Dec. 1 is World AIDS Day! With the COVID pandemic foremost on the minds of many, HIV/ AIDS seems like a distant problem. A POZ Poll asked its readers, "Are you participating in any World AIDS Day 2022 events?" On 11/28, when I responded to the poll questions, 20% said "yes," 20% said "I don't know," and 60% said "no."

In 1988, the World Health Organization designated the day to pause and reflect on the magnitude of the devastating effect this disease continues to have on domestic and global communities. Much of the focus still is on developing countries. However, African Americans are still disproportionately affected by the HIV epidemic. And the epidemic is heavily concentrated in urban enclaves like Boston, Detroit, New York, Newark, Washington, D.C., and the Deep South.

In February, on National Black HIV/AIDS Awareness Day 2022, "Poz" reported that according to AIDSVu.org, African Americans in 2019 made up 43 percent of new HIV cases and comprised roughly 12- 13 percent of the U.S. population. This means that African Americans were 8.4 times more likely to contract the HIV infection compared to whites, according to The Office of Minority Health at the U.S. Department of Health and Human Services.

Massachusetts is a world-renowned medical hub known for its HIV/AIDS research and support systems, but the outcomes are equally grim. In 2019, according to a UMass Chan Medical School report titled "Burden of HIV & AIDS amongst the Black Community in Massachusetts...." African Americans comprise 7.3 percent of the population but represent 32 percent of people newly diagnosed with HIV. This means that the rate of African American males living with HIV is 5.2 times of Whites males, and the rate of African American females living with HIV is 22.7 times that of white females. African Americans who contract HIV are more likely to die from it than members of other racial groups.

But this data doesn't reflect the wave of recent African diasporic immigrants of the last decade coming from the Caribbean Islands and the Motherland. This demographic group is overwhelmingly underreported and underserved—for fear of not only deportation but also of homophobic insults and assaults from their communities.

In 2022, why is HIV/AIDS still an overwhelmingly Black disease in the United States?

There are many persistent social and economic determinants contributing to the high rates of the epidemic in the African American community—poverty, homelessness, health care disparity, industrial prison complex, and violence, to name a few. And while we know that the epidemic moves along the fault lines of race, class, gender and sexual orientation, homophobia, stigma, and the Black Church continue to be barriers to ending the AIDS epidemic. However, the most significant obstacle is systemic racism.

"I would not expect anything other than the data quoted. No matter what is being measured in America, you already know who will fare worse Systems in America are designed to have this outcome, "said Dr. Thea James of Boston Medical Center, my spouse.

In 2021, The CDC declared racism a serious public health threat and its impact on health outcomes. World Aids Day 2021, the National HIV/AIDS Strategy (2022—2025) was released, bringing shockwaves to people of color with its goal to center people living with HIV and address racism.

"The Strategy recognizes racism as a public health threat that directly affects the well-being of millions of Americans," the strategy states. "Over generations, these structural inequities have resulted in racial and ethnic health disparities that are severe, far-reaching, and unacceptable."

The UNAIDS 2022 theme is "Putting Ourselves to the Test: Achieving Equity to End HIV."

I hope the Poz Poll is incorrect and that many will participate in a World Aids Day event. But I feel assured that no matter who does or doesn't participate on that day, Black Lives living with HIV/AIDS are beginning to matter.

"We can end AIDS — if we end the inequalities which perpetuate it. This World AIDS Day, we need everyone to get involved in sharing the message that we will all benefit when we tackle inequalities," says UNAIDS Executive Director Winnie Byanyima. "To keep everyone safe, to protect everyone's health, we need to Equalize."