REPORTER: Former HHS Secretary Louis Sullivan is co-chair of the President’s Advisory Panel on AIDS. He comments on the spread of HIV among African-Americans.

Louis SULLIVAN: This is a virus that really has moved into a group of poor countries, and poor, not only economically, but also poor in terms of level of education. Because we know people who are most at risk are those who have few economic resources and have the least education. This is a virus or disease that really is best fought not only by having protective therapy drugs available, but also by having an informed citizenry. People have to know themselves that this virus exists, how is it transmitted, how do you protect yourself from it, because ultimately that’s how we are really going to win this war.

We’re hoping to develop a vaccine. That has not yet happened. Although when I was Secretary, more than 10 years ago, we were talking about the possibility of a vaccine. Hopefully we will develop a vaccine at some time in the future, but we have to be cautious because of the experience we have had thus far. So we have to work to educate our citizens, to urge them to undertake those things to protect themselves against infection. And when they do become infected, to immediately seek help so they can be put on the proper therapeutic regimen.

REPORTER: As you know, so many African-American communities are disgusted with the government, disgusted with the health care community. Do you think that adds to the problem?

Louis SULLIVAN: There is no question that disgust persists among the health care system. It does add to that. It makes people delay coming in for an evaluation or therapy, don’t follow instructions about what is needed. So we have to work to build that level of trust and understanding so that the health care system is seen as a positive adjunct for a good way of living. So that really is a responsibility that all of us in the health profession community has to see that African-American community, the Hispanic industry, and all minority communities also take advantage of the strengths that we have in our health care system -- come in early, get the right information, the right therapy, and follow the instructions. And we have to work on that because that is just as important as having the right drugs.

REPORTER: I guess it is eye-opening that so many African-Americans don’t know their status until –- don’t know that much about HIV until they’re told their status. And that speaks of your education issue that you were talking about. But I also wonder if it speaks to another issue, and that is -- especially among poor people who are African-American, HIV might not be at the top of the list. It maybe college, it might be something else, it may be getting food. So HIV and health are not at the top of their list.

Louis SULLIVAN: There is no question that poor people oftentimes time priority is having funds for the next meal, certainly having money to pay the rent. So those needs are very pressing issues if you are poor, and that mean that we, as a society, have to work harder to see that we eliminate poverty, we eliminate those needs. Because as long as we have a population that does have that as their first priority, we’re going to have health problems like this because of the fact that health becomes really so far down on the list of priorities. So, yes we have to work to see that we have well-educated population, we have to see that jobs are available so that people can earn dollars to support their families. Clearly, when that happens, health will assume a greater priority. Meanwhile, those of us in the health professions, have to do everything we can to educate the populations about the importance of health seeking (MS?).