Twenty-five years after the first reported cases of AIDS, the epidemic's face is becoming blacker and poorer. And it is long past time that our public health system addresses these realities.
More than half of the estimated 40,000 new HIV infections clocked each year are among African-Americans. Nearly half of all people living with HIV today are black. Yet, African-Americans are just 13 percent of the U.S. population.
Meanwhile, blacks who contract HIV are eight times more likely to die from it than their white counterparts.
As a result of this blackening of America's AIDS epidemic, the virus has also migrated from urban centers like San Francisco to rural southern towns.
Today, 41 percent of all people living with HIV/AIDS reside in the Southeast. Seven out of the 10 states with the most intense epidemics are in the South.
There, teetering public health systems that never served poor blacks well in the first place are collapsing under the weight of AIDS. Uninsured people with AIDS linger on hundreds-deep waiting lists for access to affordable treatment and care -- not in Africa, but right here, in places like Alabama and North Carolina.
And the Medicaid and Medicare systems that pay for two-thirds of African-Americans receiving AIDS treatment today are in disarray and facing financial collapse.
Meanwhile, the crippling bigotry, stigma and fear that have always provided HIV with a stealth cover for its travels from body to body remain strong throughout the South, and in black communities around the country.
AIDS clinic workers in Montgomery, Ala., recently told me stories of having to hand medications out of the back door and conduct HIV tests in fast food parking lots because patients fear being seen near the clinic.
Even among the urban gay men where some successes have been found, the epidemic's fracturing is clear. A recent Centers for Disease Control and Prevention study found that a stunning 46 percent of black gay and bisexual men tested in five major cities were HIV positive, compared to 21 percent of white gay and bisexual men who were positive.
Last year in Illinois, the legislative black caucus shepherded into law a statewide plan to address its black epidemic. It included funds for targeted prevention and treatment, and for studying the relationship between incarceration and the black epidemic.
Other states around the country should wake up to this crisis and develop similar action plans, and Congress should support them with new money.
We may not know how to beat AIDS yet, but we know how to slow it down with powerfully effective treatments.
We must get these treatments to everyone who is afflicted.
AIDS doesn't discriminate.
Neither should our treatment of it.
Kai Wright is publications editor for the Black AIDS Institute. He can be reached at pmproj@progressive.org.