As we enter the twenty-first century, AIDS in America has become primarily a black disease. African Americans now constitute 50 percent of all new HIV cases, and AIDS is one of the top causes of death in young black men and women. The story of how this came to pass reaches across half a century, from the Great Migration north to the boom of the postwar era and the subsequent urban decay, the advent of heroin and crack, and the rise of the new South.

In The Secret Epidemic, Jacob Levenson tells this story through the experiences of the people at its center. Mindy Fullilove, one of the first black researchers to investigate the roots of the epidemic, leads us from San Francisco to the early appearance of the disease in Harlem and the South Bronx. Desiree Rushing must reconcile her crack addiction and HIV infection with the fate of her city, family, and the black church. Mario Cooper is a gay son of the black elite who becomes infected, works to mobilize the Congressional Black Caucus and the Clinton White House to respond to the epidemic, and eventually confronts the boundaries of American race politics. And David deShazo is a white social worker thrust into a hidden, rural black world in the heart of the American South, where he struggles to prevent the spreading epidemic and help two infected black sisters survive with the disease.

Interweaving personal stories and national policy, the legacy of discrimination and the battle for civil rights, sexuality and the role of the black church, this is a significant book for our time -- a portrait of a devastating epidemic and an examination of our changing understanding of race in America.