Magazine article Newsweek

Battling a Black Epidemic; at Home: AIDS Now Threatens Tens of Thousands of African-Americans, Many of Them Women, in Big Cities and Small Towns Alike. A Community in Peril Tries to Save Itself

Magazine article Newsweek

Battling a Black Epidemic; at Home: AIDS Now Threatens Tens of Thousands of African-Americans, Many of Them Women, in Big Cities and Small Towns Alike. A Community in Peril Tries to Save Itself

Article excerpt

Byline: Claudia Kalb and Andrew Murr (With Sarah Childress, Mary Carmichael and Catharine Skipp)

It's a warm spring morning, and two dozen African-American women are gathered around a conference table at the Women's Collective in Washington, D.C. Easter is just a few days away, but nobody is thinking about painted eggs and bunny rabbits. The collective, less than two miles north of the White House, is a haven for HIV-positive women, and on this day the focus is on sex, condoms and prevention. "Our responsibility," says one woman in a rousing voice, "is to tell the truth!" Together, the women are on a mission to educate, empower themselves and stop the spread of the virus. Patricia Nalls, the collective's founder and executive director, asks the group to read a fact sheet about HIV and AIDS, a staggering array of statistics documenting the impact of the disease in the United States. "So now we know what's happening to us," says Nalls.

What's happening is an epidemic among black women, their husbands, boyfriends, brothers, sisters, sons and daughters. Twenty-five years after the virus was first documented in gay white men, HIV has increasingly become a disease of color, with blacks bearing the heaviest burden by far. African-Americans make up just 13 percent of the U.S. population but account for an astounding 51 percent of new HIV diagnoses. Black men are diagnosed at more than seven times the rate of white men, black females at 20 times the rate of white women.

Decades into the epidemic, scientists have made enormous strides in unlocking the disease at the molecular level. Understanding why HIV has taken hold of black America and how to prevent its spread has proved to be no less daunting a challenge. The root of the problem is poverty and the neglect that comes with it--inadequate health care and a dearth of information about safe sex. IV drug use, sexually transmitted diseases and high-risk sex (marked by multiple partners and no protection) have fueled transmission; homophobia and religious leaders steeped in moralistic doctrine have suppressed honest conversations about how to stop it. All the while, much of black leadership has been slow in responding, only recently mobilizing to protect its community. HIV, says Cathy Cohen, a political scientist at the University of Chicago and author of a book about blacks and AIDS, "is one of the greatest crises threatening the black community. It's the life and death of black people."

The crisis plays out in inner cities and rural towns alike, where money, education and access to good medical care are limited. Protecting against HIV isn't necessarily priority No. 1 among the poor. "If you're focused on day-to-day survival, you're not thinking about where to get condoms," says Marjorie Hill, of the Gay Men's Health Crisis in New York City. Alijah Burwell, 39, lives in a rundown 110-year-old clapboard house with seven family members in Oxford, N.C. Burwell, who was diagnosed with HIV eight years ago and has long had sex with both men and women, doesn't know which of his partners made him sick. "I had one too many" is all he'll say. But for several years after he was diagnosed, Burwell says, he continued to have sex, often unprotected. And he didn't tell the women that he was sleeping with men too. He also smoked crack and drank a lot. And though he sought treatment for HIV, he wasn't vigilant about taking his medication, spiking his viral load, which made him a greater threat to his partners.

The virus once referred to as "gay-related immunodeficiency disease" has become increasingly gender-blind, especially in the black community, where heterosexual transmission accounts for 25 percent of male infections and 78 percent of female infections. Men who have sex with men still account for almost half of all male cases, and last week the Centers for Disease Control and Prevention published data pinpointing two key risk factors for transmission: STDs--which facilitate infection--and low levels of testing among black men. …

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