Issues of race, poverty extend AIDS' toll on blacks everywhere

The Argument

The latest data show the dreadful impact on both Africans and African-Americans.

Books

July 25, 2004|By Victoria A. Brownworth | Victoria A. Brownworth,Special to the Sun

In 1981 the Centers for Disease Control (CDC) identified a new infectious disease, AIDS (acquired immune deficiency syndrome), which had appeared in a few dozen American men, mostly white, mostly gay. Within a scant few years, the number of deaths from the disease exploded from fewer than 100 to more than a quarter million, and the demographics were global -- no one was immune.

On July 6, 2004, the United Nations issued its latest report on the global AIDS epidemic. Dr. Peter Piot, the UNAIDS executive director, revealed grim statistics: more cases than ever, more than half of them in women, with outbreaks spreading through Asia and Eastern Europe. In the United States, the picture is equally bleak. After years of declining numbers of new cases, the disease is in resurgence, largely within the black community, in which more than 75 percent of new cases are found. Piot was unequivocal: "AIDS, without any doubt, is the largest epidemic in human history."

There are more than 38 million people infected worldwide. Last year 4.8 million became infected. Almost 3 million people a year are dying from AIDS. In the 21st century, the majority of the dying are black -- not just in Africa, where the disease is pandemic, but here in the U.S. In Washington, D.C., for example, the CDC estimates that one in 20 African-American men is infected with HIV -- a rate of infection comparable to areas of sub-Saharan Africa where AIDS has killed millions. AIDS is now the leading cause of death among African-American men and women between the ages of 15 and 44.

A series of new books chillingly details the escalating AIDS infection rate and subsequent death toll among blacks worldwide. Complicit in the spread of HIV / AIDS in America are, astoundingly, black church leaders, who have frequently linked AIDS to the "sin" of homosexuality and demonized those infected, and, less surprisingly, conservative politicians, who have taken a similarly moralistic tack toward the infectious disease.

The Invisible People: How the U.S. Has Slept Through the Global AIDS Pandemic, the Greatest Humanitarian Catastrophe of Our Time (Free Press, 400 pages, $25) tells the grim tale of how AIDS exploded better than any book on AIDS to date. Greg Behrman's eloquent history of the epidemic in the U.S. and Africa is compellingly written, thoroughly researched and peopled with dozens of characters important to the discovery of AIDS and the development of strategies to control it.

The book names names and lays blame. It is unstinting in its account of how epidemiologists worldwide brought news to the U.S. government of an epidemic rising in Africa and sneaking into the U.S. in the early 1980s and how the Reagan administration stood fast in its refusal to acknowledge that epidemic and its potential consequences. (Reagan never even spoke the word AIDS until 1985, when his friend Rock Hudson died of it.)

Reagan's refusal to address the impact of the disease in the U.S., where the infection rate rose cataclysmically within three years, or in the developing world, where the death rate has been devastating, was, as Behrman asserts with provocative detail, as much a factor in the spread of AIDS as unsafe sexual practices and drug use have been in the years since.

Many have mythologized Reagan since his recent death, but Behrman illumines Reagan's greatest failing as a president and world leader. Not only did Reagan ignore the epidemic, but his anti-gay rhetoric (and that of his administration) also presupposed that a coterie of gay men had brought the disease on themselves.

That position, which, Behrman explains, refuted scientific data about the concomitant heterosexual epidemic in Africa, actually fueled the epidemic worldwide by ignoring the possibility of heterosexual transmission. The subsequent AIDS policy of George Bush Sr. -- isolating the U.S. from that worldwide pandemic by making HIV status an immigration policy -- did nothing to address AIDS within U.S. borders.

The Clinton administration deemed AIDS the greatest terrorist threat to America, and the current administration has, like Clinton's, focused its attention on global AIDS, especially in Africa. But the Bush administration has reduced AIDS funding in the U.S., has refused to address the issue of price-gouging among pharmaceutical companies for life-saving AIDS drugs and has steadfastly focused on morality-based approaches rather than safer sex and safer drug-use education.

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