As 25,000 global experts descend on Washington, D.C., this week for the first International AIDS Conference in the United States in 22 years, they face some sobering statistics: 3 percent of all residents in the nation's capital are infected with the HIV virus.
And with 7 percent of all black males HIV-positive, the city has a higher infection rate than African countries like Ethiopia, Nigeria and Rwanda.
The world might be winning the war on AIDS -- 2.7 million had HIV in 2010, down from 3.2 million a decade earlier -- according to UNAIDS, but the United States, alongside Eastern Europe, still sees new infections.
Nearly 1.2 million Americans are now living with HIV/AIDS, an all-time high, with nearly 50,000 new infections every year, according to the Centers for Disease Control and Prevention.
Even with last week's FDA approval of the preventive drug Truvada and antiretrovirus therapies that have virtually eliminated the transmission rate from mother-to-child, a large U.S. population has not reaped the good news.
African-Americans, who represent 14 percent of the U.S. population, account for the largest group, or 44 percent of all new HIV infections and deaths in 2009, according to the Foundation for AIDS Research.
"There is still no cure for AIDS and the fact that we have reduced transmission rates has generated a lot of excitement," said Gail Wyatt, associate director of the UCLA AIDS Institute.
"Our challenges have to do with disparities we have always seen between those who can afford health care and those who are not in the health care system," she said. "We are talking about affordable care and who gets treatment and which populations are disenfranchised and have not gotten care and have no insurance. The same issue has not gone away with the availability of new treatments."
Overall, African-American men represent 70 percent of all new infections in that group, a rate six and a half times that of Latino men or black women, according to the Foundation for AIDS Research.
The rate for heterosexual black women was 15 times the rate of white women and more than three times that of Latinas.
Some say America has a lot to learn from Africa in the fight against HIV/AIDS. But Wyatt argues that little attention has been paid to the U.S. crisis.
"An important point is that we are outsourcing our funds to Africa to stem the tide thousands of miles away, while we ought to provide the same concentrated efforts in America," Wyatt said. "Our policies need to take care of those at home and not be siphoned off."
The biggest obstacle has been getting those who are most at risk tested. African-American communities are plagued with the highest unemployment and crime rates and the fewest number of health resources.
"You need to create a different system to testing people, to make them feel comfortable being tested," Wyatt said. "When the [AIDS epidemic] first started, there was no need to get tested because there was no treatment. There were no clinics available or doctors they know or are comfortable with. These are barriers to care in a vulnerable community."
The highest infection rate is among men 13 to 29 who have sex with males, according to the CDC.
"It's an extreme concern and it's been overlooked for a long time," said Wyatt's colleague, Dr. John Williams, a professor of psychiatry at UCLA's AIDS Institute.