The AIDS menace has shifted ground over the years in New York. Now it is affecting people of color.
The majority of people living with AIDS in New York are people of color. African-Americans are eight times as likely to have HIV as whites, and Hispanics are more than four times as likely to have the virus. Heterosexual black and Latina women's rates are the worst of all. Yet awareness of the danger is slow to penetrate. The Gay Men's Health Crisis (GMHC), founded in 1981 to combat the AIDS epidemic among gay and bisexual, mostly white and middle-class, men, now has a clientele that is mostly people of color.
Ron Johnson, Director of Public Information for GMHC, just got back from a trip to Africa, where the AIDS epidemic rages among heterosexuals, and has already left 10 million children orphans. He knows of the dangers of heterosexual transmission well, and speaks of the special peril facing minority populations.
"From day one, AIDS disproportionately affected blacks and Latinos," Johnson says. "They suffer from higher infection rates, and develop full-blown AIDS at higher rates" than white populations.
The reasons for this are manifold. First, says Johnson, prevention messages were not targeted to the black and Latino communities. "There was some racism involvedĂ‘the same attention was not afforded them. There was also discrimination against substance usersĂ‘you don't have people advocating to save the lives of substance users. And when a heroin addict dies, that's not news."
In addition, Johnson noted, many gay men of color don't identify or think of themselves as being "gay." "Sex" is something you have with a woman; you "mess around" with men. Denial, drug use, the cultural stigma of homosexual behavior in "macho" society, and racism and neglect in the larger society have combined to create a terrible problem in preventing and treating AIDS in minority communities.
But the fastest-growing rates of all are not among gay or bisexual men, but among young women of color. According to Johnson, "there is a very serious problem with teenage girls. Their rates of infection are higher than among the teenage boysĂ‘that suggests they're not having sex with their peers, they're having sex with older, infected men." And stark statistics show that AIDS is the leading cause of death for black women from ages 25 to 40. "Heterosexual transmission surpassed drug use as the infection source for women 3-4 years ago."
A big problem, he says, is the myth that heterosexual men can't get AIDS from women. "They firmly believe it. Also, there are numbers of closeted bisexual men in the black and Latino community." To make matters worse, he adds, it is often difficult for black and Latino women to negotiate matters of sex with men, such as condom use.
GMHC is approaching the problem directly, both by offering its array of prevention, treatment, and counseling services to minorities, and by reaching out to the black and Latino communities in the city. Soul Food targets black gay men, and Troyecto PAPI is a prevention program for Latinos. GMHC also has a youth initiative that works with young people of color, teaching them about prevention and risk factors, improving their judgement. All these programs work to build the participants' self-esteem and sense of community.
GMHC programs targeting the minority communities in the City have provided AIDS educational programs for the past five years, and client services such as case management, free meals, nutritional counseling, short-term mental health counseling, child care for women, group counseling, and home visits by "Buddies."
Gail Sounds Off:
The one group that has not been strongly or directly addressed by government or private agencies in the war against AIDS is heterosexual men. "No one is talking to heterosexual men," says Johnson. "That's been my pet peeve for 14 years!" Why aren't they? "No one wants to tackle the resistance."
Yet the example of Africa, where the AIDS virus nearly always transmitted by heterosexual contact, and men most certainly get the disease and die of it, is a clear warning that more attention must be paid to debunking the myths that straight men can't get HIV from women or from young women. Men need to be educated about their responsibility for not passing the infection on to others. And everyone needs to learn about risk factors, dangerous behavior, prevention measures, and treatment options.
As long as there are at-risk groups who deny their vulnerability to the disease, there will be a reservoir of the virus among us. Luckily, AIDS is hard to contract, and prevention is very effective. But effective prevention will mean a change of attitude in all the population at risk, which is all of us.