The slogan of this year’s National Black HIV/AIDS Awareness Day was “Stay the course, the fight is not over!” Yet for health professionals and people living with HIV, or PLWH, “staying the course” is simply not good enough. The “blackening” of the HIV epidemic in America has been going on for decades, and now blacks account for 43% of PLWH and 45% of deaths among PLWH, while making up only 12% of the U.S. population. Georgia, where I practice, has the highest rate of new HIV diagnoses among states, and blacks there account for nearly three-quarters of new diagnoses. Although new diagnoses have decreased nationally overall, among black gay and bisexual men the rate has continued at a steady pace, starkly illustrating that our progress in both treatment and prevention is not sufficiently reaching those who need it most. Transgender populations, especially those of color, are largely not counted but they experience especially severe disparities.
We have tools that could reverse this epidemic, but we need to substantially improve their deployment. Testing is the gateway to both treatment and prevention, and we have rapid diagnostic tests that take only minutes and can be taken to the streets. But they must be taken to the heart of communities that need testing the most. Since 2006, The CDC has recommended routine “opt out” HIV testing in medical settings, but we as care providers do not follow this guidance. In Atlanta, rates of undiagnosed HIV among black gay and bisexual men remain as high as 20%. As many as one-third of people diagnosed with HIV in our area already have AIDS by the time they are diagnosed with HIV.
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