Sunday, April 22, 2007

HIV/AIDS

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.

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