Sounding a silent epidemic.(Collection Development: African Americans & AIDS)(African American Women and HIV/AIDS: Critical Responses)(Workable Sisterhood: The Political Journey of Stigmatized Women with HIV/AIDS)(The Boundaries of Blackness: AIDS and the Breakdown of Black Politics)(Beyond the Down Low: Sex, Lies, and Denial in Black America)(On the Up and Up: A Survival Guide for Women Living with Men on the Down Low)(Living with AIDS/HIV: The Black Person's Guide to Survival)(On the Down Low: A Journey into the Lives of "Straight" Black Men Who Sleep with Men)(Not in My Family: AIDS in the African American Community)(Social Workers Speak Out on the HIV/AIDS Crisis: Voices from and to African-American Communities)(The Handbook of Lesbian, Gay, Bisexual, and Transgender Public Health: A Practitioner's Guide to Service)(Health Issues in the Black Community, 2d ed.)(Praeger Handbook of Black American Health: Policies and Issues Behind Disparities in Health, 2d ed., 2 vols.)(Book review)

Twenty-five years after scientists first detected HIV/AIDS, the United States still has a long way to go toward containing the virus. While the media most often spotlights the devastation wrought in Third World countries--think the celebrity-backed Product RED initiative to eliminate AIDS in Africa, with participants like the Gap and American Express--statistics from the Centers for Disease Control and Prevention (CDC) show that the disease has reached epidemic proportions among African Americans.

While they make up only 13 percent of the U.S. population, blacks accounted for a shocking 50 percent of Americans diagnosed with HIV/AIDS in 2004. In addition to having a higher infection rate, African Americans are also more likely to contract HIV and to die from AIDS than the population as a whole. A November 2006 study released by Colin Mathers and Dejan Loucar of the World Health Organization doesn't bode well for anyone: they estimate that over the next 25 years, AIDS will rank in the top three causes of death worldwide, alongside heart disease and stroke.

How we got here

Several factors have contributed to the HIV/AIDS outbreak among American blacks. First things first: members of this group are more likely to be living in poverty and have less access to medical care, drugs, and prevention education. Healthcare expenses rank as a low priority when food and shelter are uncertain; the poor are at risk for many health problems that are exacerbated by late diagnosis and the financial inability to obtain medication and treatment.

The lack of early education and outreach did not help matters. Because AIDS was first identified as a "gay white male" disease, minority communities were not adequately alerted. A study reported in Cathy J. Cohen's The Boundaries of Blackness (in the following bibliography) notes that initial media reports about HIV/AIDS and African Americans primarily focused on celebrities like Magic Johnson and Arthur Ashe, as opposed to the disease's effect on the community as a whole.

Finally, denial that a disease associated with sex and drug use has anything to do with one's own family or friends has contributed to the prevalence of HIV/AIDS. Admitting to the disease requires an honesty about sexuality, infidelity, and illegal drug use that most people, whether African American or not, find difficult: "It can't be my brother or my sister--or me."

As gloomy as the …