Communities from South Africa to South Central Los Angeles and from Birmingham to Beijing will stop today and have a moment of silence for World AIDS Day. Observed on the first day of December since 1988, World AIDS Day was established by the World Health Organization to provide governments, organizations, and individuals an opportunity to raise awareness and focus attention on the global AIDS epidemic. Globally, there were 2.7 million new HIV infections and 2 million HIV-related deaths in 2007, according to the 2008 report Status of the Global HIV Epidemic commissioned by the Joint United Nations Program on HIV/AIDS. In the U.S., African Americans make up a disproportionately high percentage (45%) of those infections and deaths. Dr. Kevin Fenton, director of the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention at the U.S. Centers for Disease Control and Prevention (CDC) has consistently focused on addressing racial and ethnic disparities in sexual health. Fenton spoke with BlackEnterprise.com to address the serious toll that AIDS/HIV is taking on the African American community and advise the best course of action to reduce that impact. BlackEnterprise.com: African Americans make up 12% of the U.S. population but 45% of new HIV infections. How do you explain the high incidence of new HIV infections among African Americans? Dr. Kevin Fenton: African Americans bear a greater burden of HIV than any other racial or ethnic group in the United States, with rates of HIV infection that are more than seven times as high as that of whites and almost three times as high as Hispanics. Within the African American community, black gay and bisexual men, and black women are most heavily affected. While race itself is not a risk factor, there are a number of reasons why HIV takes such a heavy toll on African Americans. Perhaps most important is the large number of blacks who are already living with HIV. This high prevalence of HIV means that there is a greater risk of infection with every sexual encounter. It's important to note that African Americans do not take greater sexual risks than people of other races. A range of other issues are at play, including poverty, limited access to healthcare, drug use, and higher rates of other sexually transmitted diseases (which can significantly increase a person's chances of acquiring HIV). Stigma and homophobia also play an important role by too often preventing people at risk from getting tested for HIV or accessing other important HIV prevention services. New infections among African Americans have remained roughly stable for more than a decade — even though an increasing number of people are living with HIV, and can potentially transmit the disease. In addition, new infections have declined dramatically in several transmission categories where African Americans are disproportionately represented: babies born to HIV-infected mothers, injection drug users, and heterosexuals. What would you say is the most effective way for business leaders to facilitate AIDS prevention education? The African American community is mobilized and more focused on addressing the black HIV/AIDS crisis than ever before. Black business leaders, as well as leaders from every other segment of the African American community (ie., faith, civil rights, entertainment), have joined forces with CDC through a national effort we call the "Heightened National Response to the HIV/AIDS Crisis among African Americans.†One of the most important ways the business community can support the nation's HIV prevention efforts is by partnering with local health departments to promote HIV education, awareness, and testing. For example, about 75 merchants in Detroit and roughly 60 Chicago merchants are participating in a business-led initiative to provide African Americans in their cities with HIV testing and other prevention information. By simply distributing HIV awareness messages on items such as shopping bags and beverage sleeves — and initiating conversations with their customers — these business owners are making important strides in reducing the stigma of HIV. We strongly encourage all business leaders to get involved. Even the simplest activities can have a significant impact. How have AIDS prevention tactics such as education, awareness, and testing changed in the last 10 years, given changes in technology? I would say that HIV testing is the area of prevention that has undergone the most significant changes in the last decade — both in our approach to HIV testing and in the technology itself. One of the biggest changes took place two years ago, when CDC revised its HIV testing recommendations. At that time, we began recommending that all Americans ages 13 to 64 get tested for HIV in healthcare settings — regardless of their perceived risk. Prior to that time, CDC recommended routine testing only for populations known to be at high risk, such as injection drug users and gay or bisexual men. The main purpose of the revised recommendations is to have HIV testing become a regular part of medical care — just like cholesterol screening is today — in order to identify the 1 in 5 people currently estimated to be living with HIV who do not know they are infected (about 233,000 people), so they can be connected to treatment and prevent transmitting the infection to others. HIV testing itself has also undergone significant changes, particularly with the introduction of HIV rapid testing in 2002. Rapid testing produces results in about 20 minutes — a vast improvement over the two-week waiting period that was typical when a traditional blood test had to be used to screen for HIV. There are now two types of rapid tests: a simple finger-prick test that uses a single drop of blood; and a saliva test, which uses a toothbrush-like device to collect oral fluid. Better technology has also made it possible for us to track the HIV epidemic with much more precision than ever before. Is the AIDS outlook for African Americans worse than many countries in Africa? Has the U.S. done enough financially to prevent AIDS in America? You're referring to a recent report by the Black AIDS Institute (BAI), which found that if black America was its own country it would rank 16th in the world in the number of people with HIV — ahead of nations such as Ethiopia, Botswana, and Haiti. As a nation, we must recognize the epidemic for the crisis that it is and work to expand access to HIV prevention and treatment. In 2007, the CDC spent $300 million — more than half of its domestic HIV prevention budget — on fighting HIV in African American communities. But the reality is that we've been facing increased challenges at a time of relatively stable resources. An informed and engaged community is one of our most powerful weapons against the spread of HIV. Black communities need to keep HIV front and center, and we all need to talk openly about HIV to raise awareness and reduce the stigma and homophobia that have been associated with this disease for far too long. Why is AIDS testing is a critical part of educating African Americans about the disease? While it's obvious that HIV testing helps get people into treatment, the link to prevention may not be so apparent. There are two key reasons why HIV testing is critical for the nation's prevention efforts. First, research shows that more than half of new sexually transmitted HIV infections are transmitted by those who don't know they are infected. According to a recent CDC analysis, about 21% of the 1.1 million individuals living with HIV in the United States at the end of 2006 did not know they were infected. And second, studies show that once people learn they are HIV-positive, most take steps to protect their partners. Over the past five years, CDC has expanded its efforts to prevent infections on both sides of the equation — keeping HIV-negative individuals uninfected, and helping to ensure that those who are HIV-positive do not unknowingly put their partners at risk of becoming infected. The CDC remains deeply committed to expanding HIV testing, especially for African Americans. For example, we awarded $70 million in grants over the last two years to the nation's hardest-hit states and cities to support their expansion of local HIV testing services, primarily among African Americans. RESOURCES What you can do: Get tested for HIV. To find a testing site center near you, visit hivtest.org or, on your cell phone, text your zip code to Know IT (566948). Stand up against stigma, racism, and other forms of discrimination associated with HIV/AIDS. Donate time and money to HIV/AIDS organizations. What organizations can do: Promote World AIDS Day in your organization. Useful materials are available at hivtest.org. Encourage employees to get involved in World AIDS Day. Educate staff about HIV/AIDS. Develop HIV/AIDS policies for the workplace. MORE INFORMATION Key Resources from CDC HIVtest.org AIDS.gov World AIDS Campaign World AIDS Day (Department of Health & Human Services) CDC HIV Testing Database -- Locate an HIV testing site near you CDC HIV / AIDS -- CDC's Web site for HIV/AIDS in the United States CDC Global HIV/AIDS -- CDC's Global AIDS Program CDC National Prevention Information Network -- Reference, referral, and distribution service for information on HIV/AIDS, sexually transmitted diseases, and tuberculosis Source: Centers for Disease Control and Prevention