How to Stop the Black AIDS Crisis

An African-American expert on HIV/AIDS outlines three steps for ending the epidemic in our communities.

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There is an old saying: "Knowledge is power." True of many aspects of life, it is of paramount importance in facing the crisis of HIV/AIDS in the black community. As an African-American medical expert, I know that the single biggest factor fueling the AIDS epidemic in our community is that too many of us don't know our HIV status. This is despite the fact that today's HIV tests have never been more convenient, are often free and give results in as little as 10 minutes. On June 27, National HIV Testing Day, we have an excellent opportunity to close this life-threatening gap in our knowledge.

First a few basics about how HIV/AIDS is affecting our community: Of the 1.1 million Americans living with HIV today, more than 500,000 are black. We represent more than half of new HIV/AIDS cases in this country and account for more than half of AIDS-related deaths. Perhaps most alarmingly, 20 percent of African Americans with HIV do not know they are infected (pdf).

Despite these dire statistics, there is reason for hope -- because we have the power to change this picture. We should strive to reduce new HIV cases in our community and put the brakes on this epidemic. In my view, there are three concrete steps we can take to stop the black AIDS crisis.

--African Americans should get tested for HIV early and often. Too many of us have not been tested for HIV or do not get tested on a regular basis. Not surprisingly, we know that folks who are not diagnosed are much more likely to transmit HIV than those who know their status. Our chances of stopping the HIV and AIDS epidemic in our community will go up substantially if we can make HIV testing a widespread, routine practice. That's why National HIV Testing Day -- and its hundreds of free testing drives in communities across the country -- is such a golden opportunity.

--African Americans who are HIV-positive should consider starting treatment, if they haven't already. Studies have shown that early treatment improves survival: Patients who wait to start treatment until their immune systems deteriorate have a 94 percent greater risk of dying than those who start therapy earlier.

Unfortunately, delaying treatment is a real problem in the black community. Many African Americans diagnosed with HIV are not in care, and many end up going to the emergency room with symptoms of full-blown AIDS. Of those who are in care, some have problems adjusting to taking HIV medications over the long term.

We need to work together to overcome these obstacles, because in 2010, people with HIV who are treated promptly and consistently can actually look forward to a normal life expectancy. In fact, our system of HIV care today is focused on treating people before they fall sick, in order to keep them healthy as long as possible. (Or, as I like to say, it's less about "sick care" and more about "health care.") Our new focus in HIV treatment is on wellness.

--We need to spread the word in our community about the benefits of early testing and treatment. In fact, let's share the news about all the advances we are seeing in the fight against AIDS. For example, HIV testing today is frequently free (and not just on National HIV Testing Day) and has never been faster, thanks to today's rapid HIV tests. HIV medicines have also improved, with convenient one-a-day drugs, and for people on low incomes, there is an extensive network of support to help patients access those medications.

So take my advice: On National HIV Testing Day, take advantage of the dramatic progress we are seeing in the fight against HIV by making a pledge to know your HIV status. Such knowledge really is the key to protecting ourselves, our families and the future of our community.

Derek Spencer is a nurse practitioner and executive director of the JACQUES Initiative at the Institute of Human Virology, University of Maryland School of Medicine, in Baltimore. The initiative provides HIV testing and raises community awareness about HIV while providing primary care, case management and supportive services for men and women living with HIV.

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