Sunday, April 22, 2007


African Americans are well represented in many areas these days. We are leaders in business and education, have ownership in both the private and public sector, dominate sports (now with head coaches and franchise owners), have lead roles in cinema, and only comprise 13% of the United States population. Even in small numbers we have found a way to make our presence known and have a positive impact on society. So how is it that we make up only 13% of the US population, yet we account for approximately half of the more than one million people estimated to be living with the Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS)? Since the “discovery” of HIV/AIDS in the early 1980’s, 40% of all deaths among people with HIV/AIDS in the US have been among African Americans. Highly active antiretroviral therapy (HAART), an intricate, sometimes difficult, but effective treatment regimen is expensive, but has expanded the lifespan of people infected with the virus. This has also created the environment for HIV transmission as some individuals still continue to participate in unsafe practices despite known infection.

Let us look at the numbers collected by the Centers For Disease Control and Prevention (CDC) over the last 4 years (2001-2005). This data is based on information from 33 states with long-term, confidential name-based HIV reporting. African American women are the fastest growing population of HIV-positive people in the US, however, African American men continue to bear the greatest burden of HIV infection. In 2005, the rate of HIV diagnosis among African American men was seven times higher than that of Caucasian men, and more than twice that of African American women. Infection rates among African American women were more than 20 times that of white women. In our young African American brothers and sister, defined by the CDC as ages 13-24, we accounted for 61% of the HIV/AIDS diagnoses. Another shocking statistic is that there are 200-300,000 people in this country who are HIV positive and have not been tested. They are unaware of their infection, and for one reason or another have yet to be tested. Barriers to testing include poverty, lack of education and awareness, denial, and the social stigma placed on individuals that are diagnosed. Once considered a gay-white man’s disease, HIV/AIDS has become the greatest crisis facing African American men, women and young people today!

Transmission of HIV has been clearly identified and the major modes of infection are by unprotected sex, sharing needles with someone who is infected, blood transfusions (very rare now), and babies born to HIV infected mom’s during birth or through breast feeding after birth. I include substance abuse as a major risk factor because when someone is under the influence, the chance for him or her to indulge in risky behaviors increases. Health care workers and sometimes the patients are at risk of transmission and thus universal precautions and safety are a must in the hospitals and physician offices. HIV cannot be spread by casual contact (i.e. hugging, casual kissing, shaking hands). Dispelling these myths will decrease some of the negative attitudes and stigmata placed on individuals who are HIV positive.

There is some good news however. Even in the storm of rising HIV disease, there is no indication that the overall rate of infections in African Americans is increasing. Mother to child transmission has been significantly reduced, and there also has been increase use of condoms among young people and a decrease in risky sexual behavior.

In my opinion, there is nothing “positive” about being HIV positive. Once this diagnosis is handed to someone, his or her entire life changes. Negative attitudes, beliefs, and actions are directed at those living with HIV/AIDS despite the mode of transmission. Consider the 1980’s when blood transfusions where a major route of transmission. Now we have the unsuspecting mother/girlfriend/lover whose partner brings the virus into what was believed to be a monogamous relationship; or the unborn child who is infected by an HIV positive mom. Men having sex with men (MSM- the undercover brother or the down low brother) is getting more attention than the other common means of infection among African American men which are IV drug abuse and having unprotected sex with a woman who is HIV positive. For women, the most common ways of getting infected include having unprotected sex with an infected male and IV drug abuse. If you are unaware of your partner’s risk factors, have a sexual transmitted disease (STD), live below the poverty level, or have been incarcerated, your risk of HIV is higher.

Max Robinson, Eric “Easy E” Wright, and Arthur Ashe are not here anymore to be celebrity leaders, advocates, and spokes persons’ against this disease. All died from the complications of AIDS, but did live long enough to speak out against HIV. Magic Johnson is carrying the torch by himself in this celebrity role, but there are other organizations and individuals stepping up and speaking out. On December 1st of 2006, World AIDS Day, author/editor Gil Robertson, IV released his book Not In My Family: AIDS in the African American Community. This collection of powerful polemics, essays, and personal stories speaks to the lack of discussion and the denial in our community when it comes to addressing HIV/AIDS. You can read the words of Rev. Calvin Butts, Hill Harper, Jesse Jackson, Jr., Patti LaBelle, Mo’Nique, Sheryl Lee Randolph, and Dr. Jocelyn Elders, Rev. Al Sharpton, and Omar Tyree just to name a few. The CDC has several programs that are addressing HIV/AIDS across the nation including programs specifically targeting incarcerated men, gay and bisexual men, emergency rooms, and labor and delivery departments. The AIDS Drug Assistance Program (ADAP) spoke before congress in March of this year to address the lack of prescription coverage for the uninsured and underinsured. Individuals have died because they could not get/afford their medication. Whitney Breaux, sophomore at Louisiana State University and Miss Teen Louisiana has made over 100 hundred appearances educating teens and young adults on the ills of HIV. Phil Wilson, Executive Director of the Black AIDS Institute has an educational website that is constantly updated and addresses all realms of the disease. Phil is also a contributor to Not In My Family. I have personally seen the effects of HIV/AIDS on the south as southern states have been hit the hardest. Baton Rouge, my birth place and home suffers from the sixth highest AIDS case rate in the nation. Many HIV/AIDS residents, primarily African American, displaced by hurricane Katrina, have attempted to return to New Orleans or surrounding areas to find the necessities of housing, employment, and healthcare stable and fragmented. It was a “no brainier” when asked by Gil to contribute to his book.

More must be done to effectively address the impact of HIV/AIDS among African Americans men, women, and young people. Although prevention efforts have grown substantially over time and important progress has been made, major unmet needs remain. If this disease is killing “US”, then “US” needs to fight. ADAP, the CDC, Not In My Family, The Black AIDS Institute, and Whitney Breaux cannot fight this battle alone. It will take a nation wide effort.

© 2007 Rani Whitfield.

Saturday, April 14, 2007


We are under attack!

Well, our brains are for sure, and if African Americans don’t wake up we will ultimately perish from the disease that directly attacks the brain—STROKES! The month of May is Stroke Awareness Month and with the “stroke” of my keyboard I will give you the Power to End Stroke! Strokes are the third leading cause of death among Americans and a leading cause of disability and lost days of work among adults. They are more common among men, but kill more women each year. Strokes come under the umbrella of heart disease, which is the number one killer of all Americans no matter what race, gender, or ethnicity. Heart disease, which encompasses diseases of the heart and blood vessels, claims the lives of over 96,000 African Americans each year and account for 33% of all deaths among blacks in the United States. African Americans are twice as likely to die from strokes than Caucasian Americans and the rate of first strokes in African Americans is almost double that of Caucasians. So what’s up? What is a stroke, what are the risk factors, and what are the signs and symptoms? Why are African Americans so disproportionately affected? What are the myths about stroke and how do we combat this disease? Ready? Let’s roll!

Strokes, also called “brain attacks”, occur when blood flow to the brain is suddenly interrupted. In other words, no flow-no go. There are two major causes of stroke: ischemic (is-keem-ik) and hemorrhagic. Ischemic strokes are the most common types of stroke and are caused by blockages in an artery that supplies blood to the brain. These blockages result from cholesterol deposits that narrow the arteries; a blood clot forming in an artery (thrombus); and from clots originating somewhere else and lodging in an artery (embolus). Hemorrhagic strokes occur when a blood vessel in the brain weakens and burst, allowing blood to spill out into the very restricted space between the brain and the skull. In both types of stroke, the blood flow is decreased and some part of the brain is damaged. The ability to walk, talk, speak, swallow, and even breathe normally can be affected.

Risk factors, which are the things that increase your chances of having a stroke, include things that we can and things we cannot control. The risks factors that we have control over are smoking, high cholesterol, high blood pressure or hypertension, diabetes, physical inactivity, and obesity. The risk factors that we cannot control include age, a family history of heart disease/stroke, race, and gender. Being active has tremendous benefits, and if coupled with health eating and proper rest one can: control his/her weight, improve cholesterol levels and blood pressure, prevent bone loss, boost energy levels, improve stress levels and improve overall self image. The risk for stroke increases as we get older. African American men develop heart disease and develop it earlier, but women close that gap after age 55. Also remember that if a family member, especially your parents, brothers, or sisters have heart disease, you are at increased risk as well. So know your family history. Even though you cannot control that, it will help you and your physician make better choices about the way you should live.

Everyone, including family and friends, should know the warning signs of stroke. By knowing them you can significantly reduced the long-term effects of a stroke and possibly save someone’s life. The warning signs include: a sudden numbness or weakness of the face, arm, or leg, especially on one side of the body; sudden confusion, trouble speaking, or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; and sudden severe headache with no known cause.

Medicine and research have not clearly delineated why African Americans are more at risk than other ethnic groups, but we do know that high blood pressure is the number one risk factor for stroke. One in three African Americans has high blood pressure/hypertension. Diabetes also runs rampant in the African American community and is also a major risk factor for strokes. There is also a special population of African Americans, those with sickle cell anemia, who run a high risk of stroke. All patients with risk factors should see a doctor on a regular basis, eat healthy, exercise, and of course take there medicines as prescribed.

The myths about stroke need to be stated and cleared up now. Some believe that strokes are unpreventable. That is absolutely not true. Taking charge of your health and establishing a relationship with your doctor is one important step in stroke prevention, along with life style modifications like exercising, losing weight, smoking cessation, and controlling your blood pressure and diabetes. Some also feel that strokes cannot be treated and that they only happen to the elderly. Wrong again! Strokes can happen to the young and old, and if the warning signs are recognized, a stroke can be treated with very little disability. There are also those that believe that once a stroke has occurred, there are only a few months of recovery. This is also not true. Stroke recovery continues throughout life and it is possible to regain bodily function when working in conjunction with your primary care doctor, specialist (such as neurologist and physiatrist) and the treatment team that include speech therapist, occupational therapist, physical therapist, and social workers.

We can take control of our health! We must learn the risk factors for heart disease and stroke, see our doctors on a regular basis, learn our family history, exercise, eat healthy, stop smoking, and take our medicines as prescribed to control diabetes and high blood pressure. We have the power! You have the power! Together we have the power to end stroke!

For more information on disparities in health care visit,

© 2007 Rani Whitfield. Published April 2007 at