Black experts on AIDS are calling for new prevention and treatment programs tailored to minority communities in a refocused effort that they say is needed because of a distrust of government by many blacks.
At a conference in Baltimore yesterday, experts told the National Commission on AIDS that black community leaders have responded slowly to the epidemic, which has hit blacks in large ** numbers.
Of 3,099 AIDS cases in Maryland since 1981, more than half, 1,864, involve blacks.
Among the reasons for the slow response is that existing programs in black communities often aren't led by blacks and don't adequately address minority concerns and skepticism toward government, the experts testified.
The need for black-oriented programs is such that one witness asserted that a parallel commission or task force should be formed just for minorities. But Dr. Louis W. Sullivan, a commission member and U.S. secretary of health and human services, rejected the idea.
Sullivan, who is black, said "there is a lot of expertise and history on this commission," and suggested that the commission itself be improved if necessary. He didn't say, however, whether he thought changes were needed.
Sullivan acknowledged what one expert after another said -- that blacks distrust government when it comes to acquired immune deficiency syndrome.
Dr. Mark Smith, assistant professor at the Johns Hopkins Schooof Medicine, said that such distrust by blacks long predates the AIDS epidemic. He included among the reasons the infamous Tuskegee Study, begun in 1932 by the U.S. Public Health Service to study the untreated effects of syphilis on some 400 black men in Georgia.
Syphilis was allowed to run its course, until disablement and death in many cases, during the decades-long study exposed in 1972 by the Associated Press.
"So many of the people I work with do not trust hospitals or other providers because of the Tuskegee experiment -- if they did it then, they'll do it again," said Alpha Thomas, an AIDS activist with the Urban League in Dallas.
Smith said he has often heard that blacks in East Baltimore warned their children to stay away from the vicinity of Hopkins Hospital for fear the youths would be abducted and used in scientific or medical experiments.
Smith said another obstacle is that intravenous drug users -- a major transmission source of the HIV virus -- are not viewed sympathetically in drug-plagued black communities.
Fear of encouraging drug use makes it difficult to run clean-needle programs for addicts in black areas, Smith and others said.
Blacks also resent studies tracing the origin of AIDS to Central Africa, which suggests to some it's somehow the fault of black people, and are skeptical about "the motivation of the AIDS establishment," Smith said.
"Are they interested in the spread of AIDS because they're interested in us? Or are they interested in us because of the spread of AIDS?" he asked.
Whatever the causes of distrust, the experts said, black communities need their own programs, led by both new leadership sources and traditional ones such as churches.
"We need to be able to access levels of participation that allow the black community to understand it is a part of the solution -- not simply part of the problem," said Marie St. Cyr, a social worker from New York City.