michael Weinstein:
"The CDC is not an academic institution charged with collecting data to analyze for its own sake. It is a government body with an obligation to disseminate crucial information -- such as a 50% increase in reported HIV cases -- so that it may be used to protect the public health. The 2008 federal budget is being finalized now, and it is only right that Congress and the public at large have access to accurate information to ensure that public health policy and resource- allocation decisions can be made to ensure an effective response to the epidemic. That can't happen when the CDC is withholding information about the true nature of this country's epidemic. We hope that this is not yet another instance of the Bush Administration's suppression of information that could be damaging to their image, especially in light of the fact that the spike in new infections is, at least in part, likely due to failed policies of the administration, including the promotion of 'abstinence-only' prevention messages and the failure to promote condom use."
The data for the new estimate came from 19 states and cities -- including several states in the South, which has been hit particularly hard by the epidemic of HIV/AIDS and other sexually transmitted diseases. In 2003, directors of state AIDS and STD programs throughout the South issued the "Southern States Manifesto", which observed that the region has the nation's greatest proportion of persons living with AIDS and demanded immediate action to address the health emergency.

Among the factors contributing to the regional HIV/AIDS disparity are the South's relatively poor health infrastructure, higher poverty rates, and lack of affordable housing. In addition, HIV/AIDS is increasingly a disease afflicting racial minorities, and the South has a higher proportion of African American residents than other U.S. regions.

(White House photo of red ribbon adorning the North Portico of the building in honor of 2007 World AIDS Day by Eric Draper)

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posted by Sue Sturgis at 3:11 PM | Email this post

Southern News Update

Who Are These Folks?

CHRIS KROMM blogs three days a week for Facing South. Chris is Executive Director of the Institute for Southern Studies and publisher of the Institute’s award-winning magazine, Southern Exposure.

SUE STURGIS blogs four days a week for Facing South. Sue is the Institute’s Editorial Director and a former reporter for The Independent Weekly and The Raleigh News & Observer.

DESIREE EVANS blogs four days a week for Facing South. Desiree is a Research Associate at the Institute and former policy analyst for TransAfrica.

The views expressed on Facing South are those of the authors and not necessarily represent the views of the Institute for Southern Studies. The editors reserve the right to reject comments that are abusive, offensive, misleading, or that promote commercial goods and services.

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