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Hill Hearing Reveals Black HIV/AIDS Crisis

POSTED: September 22, 2008, 12:00 pm

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Last week the House Committee on Oversight and Government Reform, chaired by Rep. Henry A. Waxman (D-CA), held a hearing on the domestic HIV epidemic. The official title of the hearing, held in the Rayburn House Office Building, was “The Domestic Epidemic is Worse than We Thought: A Wake-Up Call for HIV Prevention.

Appearing before the Committee were: Dr. Julie Gerberding, M.D., M.P.H., Director, Centers for Disease Control and Prevention; Dr. Kevin Fenton, M.D., Ph.D., Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention; Dr. Anthony Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health; Dr. David Holtgrave, Ph.D., Professor and Chair, Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Health; Dr. Adora Adimora, M.D., M.P.H., Division of Infectious Diseases, UNC School of Medicine; Dr. George Ayala, Psy.D., RTI International and AIDS Project Los Angeles; Heather Hauck, M.S.W., LICSW, Director, Maryland AIDS Administration, and Chair-Elect, National Alliance of State and Territorial AIDS Directors; and Frank J. Oldham, Jr., President, National Association of People with AIDS.

Testimony obtained by reveals that the domestic AIDS crisis is taking direct aim at the Black community. As previously reported by, the Centers for Disease Control and Prevention (CDC) recently released data for 2006 from their HIV/AIDS surveillance system that reveals the epidemic in the Black community is centered on young, Black men who have sex with other men (MSM) and Black women who are being infected in heterosexual relationships. Overall, Blacks are disproportionately impact, making up 43 percent of cases despite only being 12 percent of the nation’s population. Dr. Gerberding pointed out that “new data reinforce that one group disproportionately affected by HIV is African-Americans. Although Blacks only constitute 13% of the U.S. population, 45% of new HIV infections were among Blacks.” The CDC reported that there were 56,300 new HIV infections in the United States in 2006, a figure 40 percent higher than previously estimated.

In her testimony Dr. Gerberding, the CDC Director, testified, “Young MSM of color are of particular concern. Among the Black and Latino MSM, those ages 13-29 had the most new HIV infections, accounting for 52% of new infections among Black MSM and 43% of new infections among Latino MSM. Among all MSM, Black MSM ages 13-29 had the largest number of new infections.”

Gerberding announced that the CDC has provided $70 million in additional funding to increase testing in areas with the highest number of AIDS cases among Black Americans. A meeting will be held this fall in Atlanta among grantees from these jurisdictions. In addition, CDC is conducting an evaluation to determine which testing strategies are most effective and cost efficient in reaching Black men and women who have an undiagnosed HIV infection. CDC is also working to develop and implement a social marketing campaign to increase awareness of HIV testing and to identify cases of HIV.

Frank Oldham, representing the National Association of People with AIDS (NAPWA), pointed to an effort launched by the CDC, the Heightened National Response to the HIV.AIDS epidemic in African American communities, to mobilize a targeted prevention effort. Oldham noted, “The critical issue of AIDS in America must be a political priority in the U.S. Like our economy, national security, and universal health care, HIV/AIDS remains a life and death issue for more than 1 million people in the U.S. Strong national leadership is required to make progress decreasing new HIV infections and improve the quality of life for people living with HIV/AIDS in the U.S.”

He criticized the Bush administration for its HIV/AIDS policy, charging, “The administration has pushed abstinence-only-until-marriage education and refused to remove the ban on federal funding for syringe exchange programs. These kind of short-sighted policies have real consequences for people’s lives.” Oldham did express support for the Early Treatment for HIV Act (S. 860 and H.R. 3326) and vowed to seek the bill’s passage despite the fact that it had been deadlocked in a partisan struggle.

Dr. Holtgrave testified to the benefits of preventive measures in the face of the social and economic toll the crisis is inflicting upon the nation. He called attention to the fact that, on average, a new HIV infection occurs every 9.5 minutes in the country, and that an AIDS related death occurs every 33 minutes in the United States. The Chair of the Department of Health, Behavior and Society at the Johns Hopkins Bloomberg School of Public Health, Holtgrave spoke of the value of prevention programs. He said, “I believe that from the beginning of the epidemic through 2006, there were roughly 362,000 HIV infections prevented in the U.S. Over 3.3 million quality-adjusted lives were saved. The prevention programs in the U.S. over this time frame cost approximately $18.6 billion (including federal, state and private contributions). Therefore, the cost per infection prevented was about $52,000 which is less than the cost of HIV care and treatment for one person over a lifetime; indeed prevention programs appear to have actually saved money.”

Clearly targeted efforts at prevention will be required to significantly reduce the incidence of HIV/AIDS in the Black community. The incoming presidential administration, beset by the nation’s economic woes, will be faced with hard choices regarding domestic spending priorities but this is one issue that a Democratic or Republican White House can ill afford to ignore. With the nation’s health care system strained, HIV/AIDS prevention may not only be a necessary public health priority but the cost savings realized could be beneficial to the service delivery system.

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