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HIV/AIDS and the Public Health Crisis in Our Communities: The Time for Action Is Now

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At this year's International AIDS Conference in Washington, D.C. (July 22-27), leaders and experts from around the globe will gather to strategize about ending the HIV/AIDS epidemic. I'm looking forward to participating in events and panel discussions that highlight the progress we've made and the challenges we still face nationally and internationally. But the reality is, we need to do more than talk. Community-based action is vital.

Ironically, our leaders would do well to mirror their strategies on how the HIV virus works. Since our immune system is what keeps us all healthy, the virus strategically achieves its destruction by attacking immune system cells. Our actions to combat HIV/AIDS should be at least as strategic. We know that social factors like poverty, housing insecurity, and racial discrimination in our health care system exacerbate the spread of HIV/AIDS within minority communities. Black women in the United States are 15 times more likely than white women to become infected with HIV. And although Africa is home to only 14 percent of the world's population, it is home to 69 percent of those living with HIV/AIDS. There is clearly a racial and economic lens to the spread of this epidemic. Our policies to end the crisis should be viewed through this lens as well.

For example, the recent Supreme Court ruling, while a huge victory for expanded access to health care, nevertheless jeopardized the state-level expansion of Medicaid, which should be of concern to all HIV/AIDS advocates in the United States. No matter how many conferences we hold or prevention posters we produce, we can't expect low-income people who are most vulnerable to infection to get the health education, testing, and treatment they need without access to health coverage.

No doubt many politicians will have much to say about the HIV/AIDS crisis as the international conference rolls through the beltway. But we need less talk and more action. We need our leaders to take action to expand Medicaid and other critical social supports that, in essence, protect the "immune systems" of so many communities. Are we doing enough to reach the people who are uninformed and don't have any idea they're at risk, or the domestic violence victims who are too scared to bring up the subject of protection with their sexual partners? Are we providing enough on-the-ground support for the mothers who can't get tested or receive basic health services because they don't have child care or transportation?

Those are real-life problems. The conversation at the national level is very different from what I hear and see when I speak to people in the communities that are most severely affected by HIV/AIDS. Despite promising new prevention methods like Truvada, there's no substitute for education, awareness, and vigilance. We must arm our communities in crisis with the best tools available today to enable them to preserve their health now and stop the spread of this virus. Our National HIV/AIDS Strategy, announced two years ago, must continually hew to supporting community-based mobilization. Ultimately, this is a community-based crisis, and our communities must always have a seat at the table and a say in policies and practices to combat HIV/AIDS.

After all, the HIV virus knows the value of bottom-up, systemic action. Whether it's affecting our bodies or our global public health agenda, each cellular community can be a part of the problem -- or a vital part of the solution. When I attend the International AIDS Conference, I will be bringing with me the concerns of communities across the United States that need comprehensive support to combat HIV/AIDS and the conditions of economic and racial inequality that help it to fester and spread. And hopefully, when we all leave the conference, we will bring resources to bear on the communities where our attention and action is desperately needed.