The global AIDS epidemic is now in its fourth decade

The global AIDS epidemic is now in its fourth decade, and while the efficacy of HIV treatment protocols have advanced greatly, the prevention of the spread of the virus remains problematic in the extreme.
Los Angeles County, California remains a leading locus of new, previously undiagnosed HIV infections at a rate exceeded only by that of New York City and a handful of other entire states in which there are multiple urban centers of significant population. In spite three decades worth of well-funded programs designed to curb the spread of HIV, the 62% fatality rate among infected individuals within Los Angeles County has remained consistent since the outbreak was first diagnosed in 1981.
The State of California Department of Public Health, through its Office of AIDS, began reporting statistical analysis of HIV infection incidence statewide in 1983. At that time, statewide reported cases totaled less than 10,000. Today in California, that number is close to 170,000, with 38,846 (17.7%) of those reported as African American males, nearly one-third of whom reside in Los Angeles County, giving the county the #1 ranking as a “Top 10 HIV(AIDS)” area in the state.
That grim distinction is augmented by recent data in the 2013 Los Angeles County Annual HIV Surveillance Report, which indicates that of those adults infected with the virus, 20% are African American, triple their percentage of the overall population (7%) within the county. Of those HIV-positive African Americans in the county, 13,914 are men (nearly five times the rate of infected African American women), with new cases of AIDS among African American men being reported at double the rate of Latino men and quadruple the rate of white men. Fully one-third of African-American men in Los Angeles County who engage in sexual contact with other males are currently diagnosed as HIV-positive (www.apla.org).

Assessing today’s reality
Today, there are approximately 60,000 Los Angeles County residents infected with HIV and more than 20,000 living with full-blown AIDS—a number that reflects the improved availability of more advanced treatment today than in 1981, when there were zero long-term AIDS survivors—with one-third of those unaware of their HIV status.
Regardless of the efficiency of data collection and the protocols for tracking the rate of the spread of HIV, it’s clear that solutions to the epidemic remain elusive and that the underlying causes for the increasing rate of infection need to be addressed from many fronts.
The fact that more than half the people who have died from AIDS since the discovery of the virus are African American, and that African American men are now the majority gender for new cases with 81% of those infections reported pursuant to homosexual contact, there is a clear need for culturally-focused gender-specific educational intervention and community sponsored HIV testing which specifically targets African American men.

Objectives
Any program that is designed to effectively stem the rising tide of HIV infection among African American men living in Los Angeles County clearly needs a revised strategy of communication, education, counseling, and social pathology awareness beyond those currently in place, and which are clearly failing to meet their objectives. The goals of any program of intervention, prevention, and education must be singularly focused upon reversing the current rate of HIV transmission among the group most responsible for the current rates of infection: African American Men.
There are multiple transmission vectors driving the current accelerating spread of HIV among African American men: high-risk sexual behaviors, primarily homosexual in nature, and injection of illicit street drugs. Arresting these behaviors, the product of which will be a decline in the rate of new infections, is the urgent objective of this study and any institutional efforts ensuing from it.