Cynthia Davis, one of Los Angeles’ best-known AIDS activists, wrote to the leaders of 300 black churches inviting them to a summit last weekend on the worsening problem of HIV and AIDS in minority communities.

She heard back from five.

Then, a few days before the summit, Davis watched the vice presidential debate and was taken aback as Vice President Dick Cheney said he was “not aware” that black women are 13 times more likely to die of AIDS than white women. His Democratic challenger, Sen. John Edwards, ducked the issue, talking instead about AIDS overseas and health care in general.

To Davis, an AIDS researcher at Charles R. Drew University of Medicine and Science who has tracked the epidemic since its emergence two decades ago, the incidents were just more signs of how far HIV and AIDS have fallen from the national agenda.

In 2002, blacks accounted for half of all new AIDS cases, and Hispanics accounted for another 20 percent, according to the Centers for Disease Control. In the United States, AIDS kills more black men between the ages of 25 and 44 than any other disease.

While the virus is still most likely to be passed on by men who have sex with other men, more than a quarter of AIDS cases are now women, the vast majority of whom are black or Hispanic. According to the National Center for Health Statistics, black females aged 15 and above are 15 1/2 times more likely to die of AIDS than whites.

‘Nobody’s talking’

The dramatic protests demanding funding for AIDS research have become rare and, with a few notable exceptions, the glittering Hollywood parties raise money for other causes.

Federally funded campaigns once aimed at educating the general public are now targeted at a narrower group of people who already have the disease. And throughout society there is a misperception that new antiretroviral drugs have eliminated AIDS as a major public health threat.

“Nobody’s talking about it,” said Thomas Coates, a UCLA infectious disease specialist who was one of the first physicians to study AIDS in the 1980s. “I think people are tired of it.”

With as many as 950,000 Americans infected with the AIDS virus — and another 40,000 new infections each year — AIDS workers say they are confronting a level of ignorance and misconception reminiscent of the epidemic’s earliest days.

Despite more than two decades of educational campaigns, there are an estimated quarter-million people in the United States who have the disease but don’t know it, many of them in minority communities, which have become the new epicenters of the disease.

False lore has re-emerged: anti-retroviral drugs can prevent the spread of the disease, unprotected anal sex can be safe, AIDS drugs are killers.

“There’s a lot of misinformation,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. “It’s troubling. And it’s in many respects really disconcerting … we’ve been through a terrible period in our history and now we seem to be regressing back.”

Ignoring the warnings

Complacency about HIV and AIDS — a willingness to take risks that would have been unthinkable at the epidemic’s height — is the unhappy product of the success that doctors and public health officials have had in controlling the disease.

“In part, we’re being victimized by our success,” said Ronald O. Valdiserri, head of HIV programs for CDC. “There’s a perception that HIV or AIDS is no longer a big threat, so why bother” to use condoms or abstain from sex.

The threat has indeed come down in size. At the epidemic’s height, 140,000 people were diagnosed with HIV infections every year. Today, about 40,000 people per year are diagnosed. The number of deaths has plummeted from a high of 51,400 in 1995 to about 16,000 in 2002, largely due to the success of anti-retroviral drugs.

New strategy

Then, two years ago, the government changed its strategy for combating the spread of HIV.

Instead of focusing its educational campaign on the general population, the CDC decided to target people who already have the virus and teach them how to avoid spreading it.

The strategy is a proven public health approach to infectious disease control, and the CDC has invested considerable resources in testing programs designed to help people find out if they have been exposed to HIV.

But critics say the approach has also lessened awareness of the disease outside of the most impacted groups.

The number of new infections, bullishly predicted by the Bush Administration to drop in half by 2005, has been stuck for several years at about 40,000 per year. An additional 42,000 cases are diagnosed with full-blown AIDS each year.