Make HIV testing a national priority

By JOSEPH H. NEAL

Guest columnist

As much as it pains me as an African-American to admit it, I wonder if the reason HIV/AIDS is no longer the popular cause it was is because it is now an African-American disease. We can dispel this unpleasant thought by making HIV/AIDS a popular cause again, and National HIV Testing Day, Tuesday, is an excellent place to start.

Free HIV testing will be made available across our state, and I urge all South Carolinians who have reason to believe they may be HIV-positive to take part. In doing so, you will help yourselves and others. Every HIV test is a step toward the end of the epidemic. It is shameful that after a full quarter-century, HIV/AIDS still casts such a pall across America.

Perhaps you have seen the numbers. I don’t apologize for repeating them, as they are so shocking. Across America, African-Americans were 48 percent of new AIDS cases in 2004, according to the Centers for Disease Control. African-Americans are 9.6 times more likely to be living with AIDS than whites. Women were 27 percent of new AIDS diagnoses nationally, and African-American women were 67 percent of that number.

The future doesn’t look much brighter. AIDS is caused by HIV, and again, African-Americans lead solidly in all categories: male, female, adolescent and neonatal (mother to newborn). What are the causes of this situation? Ignorance, obstinacy and government intransigence.

• Ignorance because many African-Americans do not know they are HIV-positive. According to the CDC, there are approximately 1.1 million Americans living with HIV. Of these, up to 280,000 are ignorant of their status, and if we extrapolate from the numbers above, a clear majority of them must be African-American.

The consequences of this are twofold. First, the unknowingly infected are not treated and so are likely to get much sicker. They are much more likely in fact to develop AIDS. Second, the unknowingly infected are responsible for half of the 40,000 new infections annually.

• Obstinacy because we know that to this day a great many African-Americans, especially in the South, do not believe HIV/AIDS is “their problem.” They believe it is a white thing, a gay thing, a Northern thing. This obstinacy makes them far more vulnerable.

• Government intransigence because even 25 years after the AIDS epidemic began, even after more than a half a million deaths — 5,691 in South Carolina — our government still does not emphasize HIV prevention and HIV testing. The Ryan White Comprehensive AIDS Resources Emergency Act, our keystone national care and treatment program, was passed by Congress in 1990. It was then reauthorized in 1996 and 2000. And it still doesn’t include a testing mandate.

The act is up for reauthorization now, and, incredibly, it remains to be seen whether Congress will see the light. The Centers for Disease Control has called for HIV testing to become a routine part of medical care in all settings. So has the National Minority Health Month Foundation. But Congress is still debating it.

The Comprehensive AIDS Resources Emergency Act, which could be passed by Congress this year, will remain in force for five years. And so it will have a profound effect on America into the next decade. Congress must recognize that prevention is always the best form of medicine and that it pays for itself many times over in the future.

For this is what this debate is all about — the future. The future of HIV/AIDS, the future of American public health and the future of the African-American community. It’s time for African-Americans to admit the truth about HIV/AIDS in America, but they need their government to admit the truth as well.

Rep. Neal represents District 70 in the S.C. House.