Seeking Solutions in Southeast Asia

For nearly 20 years my campaign to mobilize people against HIV has kept me constantly on the road. I've been across the country and around the world more times than I can count. These are not pleasure trips. Traveling takes a lot out of me, and living with HIV is hard enough without the stress of shifting time zones, skipped meals, and time away from family. But this is the life I have to live, and I'll keep living it as long as black people are dying of AIDS. Every trip I've taken has been important in some way, but my most recent one stands out. Half a world away, in Bangkok, Thailand, I joined 15,000 of the world's leading AIDS experts for the 15th International AIDS Conference. This biennial event is one of the world's most important health meetings. Although the conference was in Thailand, what I heard there was a powerful reminder that the face of AIDS is still overwhelmingly black. That's true in Africa, of course, where 29 million people are living with HIV and 3 million more are infected every year. And it's true in the United States, where blacks make up about half of new HIV diagnoses each year and account for more than 40% of people living with AIDS. Many of the studies presented at the conference proved that it's possible to change behavior and save lives with the right mix of science, leadership, funding, and community involvement. Some of the most encouraging U.S. news was about black teens. In a national study of high school students, researchers from the Centers for Disease Control and Prevention found that condom use has increased 40% among young African-Americans since 1991. Another study showed that black parents who participated in an intensive training program became more comfortable talking with their kids about the risks of having sex. And other research showed that an HIV prevention program emphasizing self-respect, communication skills, and condom use reduced risky sex among African-American adolescent girls. Clearly, our young people don't have to be at risk. There was also hopeful news about adults. In a study of men who were recently in prison, researchers found that counseling them about HIV through their transition from incarceration to release made a big difference in their choices later on. After the men'most of whom were black'went back to their communities they were more likely to practice safer sex. Of course, not all the news at the conference was good. In one CDC report on young men who have sex with men, the incidence of HIV infection among black men participating in the study was nearly 15% in a single year'a higher rate than previously thought. Another analysis from the same study found that many young African-American men who have sex with men also have sex with women and that their rate of unprotected sex with partners of both genders is high. This doesn't tell us anything about men on the 'down low,' which we've been hearing so much about lately, but it does tell us that we're a long way from ending HIV disease in black America. So what needs to be done? First, more of us need to get tested for HIV. Today, close to half of Americans who test HIV-positive develop AIDS less than a year later. That means these people didn't get tested until it was probably too late to fully benefit from life-prolonging treatment and that they may have unknowingly infected their partners. Second, we need to talk openly about HIV in our homes, churches, and workplaces. Silence breeds stigma, helping HIV keep its grip on black America. Finally, we all need to get involved in preventing HIV in our own communities. Not sure how to make a difference? E-mail me at the Black AIDS Institute. We have the information you need to get started. Two years from now I plan to be in Toronto at the next international AIDS conference. There, I hope to see the results of our collective efforts'in terms of fewer new infections and a healthier black America. Let's join together to make that hope a reality. Wilson is the founder and executive director of the Black AIDS Institute.