HIV and AIDS in Black America: The Uphill Battle

What exactly is fueling the flames of the crisis in our community?

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By Kellee Terrell

In the fall of 1991, during a game of capture the flag in my eighth-grade gym class, the teacher told us to stop playing, get in two lines and be very quiet. She told us that a serious announcement was going to be made. A few minutes later, over the speaker system, the principal played a press conference that was on the news. Earvin "Magic" Johnson, star of the Los Angeles Lakers basketball team, announced to the world that he was HIV positive.

I was completely shocked. Growing up, all I "knew" about HIV was that it was a white disease, and a gay one -- except for Ryan White, who somehow contracted HIV through a blood transfusion. I was under the impression that this was not something that black people had to worry about.

Almost 20 years have passed since Johnson's public disclosure, and so much has changed.

The face of this epidemic in the U.S. is now one that resembles mine. AIDS is the number one killer of black women ages 24-35. Black men who have sex with men (MSM) have the highest HIV rate among all racial groups of MSM. Overall, while African Americans make up a mere 14 percent of the overall U.S. population, they account for more than half of all new HIV infections that are diagnosed each year. And to make matters worse, African Americans are more likely to be diagnosed with HIV and AIDS at the same time than any other racial group, meaning they're less likely to get tested until they're very ill.

Black AIDS Institute's chief executive and president, Phill Wilson, wasn't exaggerating when he said that "AIDS is the fire that is ravaging the black community."

So what exactly is fueling the flames?

There is no one answer. It's a combination of many factors: Poverty and economic instability. Institutionalized racism. Lack of quality health care, poor access to health care in general and mistrust of the medical system. Gender inequality and domestic violence. Homophobia. Intravenous drug use and the lack of needle-exchange programs. Poor health literacy. High rates of incarceration. Untreated sexually transmitted diseases, such as herpes and gonorrhea, which make people more vulnerable to contracting HIV. And people having unprotected sex while they're unaware that they are HIV positive, and who thus go untreated while they're highly infectious.

The slow response by the federal government has also played a role, as has a lack of funding. Thirty years into the epidemic, and it was only just last year that the U.S. government finally released a national HIV/AIDS strategy.

But most important, the black community's own slow response to the epidemic has had a profound impact. Minus a few exceptions, most black media publications, churches and community leaders set the tone early by turning a blind eye to HIV, believing that this epidemic was not their problem and that HIV was a moral issue as opposed to a public health crisis. In the end, we have all paid a price for their unwillingness to address the disease early on.

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