No matter how you slice the numbers -- young or old, male or female, gay or straight -- the US HIV/AIDS epidemic is attacking Black people most aggressively.

Each year, the epidemic worsens in Black neighborhoods, says The Institute, and each year, the national commitment to interrupting HIV's spread and caring for those who already are infected further lags.

"The Time is Now!" explains the policies and politics that have helped shape the HIV/AIDS epidemic in Black America and our nation's response to it.

the report articulates the challenges faced by Black Americans in reshaping and ultimately stopping the HIV/AIDS epidemic, addressing both AIDS experts and members of the community who may have just become aware of the problem and need information on how and where to get involved.

Conspiracy Theories

Since opening its doors in 1999, The Institute has sponsored numerous projects and campaigns designed to raise awareness of HIV's differential impact on African American communities. However, as a recent Rand Corporation report made clear, just being aware of a threat is only the first step in confronting it.

Rand surveyed African Americans about HIV/AIDS and found widespread belief in "conspiracy theories" about the origin of the virus and government efforts to withhold treatments and cures from those who are infected.

"These beliefs stem from an undeniable reality: Public health has consistently failed Black America, sometimes deliberately neglecting its needs," said Black AIDS Institute Executive Director Phill Wilson.

"In this context, conspiracies about HIV persist because the community has not been adequately informed about the actual political, cultural and socio-economic forces driving the epidemic," Wilson explained. "The Institute is dedicated to giving Black America the information it needs to move beyond imagined enemies, so that we can start fighting our all-too-real ones," he declared.

"For Black America, the moment of truth has arrived," said Wilson. "If we're going to survive this epidemic, we are going to have to gather all of our resources and marshal them for the struggles that lay ahead."

Differential Impact

In the decade since groundbreaking treatments began to slow HIV's carnage, the epidemic has grown steadily more Black and brown, The Institute notes.

No matter how you slice the numbers -- young or old, male or female, gay or straight -- this epidemic is attacking Black people most aggressively, according to the group.

• African Americans now account for 54 percent of annual new infections, though they are just 13 percent of the population.

• African Americans account for two-thirds of new AIDS cases among teens, but are only 15 percent of the national teen population.

• Black women accounted for 72% of all new HIV/AIDS cases among women in the United States.

• Studies have shown as much as a third of Black gay and bisexual men under the age of 30 may be HIV positive.

Yet, as the splintering epidemic deepens in Black neighborhoods, America's response to the domestic epidemic grows weaker each year, says The Institute.

From media attention to government funding for the programs that HIV-positive African Americans overwhelmingly turn to for care and treatment -- all signs show the nation moving on from the domestic AIDS epidemic, the organization maintains.

• Although there are now more Americans diagnosed with AIDS than ever before -- 42% of whom are Black -- funding for the primary federal AIDS program has remained flat for the last three fiscal years. In fact, portions of it have been cut.

• Two-thirds of those programs' clients are people of color, and nearly a third are women.

• One study found that the number of news reports on the domestic AIDS epidemic published or broadcast every year decreased by 57 percent between 1997 and 2002.

  Meanwhile, substantive efforts to establish or widen the prevention programs most likely to interrupt the epidemic in Black neighborhoods have ceased.

• Nearly 40 percent of all Black AIDS cases could be traced to dirty needles as of 2003.

  At least eight major government studies have found that needle exchange programs both efficiently stop the spread of HIV among injection drug users and facilitate their clients' entry into drug treatment programs. Yet, a ban on federal funding for these programs remains in place and 17 states offered no form of needle exchange as of 2000.

• With the astronomical incarceration rates of Black men (an estimated five percent are locked up), the separation that public policy assumes between those in and out of prison does not exist in Black neighborhoods.

  The epidemic is entrenched inside our nation's prisons. Yet, most do little to stop HIV's further spread through drug use, tattooing and sex inside their facilities. And few offer serious transitional services to inmates living with HIV who are returning home.

• Federal research has found that comprehensive sex education successfully reduces sexual behavior that puts youth at risk for diseases. A recent government survey found 97 percent of Black parents believe they should teach their kids about sex.

  But the federal government is leading a campaign to make abstinence-only education the norm in our schools. Abstinence-only programs omit any discussion of skills and tools to prevent disease transmission during sexual activity.

Treatment Lapses

Once positive, African Americans are more likely to advance to an AIDS diagnosis, are more dependent upon publicly financed care systems, and die sooner than any other group, The Institute reports.

• While AIDS diagnoses continue to decline every year among whites, they have remained at the same level among African Americans. In 2001, the AIDS case rate among African Americans was 11 times higher than that among whites.

• Nearly two-thirds of African Americans in treatment for HIV depend upon public health insurance. But those public insurance programs are now teetering on the edge of financial collapse. Forty-nine states have recently implemented or stated plans to implement cost-containment measures for Medicaid.

• HIV-positive African Americans are seven times more likely to die from HIV-related illness than their white counterparts. One study found that African Americans in treatment for HIV were twice as likely as whites to have not received "combination therapy," which is credited with reducing AIDS death rates.