Phill Wilson, executive director of the Black AIDS Institute, utters five words that send people into a frenzy: AIDS is a black disease.
"Everytime I say 'AIDS is a black disease,' it irks everyone," he explains. "Whites call me racist, and blacks say, 'You have stigmatized us. We're not the only people with AIDS.' "
Wilson says critics from both camps miss the larger point. He is trying to rally the black community to confront the raging epidemic, he says.
"What's more disturbing is there are so many people more concerned about what other people think of us than whether we survive or not," he says. And because the African American share of AIDS diagnoses has nearly doubled from 25 percent in 1985 to 49 percent in 2006, some white AIDS organizations fear that funding will now shift from them to black groups, Wilson says.
There is no question that African Americans are disproportionately represented among the ranks of those with HIV and AIDS:
Though blacks represent only 13 percent of the population, nearly 50 percent of all people living with HIV, the virus that causes AIDS, are African Americans.
Although black teens represent only 16 percent of U.S. teenagers, they account for 69 percent of all new AIDS cases among teens.
A recent study in five major cities found that 46 percent of black men having sex with other men were infected with HIV, compared with 21 percent of white men in the same category.
AIDS is the leading cause of death among black women between ages 25 and 34 and the second-leading cause of death in black men between 35 and 44.
To dramatize the depth of the virus on African Americans, the Black AIDS Institute released a study titled "Left Behind," which paints a portrait of what black America would look like if it were a separate country.
With nearly 39 million people, black America would be the 35th most-populous country in the world. It would have the 28th largest economy in the world.
In life expectancy, black America would rank 105th (73.1 years, 5.2 years less than U.S. whites), lower than in Algeria, Dominican Republic and Sri Lanka. The infant-mortality rate of blacks (13.6 per 100,000 live births) is twice as high as the rate in Cuba and considerably higher than the rates in Belarus, Bosnia and Herzegovina, ranking 88th.
With a poverty rate of 24.3 percent - a rate three times higher than for whites - blacks are substantially more impoverished than any of the 27 countries in the European Union. Black unemployment, at 8.6 percent, is higher than joblessness in Laos, the Philippines and Russia. One-tenth of blacks are incarcerated, with more blacks in prison than in every country but the United States, China and Russia.
A freestanding black America would rank 16th in the world in the number of people living with HIV, exceeding the HIV population of such heavily affected countries as Botswana, Swaziland and Ukraine.
There are more black Americans infected with HIV than the total population in seven of the 15 countries in the President's Emergency Plan for AIDS Relief (PEPFAR), a program that devotes $3 billion a year to the countries hardest hit by HIV.
Some worry that not enough money is being spent at home.
"Over the last five years, the White House and Congress have increased spending on HIV prevention, treatment and support programs for low-income countries dramatically - at the same time that domestic spending has remained all but flat," according to the Left Behind study.
For example, PEPFAR spending increased 46 percent in 2007 as domestic spending on AIDS increased 2.5 percent. This year, global funding is expected to increase 34 percent, while domestic funding will rise only 1.2 percent.
Any effort to lower the prevalence of HIV/AIDS in the United States must take into account the different ways black men and black women get infected. Of black men living with HIV, 49 percent were infected as a result of having sex with other men; 22 percent from women; 22 percent from injection drug use; and 7 percent from a combination of drugs and having sex with other men.
The overwhelming majority of black women - 75 percent - were infected by having sex with men; 23 percent from drug use; and 2 percent from other causes.
Wilson says he will continue calling AIDS a black disease: "I think it's better if they think ill of us and we're alive, instead of thinking well of us and we're dead."