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JewishJournal.com

June 5, 2008

HIV/AIDS impacts the vulnerable across the city, up the state, over America and around the globe

http://www.jewishjournal.com/world/article/hiv_aids_impacts_the_vulnerable_across_the_city_up_the_state_over_america_a

Los Angeles resident Darryl Hendrix often struggles to get by. Like many of his neighbors, Hendrix's costs for housing and personal necessities sometimes exceed his modest monthly income. But Hendrix, an African American gay man and a client at AIDS Project Los Angeles (APLA), is also living with HIV.

His diagnosis has complicated daily living. To stay healthy, he must maintain a nutritious, balanced diet in the face of rising food prices. He must confront HIV-related dental problems as health care costs climb. He must travel to medical appointments as gas prices and transportation fares skyrocket. And he must live with a disease that still carries tremendous stigma.

Hendrix's story repeats itself locally, nationally and globally, among the most vulnerable populations: communities of color; the poor and disenfranchised; people struggling with addiction, mental illness and histories of abuse; and gay and bisexual men. More than 25 years into the epidemic, HIV/AIDS is the greatest public health crisis we've known.

A Global Crisis

Worldwide, there are more than 33 million people living with HIV/AIDS, and the epidemic continues to expand. In 2007, there were more than 6,800 new HIV infections globally each day. And while new treatment options make longer, better life with HIV possible, more than 5,700 die from AIDS-related complications daily.

Internationally, Sub-Saharan Africa remains the hardest hit. The region, which accounts for only 11 percent of the world's population, is home to 68 percent of people living with HIV/AIDS. In response, APLA has partnered with several agencies on the ground in South Africa to develop sustainable food programs that support the nutritional needs of people living with HIV/AIDS.

APLA has also formed key collaborations with local organizations in India, which has the highest HIV prevalence rate in the world; in Latin America, where 100,000 new cases of HIV were reported in 2007; and in China, where high levels of stigma surrounding homosexuality complicate intervention efforts.

A Growing Epidemic in the U.S.

Since the first cases of AIDS were reported in the United States in 1981, more than 1.7 million Americans have been infected. More than 550,000 have died, and approximately 1.2 million are living with HIV/AIDS today. More than 25 percent of those who are infected do not know it.

The national epidemic is also growing. While previous estimates indicate 40,000 new HIV infections occur each year in the United States, the Centers for Disease Control and Prevention (CDC) is soon expected to raise that estimate to as many as 60,000.

The disease disproportionately affects communities of color and other minorities in the United States. African Americans, who comprise 12 percent of the U.S. population, accounted for nearly 50 percent of 2006 AIDS diagnoses. Latinos and Native American/Alaska Natives have the second- and third-highest rates of AIDS cases, respectively. Gay, bisexual and other men who have sex with men account for nearly 60 percent of AIDS cases among men annually. And more than one-quarter of all new AIDS cases are among women.

Responding to these trends, APLA formed the Sexual Health Exchange (SHX) in 2007, a nationwide partnership with other AIDS service organizations to address these disparities in HIV infection rates among communities of color.

The Face of AIDS in Los Angeles

Los Angeles is the second-most HIV/AIDS-impacted community in the United States. Today, more than 60,000 Angelenos are living with HIV/AIDS -- more than ever before -- and Los Angeles sees 1,500 to 2,000 new infections each year.

As nationally, HIV/AIDS continues to impact communities of color and gay and bisexual men. Where these communities intersect, the statistics are even more striking: an estimated one in three African American gay men in Los Angeles is living with HIV.

APLA's client profile offers a snapshot of the Los Angeles epidemic. APLA clients are diverse, with 37 percent Latino, 36 percent white and 23 percent African American. They are poor. Nine out of 10 live on less than $20,000 per year. Too many are uninsured. And while they are living longer thanks to treatment advances, their need for food, dental care, mental health services and other programs is also increasing.

Challenges Ahead

Darryl Hendrix's story is a common one among APLA clients. For many, the cost of daily living is rising, while income is not. Necessities like food, housing and medical care are too quickly becoming expensive luxuries.

Government funding for HIV/AIDS services is also shrinking. Last month, Gov. Schwarzenegger announced plans to slash nearly $10 million from the state's HIV/AIDS programs, along with proposed cuts to Medi-Cal dental benefits for adults that could leave millions of low-income beneficiaries (including people living with HIV/AIDS) without dental coverage.

Still, in the face of these challenges, APLA is doing more to support the hardest hit. Last year, more than 9,600 people living with HIV/AIDS accessed APLA's direct services and education programs, including our countywide network of food pantries, our state-of-the-art dental clinics and a wide array of supportive services.

We reached nearly 600,000 through our publications and Web sites, working to prevent HIV infection through comprehensive HIV risk reduction and health education programs that target those at highest risk.

And we're in Sacramento and Washington, D.C., responding to budget cuts by bringing our clients face-to-face with lawmakers to find solutions and shape the future of HIV/AIDS-related policy.

But our work would not be possible without our generous supporters. Two-thirds of our operating budget comes from private donors. We are particularly inspired by the generous contributions of the diverse communities of faith in Los Angeles. It is these gifts that allow us to fight an epidemic that still outpaces our most aggressive efforts to control it.

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