AIDS at 25

Leslie Fulbright, San Francisco Chronicle, June 5, 2006

When AIDS emerged 25 years ago, it was branded a gay white man’s disease.

Millions of dollars poured into research and prevention efforts have reduced the number of diagnoses and deaths in the United States over the years. But that success hasn’t touched African Americans, many of whom have remained reluctant to acknowledge the disease’s impact in their community.

From the epidemic’s start, black people have been disproportionately likely to test positive for HIV, the virus that causes AIDS. African American men, women and children now account for 51 percent of new HIV diagnoses—up from 25 percent in 1985—and 55 percent of people dying nationally of AIDS, although they make up 13 percent of the U.S. population.

The black community’s high poverty rate contributes to this disparity, because poor people have less access to medical information, preventive health care and treatment, researchers say. Higher rates of sexually transmitted diseases also contribute because a person with genital lesions, for example, is more likely to contract HIV and a person carrying another disease in addition to HIV is more likely to transmit the HIV.

But AIDS activists, researchers and people with HIV say a much bigger factor has been the ongoing reluctance by many African Americans to address the disease at all.

More than 2 percent of all African Americans are HIV-positive, a higher incidence rate than in any other group, according to a federal analysis of cases between 1999 and 2002 cited by the nonprofit Henry J. Kaiser Family Foundation. Black women make up two-thirds of new HIV diagnoses among women, and black teens make up 66 percent of cases among youth.

African Americans are the only group experiencing a continuous rise in HIV infections, even though there is little difference from the rest of the population in how black people contract it.

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It wasn’t until 1999 that the first national conference explored AIDS as a black issue, even though it was the leading killer of African Americans ages 25 to 44 from 1990 through 2000.

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Black health advocates and community leaders say they often are asked to speak at schools and community gatherings on AIDS Day or during Black History Month, only to find the information they provide is not being incorporated in the community.

“People under 30 have no idea that this is the No. 1 killer and still tend to think they are invincible,” said Terrance Hodges, a 43-year-old Oakland resident who was diagnosed with HIV three years ago. “They don’t have a sense of fatalism and don’t think anything can stop them. I know because I was like that. And I practiced unsafe sex.

“Violence is much more of a reality among people of African descent than HIV.”

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