The 38-year old former medical assistant has lived in Augusta for the past eight years. Melissa prides herself on being drug-free, not even so much as a puff of marijuana. She was also never one to sleep around. Melissa counts five sexual partners during her entire life, two of them husbands. Melissa and her current husband have been married for 16 years. That’s nearly as long as Melissa’s been living with HIV.

Melissa counts herself among the more than 1 million people recently estimated to be living with HIV/AIDS in America today. Whereas before, Melissa’s diagnosis could have translated to a death sentence, she and other like her are able to live relatively full lives through recent strides made in medications and treatment.

Melissa, who asked that only her first name be used for this story, learned she had the virus that causes AIDS when she became pregnant with her third child from her current husband in 1992. Melissa first husband was an IV drug user and died from the HIV virus.

This story about Melissa was the bases for a story entitled AIDS in Augusta by Brian Neil that appeared in the June 23-29, 2005 issue of the Metro Spirit, an independent news weekly in Augusta, Georgia where I live and work.

I begin with this story about Melissa, not that you would know her. But that She could be any one of us in any one of our communities, and in any one of our congregations. It is a way to say very simply, HIV is a virus that does not discriminate and those who are infected are all around us and we are all affected, one way or the other, by the virus that causes AIDS, Acquired Immune Deficiency Syndrome.

Those of us, who work as care givers, HIV/AIDS educators, Counselors, and Service providers, and clergy know the frustration when we hear from people in the church and in the community at large say that HIV just doesn’t affect them anymore. We tend to forget, or not think, about what we do not see regularly. I am thankful that HIV/AIDS was included as a topic for this conference. I am thankful for the invitation to speak to you on this subject and invite you to seek out other in your communities who can help to facilitate a dialogue on this deadly disease. I hope I will be able to share some information with you that will educate, encourage and even shock you into action where needed. I am here to remind you today that our church still has AIDS and the very least we can do are to speak openly about it in our churches.

As Vice Chair of the board of directors of the National Episcopal AIDS Coalition - NEAC - and a member of the Executive Council Standing Committee on HIV/AIDS for the national church, I have the privilege of visiting congregations and dioceses throughout the country. In major cities over the past few years, I have noted that from city to city there is sigma, shame, increasing numbers of new infections among young people, misinformation, rejection (or simply silence) on the part of the church, and in some cases blame.

The Centers for Disease Control and Prevention - CDC reports the first case of what would later become know as AIDS were reported in the United States in June of 1981. Since that time, more than 1.5 million people in the U.S. alone have been infected with HIV, including more than 500,000 who have already died. The response to the U.S. epidemic has yielded numerous successes, but challenges remain:

• It must be mentioned that the annual HIV infection is down from its peak of more than 150,000 in the 1980s to approximately 40,000 new infections per year today. However, it also worth mentioning that this number has remained at this level for over a decade and recent analyses suggest that the infected population is shifting. 
• HIV testing is important for both prevention and treatment efforts.  New technologies, such as rapid testing, are now available. Yet approximately 24-27% of those infected with HIV do no know it. We must encourage testing.
• Advances in HIV/AIDS treatment have substantially reduced AIDS-related morbidity and mortality and extended the lives of many. New treatments, however, are not a cure and do not benefit all people with HIV. An estimated 42% to 59% of people living with HIV/AIDS are not in regular HIV care.
• The epidemic has had a disproportionate impact on some populations, particularly minorities.
  Impact on Racial and Ethnic Minority Americans
• Racial and ethnic minorities have been disproportionately affected by HIV/AIDS since the beginning of the epidemic, and according to the most recent CDC numbers,  minority Americans now represent the majority of new AIDS cases (71%) and of those estimated to be living with AIDS (64%) in 2003.
• African Americans and Latinos account for a disproportionate share of new AIDS diagnoses. Of the 43,171 cases reported in 2003, 28% was white, non-Hispanic; 49% African American; 20% Latino; 1% Asian/Pacific Islander and 1% Alaska Native American.
• African American accounted for 55% of all HIV/AIDS related deaths in 2002; Latinos accounted for 13%.
• HIV was the 3rd leading cause of death among African Americans between the ages of 25 and 34 in 2001, and the 6th leading cause of death for Latinos and whites in this age group. HIV was the #1 cause of death for African American women ages 24-34 in 2001.

Impact on Women and Young People

• Women account for a growing proportion of new AIDS diagnoses, rising from 8% in 1985 to 27% 2003.
• Women of color are particularly affected. African American women account for 67% of estimated new AIDS diagnoses among women in 2003; Latinos account for 16%.
• Young adults and teens continue to be at risk. At least half of all new HIV infections are estimated to be among those under the age of 25. Most young people are infected through sex.
• Among youth, teen girls and minorities have been particularly affected. In 2002, teen girls represented about half (51%) of HIV cases reported among 13-19 year olds. Young African Americans represented 65% of AIDS cases reported among 13-19 years olds in 2002; Latino teens represented 20%.
• Prenatal HIV transmission (HIV+ mother to un-born child) has declined significantly in the U.S., largely due to antiretroviral treatment.

Impact on Men Who Have Sex with Men (MSM)

• Despite declines in HIV infection rates among men who have sex with men since the early years of the epidemic, MSM continue to be at high risk for infection, accounting for an estimated 57% of AIDS diagnoses among men in 2003. Studies indicated that risk behavior continues among MSM and that they are at significantly greater risk for HIV infection than other groups in the U.S.
• Younger MSM and MSM of color are at particularly high risk CDC studies have found high HIV incidence and among MSM in some cities and low levels of awareness of infection status among those with HIV. Young men who have sex with men are not being tested for HIV.
  

I have given you a lot of statically information. Most of it is depressing I know. However, it is the reality of where we are with this epidemic. These are facts that can cause some to dose off or dismiss the information as not relating to our particular situation. The reality is that if one of us has the virus that causes AIDS, the Church has AIDS. We must talk about it, about education and prevention.

These facts are real for us and the church:

• Of the estimated 40,000 new HIV infections each year, more than 50% are African Americans.
• African American women constituted 64% of new female AIDS cases.
• AIDS is the number one cause of death for Black adults aged 25 to 44, before heart disease, cancer and homicide.
• One in 50 Black men is HIV-positive. One in 160 Black women is HIV-positive.
• Black senior citizen represents more than 50 percent of HIV cases among persons over age 55. Less than half of this group returns for follow-up or treatment after diagnoses.
• Intravenous drug use is fueling the epidemic in Black communities. It accounts for 43 percent of infections among Black women and 38 percent among Black men. Many women contact HIV infection through sex with an injection drug user.
• In 1998, men of color who have sex with men represented 52 percent of total AIDS cases. By comparison, in 1989 men of color who have sex with men represented 31 percent of total Aids cases.
• Although only 15 percent of the adolescent population in the United States is Black, over 60 percent of Aids cases reported in 1999 were among 13-19 ear olds were black.
• AIDS is a global problem among Black people. The World Health Organization reveals that the disease is the number one leading cause of death in Africa. The United Nations estimated that over two million Africans have died of AIDS.

It is important that I say at this point that HIV is a virus (Human immunodeficiency Virus). It destroys a person’s immune system-their ability to fight off infections. AIDS (Acquired Immune Deficiency Syndrome) is the end stage of HIV infection. When the body’s immune system is so weakened that people can get sick and die from almost any kind of infection.

HIV is transmitted by:

• Having sexual intercourse with an infected person
• Sharing needles with an infected person
• Being born to an infected mother
• Blood transfusions from un screened blood supply

You contact HIV because of risky behavior, not because you are a member of a group. It is not who you are or who you think you are, if you share a needle and have unprotected sex, the chances are great for HIV infection.

Where is the Church in this?
The question I continually ask is where is the Church in this? In the early days of this crisis, the Episcopal Church was out front in speaking out, calling for a national response and social justice. The church was a safe place for those infected and affected by the HIV virus to gather for support and experience Christ‘s love. Today many of us with NEAC and other Care Providers feel that the even Episcopal Church has become silent.

While meeting in New Orleans in January this year, NEAC asked members of he staff of New Orleans’ largest AIDS service organization how the local faith community is responding to HIV in New Orleans. They seemed surprised by the question. They knew very little, if anything, being done by any of the local churches in response to the HIV epidemic. Yet, there is so much that we the Church can do to fight this disease.

As Christians, we are empowered by God’s Spirit to be witnesses to the gospel of Christ. “You will receive power when the Holy Spirit has come upon you; and you will be my witnesses…to the ends of the earth.”

In the words of the Baptismal Covenant, we are called to “seek and serve Christ in all persons, loving our neighbors as ourselves. And that we always strive for justice and peace among all people, respecting the dignity of every human being.”

HIV is a justice issue. It deserves our prayerful Christian response. We may hear people ask, why does HIV deserve special treatment? Why is it different from cancer or diabetes or any other disease? Well, people are not thrown out of their homes or shunned by their families because of cancer. People are not refused a proper Christian burial because of diabetes. After all of these years, the stigma surrounding HIV still very much exists.

In dealing with HIV/AIDS, it is not only sickness that we fear. Two issues that trouble our society even more deeply, inherent in the AIDS crisis, are sexuality and death. The complexity of fear surrounding these two issues compounds our fear of AIDS. It also makes it easy to practice denial of the realities of HIV infection when the media reports on new treatments.

Fundamental to a Christian approach is our belief that “love casts out fear” (1 John 4:18). With understanding, we are free to love because we are free from fear. “We love, because He first loves us” (1 John 4:19).

Thankfully, there are things we as Episcopalians can do to fight HIV. Our churches can become safe places where conversations about HIV/AIDS prevention can take place. We can contribute to the work of NEAC, which is the Episcopal Church’s national response to the HIV pandemic. Those of us in Province IV can support the Province IV HIV/AIDS Retreat at Kanuga each June. This is one of the Episcopal Church’s ministries that mean so much to so many who attend each summer. Support your diocesan AIDS Ministries. Start one where none exist. Finally, preach about HIV prevention. October is HIV awareness month in the Episcopal Church. December 1st is World AIDS Day. Organize, educate around prevention and support those infected and affected by HIV.

We can also support this important work with our prayers in spirit and our prayers in action. I invite you to pray with me in this struggle - as mothers and fathers, as sisters and brothers, as daughters and sons, as people, HIV-positive and HIV-negative and as people of faith for a cure.

An AIDS Walk or prayer vigil is public prayers in action. A health and education fair in your parish hall or diocesan convention is prayer in action. It isn’t often enough that people living with HIV know that God’s people are praying for them, particularly in a good way. It is my hope and prayer that we, the church, may give witness to God’s infinite love through our pray and presence. May we remain steadfast in our love for all of God people… May we be strong for those who are weak… May we claim the power that is given to us by God’s Spirit in baptism… And may we serve as Christ’s witness to the ends of the earth. There are people like Melissa, infected with the HIV virus, in all our Dioceses and congregations depending on the prophetic voice of the Church to share God’s love with them.

Let us pray:
God of mercy and Creator of all, we pray for those who are and will be infected with HIV, for all those who put themselves at risk, and for all those living with HIV and AIDS, their loved ones, and all caregivers and researchers, that from suffering, rejection and loss may come strength, compassion, and faith; and that we may be healed of fear and moved to give support to those in need, in the name of Jesus, the healer and friend of all. Amen.