Remember World AIDS Day in Manhattan

Today is World AIDS Day. It is an important day for remembrance and reflection as well as for looking ahead and for advocating changes that will combat the spread of HIV and AIDS. Manhattan remains the capital of the AIDS epidemic, and African Americans remain its most victimized community.

AIDS Testing in NYC Must Be Expanded to Include Manhattan

In August 2008, Manhattan Viewpoint advocated HIV testing throughout Manhattan in response to the announcement by New York City that it would fund HIV testing for every adult in the Bronx. http://manhattanviewpoint.blogspot.com/2008/08/hiv-and-aids-testing-for-manhattan.html The Bronx was chosen for this effort despite the fact that Manhattan has the highest level of HIV infection in New York City. We continue to encourage our fellow Manhattanites to demand that New York City provide Manhattan's adults with the same opportunities to be tested for HIV and AIDS that are being provided to adults in the Bronx.

The Shocking Statistics

Even for those who are familiar with the AIDS epidemic and its devastating impact on New York City, the official statistics remain breathtaking.

• Approximately 1 in 70 New Yorkers is infected with HIV
• 1 in 40 African Americans in NYC is infected
• 1 in 25 men living in Manhattan is infected
• 1 in 12 black men in NYC age 40-49 years is infected
• 1 in 5 black men age 40-49 in Manhattan is infected

New York City has the highest AIDS infection rate in the country. NYC has more AIDS cases than Los Angeles, San Francisco, Miami, and Washington DC combined.

Unfortunately, AIDS in NYC is becoming more concentrated amongst people of color, as 80% of new AIDS diagnoses and deaths are among African Americans and Hispanics. Black men in New York City are 6 times more likely to die of AIDS than white men. Black women are 9 times more likely to die of AIDS than white women. Hispanic men and women are 4 times more likely to die of AIDS than white men and women.

Take Down the Barriers to Testing

New York State laws prevent a more effective testing regime in NYC. The State laws currently in force regarding HIV were enacted more than 20 years ago. Today, the treatment opportunities for those who contract HIV are dramatically improved versus 20 years ago, but those who contract the disease must be aware of their infection in order to know to seek treatment. Without a more effective testing regime, much of the improvement in treatment is being wasted. Each year in NYC, more than 1,000 people realize that they have contracted HIV when they develop the symptoms associated with AIDS - long after the virus has begun to do damage to their bodies and long after we'd want treatment to start in order to have the best possible results.

Early diagnosis allows patients to receive treatment and care earlier. Earlier care reduces hospitalizations, cuts health care costs, and prolongs life.

Earlier diagnosis allows those infected to take steps to reduce the spread of AIDS, and studies show that those who are infected typically change their behaviors immediately and dramatically to prevent the spread of the disease.

We need changes to state law to require only documented oral consent rather than written consent for HIV testing. With these changes, physicians will be more likely to incorporate HIV testing into their typical consultations with their patients. As a result, more New Yorkers will be tested, and the spread of the HIV virus will be slowed.

We must also ensure that counseling programs and treatment programs are expanded and improved for those infected and for those who are the most at-risk for infection, and it is imperative that all testing remain completely voluntary and confidential.

The nature of the testing must also be the most effective. http://www.sciencedaily.com/releases/2007/04/070411115138.htm Rapid tests can yield results almost instantly, as opposed to the traditional blood tests which take days or weeks to reveal whether an infection is present. Many New Yorkers avoid testing because they are uncomfortable with the testing procedure, and many do not return for their results because they grow afraid of the results during the long delay between the time of the test and the delivery of the results. After finding the courage to be tested, they often cannot resurrect that courage a second time to finish the process. Rapid, non-invasive testing will bring out more New Yorkers and virtually eliminate the group who get tested but never receive their results.

Manhattan Needs Albany Now While We Hope For Help From Washington

Our country needs the incoming administration to change the approach we take to fighting AIDS at the national level. In October 2007, the National Conclave on HIV/AIDS Policy for Black Clergy convened in Manhattan with unprecedented attendance from leading church voices from all around the United States. http://www.nblca.org/conclave2007/index.html The Conclave developed the basis for the HIV/AIDS Elimination Act, which will be introduced in the US House of Representatives during the next Congress by Upper Manhattan's Congressman, Chairman Charlie Rangel. The Conclave also agreed to promote HIV testing and awareness through black churches. As a continuation of the momentum of the Conclave, last week in her op-ed, C. Virginia Fields, the CEO of the National Black Leadership Commission on AIDS http://www.nblca.org/, gave us an optimistic and clear vision of how we can work together at the national level to begin to make progress against HIV. http://www.lasentinel.net/Ending-AIDS-in-Black-America-Yes-We-Can.html Manhattan Viewpoint shares her national vision and her optimism. The January 20, 2009 inauguration of Barack Obama as our 44th President should also be the beginning of the end of the period in which we were losing the war against HIV in the United States.

Closer to home, we need the State Legislature and the Governor to change the state laws to make testing more likely to reach more of our people and reduce the spread of HIV in our neighborhoods. On this World AIDS Day, let us commit to standing united against HIV and standing united in favor of an improved testing regime for Manhattan and the for the rest of New York City.

HIV and AIDS Testing for Manhattan

All of us need to commit to focus attention on HIV testing and prevention in Manhattan and to demand from our elected leaders increased leadership in this area. A number of recent developments have caused me to seek to catalyze Upper Manhattan communities to advocate for HIV/AIDS testing throughout Manhattan:

1) The NYC government announced in late June 2008 its decision to test all adults in the Bronx for HIV/AIDS. The decision should be applauded, but it highlights our needs in Manhattan. Manhattan has the highest level of HIV infection and AIDS in NYC. The city government needs to focus its AIDS testing and prevention resources on Manhattan with at least as much commitment as it is demonstrating in the Bronx. The article below from the New York Daily News mentions Manhattan's needs in describing the NYC choice to begin its mass testing efforts in the Bronx. http://www.nydailynews.com/ny_local/bronx/2008/06/25/2008-06-25_aids_tests_for_500000_in_bronx.html

A 2004 report from the NYC Department of Health showed that Manhattan had 50% more AIDS cases than the Bronx and that Manhattan had far more individuals living with AIDS than any other Borough. Here is a link to that report. http://www.nyc.gov/html/doh/downloads/pdf/dires/epi-surveillance-manhattan200406.pdf

2) In late July 2008, CNN focused on the Alarming rates of AIDS in the African American community and the lack of commitment by the US Federal Government to prevention efforts in the United States. The US spends billions on AIDS prevention overseas but less than one billion dollars each year on domestic prevention. http://www.cnn.com/2008/HEALTH/conditions/07/29/black.aids.report/index.html

3) In Early August 2008, the Center for Disease Control announced that there were 40% more HIV positive individuals in the US than the CDC had previously believed. It is urgent that all in Manhattanites know their status and take steps to avoid the spread of HIV and AIDS. If the national numbers are 40% higher than previously believed, the Manhattan numbers might very well represent an even greater undercount. While we hope that Manhattan's numbers turn out to be more accurate than the CDC's national numbers of HIV infected individuals, only a strong testing regime will allow us to be certain. http://www.cnn.com/2008/HEALTH/conditions/08/02/hiv.cdc/index.html

4) Before the new, alarming CDC numbers came out, I attended, in late July 2008, a private event sponsored by the National Black Leadership Commission on AIDS (NBLCA - pronounced en-BLAK-uh or simply BLAK-uh). Its leader is the former Borough President of Manhattan, C. Virginia Fields, a dynamic and impressive leader who is certain to continue to groundbreaking fight against AIDS started by my mother-in-law, Debra Fraser Howze when she founded NBLCA more than 20 years ago. At the event, a group of young professionals from all over the NYC area were educated about the continued spread of AIDS amongst African Americans in NYC and throughout the US. NY State is the state in the US with the largest number of African Americans with AIDS, and the numbers continue to increase. Many of the other stats were astonishing even to those of us who have been associated with the AIDS fight for years. Below, and at http://www.nblca.org/aidsInfo_more.html is a sampling of these stats:

HIV/AIDS in 2005

• According to the 2000 census, blacks make up approximately 13% of the US population.
• However, in 2005, blacks accounted for 18,121 (49%) of the estimated 37,331 new HIV/AIDS diagnoses in the 33 states with long-term, confidential name-based HIV reporting.
• Of all black men living with HIV/AIDS, the primary transmission category was sexual contact with other men, followed by injection drug use and high-risk heterosexual contact.
• Of all black women living with HIV/AIDS, the primary transmission category was high-risk heterosexual contact, followed by injection drug use.
• Of the estimated 141 infants perinatally infected with HIV, 91 (65%) were black (CDC, HIV/AIDS Reporting System, unpublished data, December 2006).
• Of the estimated 18,849 people under the age of 25 whose diagnosis of HIV/AIDS was made during 2001–2004 in the 33 states with HIV reporting, 11,554 (61%) were black.
• Of persons whose diagnosis of AIDS had been made during 1997–2004, a smaller proportion of blacks (66%) were alive after 9 years compared with American Indians and Alaska Natives (67%), Hispanics (74%), whites (75%), and Asians and Pacific Islanders (81%).

AIDS in 2005

• Blacks accounted for 20,187 (50%) of the estimated 40,608 AIDS cases diagnosed in the 50 states and the District of Columbia.
• The rate of AIDS diagnoses for black adults and adolescents was 10 times the rate for whites and nearly 3 times the rate for Hispanics. The rate of AIDS diagnoses for black women was nearly 23 times the rate for white women. The rate of AIDS diagnoses for black men was 8 times the rate for white men.
• The 185,988 blacks living with AIDS in the 50 states and the District of Columbia accounted for 44% of the 421,873 people in those areas living with AIDS. Of the 68 US children (younger than 13 years of age) who had a new AIDS diagnosis, 46 were black.
• Since the beginning of the epidemic, blacks have accounted for 397,548 (42%) of the estimated 952,629 AIDS cases diagnosed in the 50 states and the District of Columbia.
• From the beginning of the epidemic through December 2005, an estimated 211,559 blacks with AIDS died.
• African-Americans have the highest AIDS case rate per 100,000 population of all ethnic/racial groups-66.4 per 100,000 population compared with 8.2 for whites. African-American males have an AIDS case rate of 125.2, over seven times the rate for white males who have a rate of 17.8 per 100,000 population. African-American women have an AIDS case rate of 49.8, over 20 times the rate for white women who have a rate of 2.4 per 100,000 population.