Guest post by Tony R. Wafford

According to the Centers for Disease Control and Prevention (CDC) the AIDS epidemic, caused by HIV (Human Immunodeficiency Virus), found its way to the United States between the 1970s and 1980s, roughly some 43 plus years ago.  Treatment of HIV/AIDS is primarily the use of multiple antiretroviral drugs, and educational programs to help people avoid infection.

In 2010, President Barack Obama created the National HIV/AIDS Strategy for the United States (NHAS), with three main objectives—reduce the annual number of HIV infections, reduce health disparities, and increase access to resources and HIV care.  What was going to make this strategy different from other HIV/AIDS plans, was that it was to include an Implementation Plan, with a timeline for achieving each of the three goals, as well as a document outlining the specific action plan that was to be used.  All of this was a very good idea, but the plan was missing two major components.  It did not contain a comprehensive, culturally competent approach to address a population disproportionately impacted by the HIV/AIDS crisis, i.e., the Black community, nor did it have a very necessary element that would have made the plan successful…FUNDING, all of which were needed to achieve these three goals.  The way I see it, any idea without the necessary funding to implement it—is just that, an idea.

Don’t get me wrong, we have made some tremendous progress in HIV/AIDS treatment and care; take Pre-exposure prophylaxis (or PrEP) for instance.  PrEP is medicine taken to prevent HIV transmission.  PrEP is highly effective for preventing HIV when taken as prescribed, it reduces the risk of getting HIV from sex by about 99%, it reduces the risk of getting HIV from injection drug use by at least 74%, but it’s only as effective when taken as prescribed.  PrEP is not a “wonder” drug, PrEP only protects against HIV, condom use is still very important against other sexually transmitted diseases (STDs) i.e., Chlamydia, Gonorrhea, Syphilis, Herpes and Human Papillomavirus (HPV).  PrEP is not a panacea, but it’s a good start at reducing the spread of HIV in our community.

It angers me when we’re faced with serious issues such as HIV/AIDS as well as other disease states and mainstream media and the dominant society seems to somewhat get things under control for “their” population or it becomes manageable, however these same issues continue to kill, that’s right kill, people in my community, and somehow these issues no longer seem to be important enough anymore to address.  Not only does the conversation disappear but so does the funding to address the problem and the next thing we know is they begin to blame the victims for the problem.  I don’t need to give you a history lesson—do I?  Heroin and crack are being used by lowlife people, while fentanyl and methamphetamine addiction is a disease effecting troubled youths, you get my point, but I digress.

Let’s not blame the victims, but let’s address the facts as well as the truth.  It’s no secret the research shows that centuries of racism and discrimination in this country has had a profound negative impact on the Black community—that’s a FACT! That impact is pervasive and deeply embedded in American society, affecting where we live, learn, work, worship, and play.  All of which plays a major role in creating inequities in access to housing, quality education, wealth, employment, and a range of other social and economic benefits.  These conditions, often referred to as social determinants of health, are key drivers of health inequities, causing people within some populations to experience greater risk for poor health outcomes.  This is the truth!

And speaking of truth, it’s time we address the truth around Political Determinants of Health or the lack thereof.  Daniel E. Dawes says it best in his book, The Political Determinants of Health.  Political determinants of health involve the systematic process of structuring relationships, distributing resources, and administering power, operating simultaneously in ways that mutually reinforce or influence one another to shape opportunities that either advance health equity or exacerbate health inequities.  Political determinants of health create social drivers—including poor environmental conditions, inadequate transportation, unsafe neighborhoods, and lack of healthy food options, that affect all other dynamics of health.  By understanding these determinants, their origins, and their impact on the equitable distribution of opportunities and resources, we can be better equipped to develop and implement actionable solutions to close the health gap.  I respect facts, but this is some truth for your ass!

More than 40% of new HIV cases in the United States occurred among Black people.  I said it before and I’ll say it again, this seems almost mathematically impossible when we are just 14.2% of the US population according to the 2020 census. And the COVID-19 pandemic coupled with this has only made it worse for Black people, which led to disruptions in HIV testing, access to clinical services, housing, and the list goes on and on.  While it’s too early to know just what the full impact the COVID-19 pandemic has had on our brothers and sisters dealing with HIV, CDC data has shown concerning setbacks to HIV prevention, including sharp declines in HIV testing and diagnosis, as well as slowed pre-exposure prophylaxis (PrEP) prescriptions.  In 2020, 44% fewer HIV tests were administered among Black people in non-healthcare settings than in 2019. Brother Malcolm X said it best when he said, “Of all our studies, history is best prepared to reward all research.”  So, for me it’s pretty clear what the impact COVID-19 has had on our brothers and sisters diagnosed with HIV.

This National Black HIV/AIDS Awareness Day let’s not just talk about the issues, but let’s make some moves to fix it.  Pick your lane and do what you can to help our people.