JIM LEHRER: Next, AIDS in America, which is drawing new focus this week at the International AIDS Conference in Mexico City.
More than one million Americans have HIV. The latest figures show that, in 2006 alone, there were about 56,000 new infections. African-Americans have been particularly hard-hit.
NewsHour health correspondent Betty Ann Bowser reports on the situation in Washington, D.C. The Health Unit is a partnership with the Robert Wood Johnson Foundation.
BETTY ANN BOWSER, NewsHour Correspondent: The nation’s capital is in the midst of a modern-day HIV-AIDS epidemic. In a city of 600,000 people, the District of Columbia has more than 12,000 cases, and 81 percent of them are African-Americans.
That’s why community organizers like Terry Hawkins of the Greater Mount Calvary Holy Church are trying to get to young people before it’s too late.
TERRY HAWKINS, Greater Mount Calvary Holy Church: All it takes is one time, just one time, one slip-up, “Oh, I forgot the condom,” or, “Oh, I’m going to try. You know, I don’t think it can happen to me.” One time is all it takes for you to become infected.
BETTY ANN BOWSER: The kids are given very explicit information about how to use condoms and are told that, to stay safe, they must always use them when having sex. It’s just one community organization’s attempt to get at an issue that is Washington’s number-one health problem.
The District of Columbia has more HIV-AIDS cases than any city in the country. Here, a staggering 1 out of 20 people is infected with the virus. And like most American cities with an HIV-AIDS problem, the burden disproportionately falls on the black community.
In fact, more than 80 percent of all new cases in the district are African-Americans.
Infection numbers have exploded
Dr. Theo Hodge treats a lot of HIV-AIDS patients. And what he's seeing in his practice crosses all demographic groups in the black community.
DR. THEO HODGE, Infectious Disease Specialist: I'm seeing a huge influx of women of color who are HIV-positive. I'm seeing younger patients, patients less than 30. There seems to be an influx of patients coming in with new infections. And African-American men who have sex with men population has exploded, in terms of the numbers of new infections that I seem to see in my practice.
BETTY ANN BOWSER: Hodge says among his patients who are not HIV-positive, he has a hard time getting them to use condoms.
DR. THEO HODGE: A patient actually said to me it was condom fatigue. Another patient did say to me, "Oh, well, there's a pill for that." Another patient actually said, "Well, you know, it's kind of glamorous to have HIV. Look at Magic Johnson. He's out. He's doing all these things, and he's glamorous."
BETTY ANN BOWSER: Dr. Pierre Vigilance is director of the D.C. Health Department. He says what's driving the high numbers in part is people not heeding the advice about safe sex.
DR. PIERRE VIGILANCE, Director, District of Columbia Department of Health: It does come down to a behavior piece. It is a pretty broad segment of the population that conducts various risky behaviors at different times.
What drives the disease, as far as we're concerned, is the multiplicity of behaviors that go on out there and people just really feeling that they don't need to do the things that they know to do.
Early detection helps survival
BETTY ANN BOWSER: According to the medical journal Lancet, that kind of risky behavior is not unique to the black community. The Centers for Disease Control say there are other factors that contribute to the high rates of infection among blacks, including lack of awareness of their HIV status, or their partner's.
The CDC also says other sexually transmitted diseases and substance use increase infection rates.
Sabrina Heard has been living with HIV for 16 years, AIDS for the past three. She got it from having unprotected sex with an infected man and was unaware of his status.
Now she's on a mission to get people tested. She knows that, when the virus is found early, patients have a better chance for long-term survival with today's antiretroviral drugs.
Twice a week, Heard and other members of the Washington, D.C., Women's Collective hit the streets hoping to convince people to get tested in their mobile units. The collective is a nonprofit dedicated to serving women with HIV in the D.C. area.
SABRINA HEARD, Volunteer: We're also going to go over information pertaining to HIV and its transmission.
Taking HIV lightly
BETTY ANN BOWSER: And for all those who agree, there are incentives: tote bags laden with coupons for free food, condoms and hygiene products. Heard says her work is important because too many African-Americans don't take HIV seriously enough.
SABRINA HEARD: I talk with lots of people in the community. They don't talk about HIV. They don't believe that this disease is something that's devastatingly taking people's lives to the degree that it is.
BETTY ANN BOWSER: What Heard is seeing in the Washington black community mirrors a pattern cited by the Centers for Disease Control this week. It said 45 percent of all new HIV cases in 2006 were in the African-American community and that rates among blacks were seven times higher than those among whites.
That's why Heard has been so careful to explain the dangers of the virus to her children, but one of them didn't listen.
SABRINA HEARD: I have one daughter who I do know, she makes the decision as to who she's going to be protected with or not. You know, she still has unprotected sex with some people.
BETTY ANN BOWSER: Terrance Moore is a Washington AIDS activist who says people are having unprotected sex because they don't think HIV-AIDS is a big problem. Moore has been HIV-positive for seven years.
TERRANCE MOORE, National Alliance of State and Territorial AIDS Directors: There is a sense in 2008, people are not concerned about HIV. It's something that is treatable these days. It's not necessarily something that you are going to die for.
We see these wonderful ads in newspapers and magazines of, you know, gay men climbing mountains, you know, only if they take their medications. And so I think that there is a perception out there that this is something that you can live with and that you don't need to worry about.
Responses to the crisis
BETTY ANN BOWSER: Adjusted statistics released this week by the CDC show that, in 2006, 53 percent of all new HIV-AIDS cases were contracted from men having sex with men. It's those high numbers that have Dr. Shannon Hader, the D.C. AIDS czar, urging every physician in the district to offer voluntary testing to their patients.
DR. SHANNON HADER, Director, HIV-AIDS Administration: Part of the reason most people aren't getting tested is it's not being offered. Some of our studies that we've done, 75 percent of people who are newly testing positive, their first diagnosis had at least one visit with a medical provider in the last 12 months where they weren't diagnosed. So missed opportunities are happening all the time.
BETTY ANN BOWSER: Because of the scope of the epidemic, two area emergency rooms are offering HIV testing to all who come in for treatment. Hader's department hopes that will eventually be a policy city-wide.
Phil Wilson is an HIV-AIDS activist who says what's needed is a massive increase in federal government spending on AIDS in the black community. His organization, the Black AIDS Institute, has just released a report that says, in part, "The U.S. government's response to the most serious health crisis facing black America remains timid and lethargic."
Wilson applauds Congress for its recent passage of the $48 billion President's Emergency Plan for AIDS Relief in the developing world, but thinks the government is neglecting its own people.
PHIL WILSON, CEO, Black AIDS Institute: We have an AIDS epidemic that's worse than the AIDS epidemic in Port-au-Prince, the capital of one of the poorest countries on the planet. Furthermore, when you look at populations like black gay men or black men in general, you see epidemics that outstrip the same epidemic that you might see in Botswana, or Zimbabwe, or Senegal.
BETTY ANN BOWSER: Wilson's organization has called for implementation of a national AIDS strategy and increased spending by the CDC on prevention. AIDS activists in the short run say they hope to put the AIDS crisis in the black community on the national agenda by making it a focus of the presidential candidates and the campaign in the weeks to come.