Feb. 7, Douglas Brooks, director of the Office of National AIDS Policy, participated in a forum on the “State of HIV in Black America,” held at Harlem’s Schomburg Center.

Brooks forcefully asserted that African-American communities “need to be focused and strategic and thoughtful as we can be about what we are going to do to end this virus.”

In her remarks, National Black Leadership Commission on AIDS President and CEO C. Virginia Fields, who convened the forum, highlighted startling statistics to draw attention to the fact that HIV continues to disproportionately affect African-Americans.

African-Americans get HIV more than eight times greater than the white population, she said, citing the Centers for Disease Control and Prevention. “One in 16 African-American men and one in 32 African-American women will be diagnosed with HIV during their lifetime.

“Although only 13 percent of the U.S. population, African-Americans account for 44 percent of all new HIV infections in adults and adolescents living in the United States.” She added that African-American gay and bisexual men—particularly young men—remain the population most heavily affected by HIV in the U.S.

Rep. Charlie Rangel, of New York’s 13th Congressional District, also spoke at the forum to present his views on HIV and AIDS prevention. In his address, he stressed personal responsibility.

“It’s not worth the risk,” he said regarding one’s chances of getting HIV. “But the fact that they don’t care about themselves doesn’t mean that we don’t care to have to care for them.”

Brooks, President Barack Obama’s primary advisor on domestic HIV and AIDS policy, said his priorities for the Office of National AIDS Policy are focused on achieving the goals of the National HIV/AIDS Strategy, released in 2010, which include reducing HIV-related health disparities among gay and bisexual men, with a focus on young men of color.

“At the Health Resources and Services Administration, we have an over $2 billion Ryan White HIV/AIDS Program portfolio, which is caring for people living with HIV, including about $900 million for the AIDS Drugs Assistance Program that keeps people on their medications,” said Brooks.

The Ryan White HIV/AIDS Program is the largest federal program focused exclusively on HIV/AIDS care. Total U.S. government spending on HIV/AIDS for fiscal year 2015 is an estimated $30 billion, according to a Kaiser Family Foundation study. Said Brooks, “Of that, the domestic HIV/AIDS portfolio is about $24 billion.”

Beyond the U.S., global spending on HIV/AIDS is about $6 billion.

“The Affordable Care Act is a huge portfolio for people living with HIV and AIDS, in that for the first time, it also eliminates barriers because of pre-existing conditions,” said Brooks.

One of the major steps to increase health insurance coverage under the Affordable Care Act, better known as Obamacare, is an expansion of Medicaid. Medicaid covers 59 percent of African-Americans living with HIV/AIDS, according to the HIV Cost and Services Utilization Study.

However, the states that have not expanded Medicaid, particularly in the American South, accounted for about half of HIV diagnoses.

Another panelist, Johannes Morne, director of planning and community affairs at the New York State Department of Health AIDS Institute, reported on New York Gov. Andrew Cuomo’s bold plan to decrease the number of newly infected people with HIV each year from almost 4,000 people in 2015 to 750 people by 2020. New York leads the nation in the number of new HIV cases.

“We’re in a place where we are talking about ending the epidemic in our state, and that’s incredible!” Morne exclaimed.

Overall, today, more than 100,000 New Yorkers are living with HIV/AIDS, yet most do not know their HIV status. The only way to know for sure if you have HIV is to be screened for it by a blood test or swab. The American Foundation for AIDS Research recommends that all sexually active people, particularly those who have had multiple sex partners, whether gay or straight, should get tested.

Vignette Charles, senior vice president at AIDS United, a grant-making foundation based in Washington, D.C., was the remaining panelist. She stressed that pre-exposure prophylaxis, or PrEP, in combination with using condoms, is an amazing HIV prevention tool.

PrEP, in combination with using condoms, is a new way people who do not have HIV infection can protect themselves by taking one pill, brand name Truvada, a day. Truvada prevents HIV from making new viruses and establishing a permanent HIV infection in the body.

Brooks, himself a survivor of HIV, said, “We in the LGBT or HIV community are still having our internal debate over the validity or value of PrEP.”

The new federal guidelines recommend that health providers consider PrEP for high-risk people who wish to remain HIV-negative, an intimate HIV-positive partner notwithstanding.

While the number of newly infected people with HIV each year in the U.S. has stalled at around 50,000 people over the past decade, gay men are the only risk group in the U.S. in which new HIV infections are increasing. Young African-American gay men are even more severely affected.

Brooks said the Department of Health and Human Services Secretary Sylvia Burwell recently announced a new four-year demonstration project to address HIV disparities among gay men, including young African-American gay men.

Brooks said the “Greater Than AIDS” campaign and the “Act Against AIDS Leadership Initiative,” both launched in 2009, are two HIV prevention initiatives that are completely focused on African-American communities.

Defeating HIV will require a comprehensive response, and effective programs must be expanded to treat people already infected and prevent new infections. Whereas government and private funders directly aid local communities in the form of external grants and programs, funding organizations contribute in other ways that may not be as easily quantifiable or measurable, according to research tracking data.

“It is a really good time to start thinking about strategic alliances and partnerships where you can get funding that you bundle to provide the range of services that are necessary for us eradicating this virus,” said Brooks.

Along with its consideration of eliminating HIV racial disparities, closing gaps in health care delivery, expanding HIV prevention programs and testing and personal responsibility, the three forum panelists addressed the adverse effects of HIV-related stigma and fear of HIV on HIV/AIDS prevention programs and treatment. HIV-related stigma and fear of HIV are considered major barriers for developing effective HIV prevention and care programs in African-American communities.

Brooks said, “If you go online to CDC.gov or AIDS.gov, there are lots of resources and tools where you can help educate or bolster our ability to discuss stigma and the impact on Black communities or share those tools with other people as well.”

Experts say many people living with HIV deal with stigma and discrimination by joining and participating in HIV and AIDS support groups that have emerged in response to the AIDS epidemic.

After the panel discussion, the panelists took some questions from more than 200 AIDS activists and community partners in attendance, and took to Twitter to source and answer questions to #StateofHIV from the public. NBC-4 New York reporter Sheldon Dutes moderated the forum.

NBLCA sponsored the event, the first in a four-forum series called “State of HIV in Black America” in observance of Black History Month.

Dr. Alvin Ponder serves as chair of the National Action Network HIV/AIDS Committee. He can be contacted at apondermd@yahoo.com or @alvinponder on Twitter.