WASHINGTON -- Seventeen years after AIDS was first recognized among gay white men in New York and San Francisco, the disease in this country is becoming largely an epidemic among black people, quietly devastating families and neighborhoods, yet all but ignored by leading black institutions.
Blacks make up 13 percent of the U.S. population. But they now account for about 57 percent of new infections with human immunodeficiency virus, which causes AIDS, according to the U.S. Centers for Disease Control and Prevention. Among people ages 13 to 24, the estimate, based on data collected from 25 states between January 1994 and June 1997, is even higher: 63 percent.
And while the death rate from AIDS is dropping overall, the disease remains the leading cause of death among black people ages 25 to 44. Dr. David Satcher, the surgeon general, said: "I don't think there is any question that the epidemic in this country is becoming increasingly an epidemic of color."
As thousands of AIDS experts gather in Geneva for the 12th World AIDS Conference this week, much of the attention is being focused on Africa, where HIV is so prevalent in some regions that one in four adults is infected. The situation in the United States is not nearly as dire. The recent demographic shifts in the domestic epidemic are due more to a sharp drop in cases among whites than an increase among blacks.
Nonetheless, as the racial disparities grow, many worry that AIDS will become minimized and perceived as just another inner-city problem like crime or drugs or graffiti.
AIDS services have not kept pace with the demographic changes. The lack of education about the disease among poor black people is profound, in large part because few prevention programs have been tailored to them. One prevailing myth is that Magic Johnson, the retired basketball star, has been cured. Another is that only gay men are at risk.
"There is still a disbelief that African-Americans are at risk," said Lisa Gray, who runs an AIDS education program for black women who live in public housing here. "A lot of people don't know how the virus is transmitted."
While ignorance is fueling the spread of the virus, public health experts such as Satcher complain that the epidemic has been greeted with silence by civil rights groups and by black preachers, long an important force in African-American society.
"I grew up in the black church," Satcher said. "I think the church has problems with the lifestyle of homosexuality. A real problem has been getting ministers that are even willing to talk about it in their pulpits."
The nation's two largest black civil rights groups, the Urban League and the National Association for the Advancement of Colored People, will hold their annual conventions this summer; AIDS is on neither agenda.
"It's outside of our traditional purview," said Lee Daniels, a spokesman for the Urban League. The NAACP, which recently declared AIDS a public health crisis, already has a health issue on its conference roster: cancer.
"It's exasperating," complained Rep. Louis Stokes, the Ohio Democrat who is chairman of the Congressional Black Caucus' health committee. The caucus recently asked the Clinton administration to declare AIDS a national public health emergency among blacks, a move Stokes said he hoped would rally civil rights leaders. "But," he said, "this is one that black leadership has shied away from."
"When you deal with AIDS you have to deal with all of the issues, all of the -isms of our community," said Rev. Kwabena Rainey Cheeks, 46, pastor of the Inner Light Unity Fellowship Church here. He has been HIV-positive for 14 years. "You can't touch AIDS and not deal with homophobia, drug abuse, homelessness. It touches all of the things that people don't want to talk about."
Those perceptions, however, can be misleading. Among black women, who represent 56 percent of the total AIDS cases among females, heterosexual sex has surpassed injection drug use as the most common route of transmission. Many have no idea they are at risk; often, they do not find out they are HIV-positive until they become pregnant, when testing is routine.
Pub Date: 6/29/98