AIDS is a disease that has had a disproportionate effect on African Americans. While there has been significant progress in the treatment of people with HIV infection, there are obstacles to the optimal treatment of African Americans, such as distrust of the medical system, cultural differences between patients and providers, and institutional racism. To optimize treatment of African Americans with HIV/AIDS, health care providers must learn more about cultural issues that impact treatment. The goals of treatment for African Americans with HIV infection are the same as those for all patients: maintain durable suppression of HIV replication, prevent resistance, support optimal immune system function, extend AIDS-free survival time, maximize adherence to antiretroviral regimens, and improve quality of life.