The Changing Face of AIDS

Eradicating AIDS in the U.S. will require special attention for one community — and help from an unlikely source.

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Article created by The Century Foundation.

June 5 marked the twenty-fifth anniversary of the first reported cases of AIDS. And though fewer people are dying of AIDS as treatments improve, greater numbers of people are contracting the virus each year. In June of 1981, there were five confirmed cases of the disease. As of 2004, the cumulative estimated number of AIDS diagnoses in the United States was 944,306. So, the question is, Will the spread of AIDS have slowed down by the time we’re commemorating its fiftieth anniversary?

Until we can curb the rapid spread of the disease among young African-American women, at least domestically, the answer is no. According to the Centers for Disease Control and Prevention, HIV infection was the leading cause of death for African-American women between the ages of twenty-five and thirty-four in 2002, ahead of cancer and heart disease. In 2004, the AIDS diagnosis rate for black women was approximately twenty-three times higher than it was for white women. Most disturbingly, these numbers show no signs of slowing. HIV prevalence per 100,000 for black women increased by twenty percent between 1999 and 2002, according to a report published in the Journal of the National Medical Association.

So what can we do about it? Mark Harrington, executive director of the Treatment Action Group, said at a recent Columbia University symposium that young black women should campaign for national health care coverage. It’s a good point. Better insurance coverage would lead to earlier detection of AIDS and better treatment. People who know their HIV status as a result of early detection are less likely to transmit the disease to others. Also, despite the falling cost and greater effectiveness of AIDS medications, they are still prohibitively expensive for the growing numbers of poor people infected with the disease. At the same time, funding for the Ryan White Care Act, federal legislation that addresses the unmet health needs of people living with HIV/AIDS, has been static for the past three years, even as the number of people living with HIV/AIDS increases. Such a movement toward national health care coverage could address these inadequacies.

Yet while such a movement is necessary, it isn’t sufficient. Because HIV/AIDS is striking the African-American community in such large and growing numbers, managing the disease more successfully is not enough. In addition to health coverage and improved medication, we must find more ways to prevent the spread of HIV.

Phill Wilson, executive director of the Black AIDS Institute, says, “The only way for AIDS to be over in America is for AIDS to be over in Black America, and the only way to stop AIDS in Black America is for Black people to take ownership of the disease and mount a mass Black mobilization.” Although Wilson’s words are controversial, they are apt. And who better to spearhead such a campaign than young, black, female celebrities? The celebrity power of women like Eve, Halle Berry, Beyonce Knowles, Mariah Carey, and Alicia Keys, just to name a few, is soaring.

These women can carry on the legacy of community involvement and civic education as other celebrity activists—Arthur Ashe, Tony Kushner, Danny Glover, Magic Johnson, and Rosie O’Donnell—have done before them. Oprah Winfrey, for example, has a section of her website dedicated to AIDS in the United States, including CDC statistics and a “How much do you know about AIDS?” quiz that primarily targets middle-aged women.

This group of younger African-American celebrities could have a similar impact on at risk girls, especially in poor black neighborhoods where the effects of poverty—high levels of drug use, little adult supervision, lack of education and resources, and the exploitation of women—lead to some of the highest AIDS rates in the country. New York City, for example, has the highest AIDS rates in the country, with more AIDS cases than Los Angeles, San Francisco, Miami, and Washington, D.C., combined. In the Bronx, the poorest borough in New York City, where average household earnings are only 71 percent of the rest of the city’s, there are 7,917 women infected with HIV/AIDS. That figure is 60 percent higher than the New York City average.

Yet because sexual health is such a taboo subject, very few people talk about it even when the dangers are as high as they are. A celebrity could make an important impact by breaking the silence. In the month after Magic Johnson announced that he had HIV, the number of people tested for the virus in New York City increased by almost sixty percent. Similarly, imagine the effectiveness of an advocacy campaign spearheaded by Beyonce Knowles and Halle Berry encouraging young women to use condoms. Sixty-seven percent of African American women with HIV contracted it from heterosexual sex. A campaign to educate these young women would empower them to insist on using a condom. Then they would be protecting themselves against HIV as well as STDs and unwanted pregnancy.

Without the support systems that give African-American women the voice and power to demand that their partners wear condoms, AIDS rates will continue to rise disproportionately within this group. And unless the black community has positive female role models to speak to this endangered population and finally break the cycle of sexual silence, the main difference between AIDS at twenty-five and AIDS at fifty will be the even higher number of young black women infected with the disease.


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