Very good article covering issues relating to stigma, racism, and homophobia nationally but especially here in the South.
Black men in focus in U.S. HIV drug trial
By Matthew Bigg
Reuters
Tuesday, January 9, 2007; 10:48 PM
ATLANTA (Reuters) – AIDS research in the United States has often focused on gay white men because the virus was identified early in that group and they developed an effective lobbying voice.
But a clinical trial by the AIDS Research Consortium of Atlanta is focusing on gay black men, who are not as well organized but who have a higher incidence of the disease.
The trial aims to determine whether an AIDS drug is safe for people who are negative for HIV, the virus that causes AIDS. It has stirred debate among participants and researchers about gay sexuality within the black community and its attitude to safe sex.
“The black gay community has become complacent about HIV and STDs (sexually transmitted diseases) as a whole,” said Duncan Teague, recruitment coordinator for the project.
“A lot of people in the black gay community are looking for love so they have sex because they think that means that that person loves them,” Teague said.
Blacks make up around 12.8 percent of the U.S. population but comprised 50 percent of new diagnoses of HIV in 2003, according to data from the Centers for Disease Control and Prevention and the U.S. Census Bureau.
In Georgia, 78 percent of people diagnosed with AIDS and 81 percent of people diagnosed with HIV in 2005 were black, as were almost all of the women who were newly diagnosed, said Melanie Thompson, the trial’s lead investigator.
“African-American men are disproportionately affected by HIV and underrepresented in clinical trials. We are testing in order to know whether a drug is safe for the people who will ultimately use the drug,” she said.
“While the study is open to men of any race, we are working hard to enroll as many men of color as possible,” she said.
The trial involves giving daily doses of the drug tenofovir, an anti-retroviral drug made by Gilead Sciences Inc. and marketed as Viread, to men.
Participants, who could also be given a placebo, complete a computerized questionnaire about their sex lives and get risk-reduction counseling and condoms at every visit.
TUSKEGEE EXPERIMENT
As a control, half the group don’t receive the drug for the first nine months to see if taking a pill that might potentially make them less likely to contract HIV might encourage men to take more risks with sexual health.
It’s part of a long-term project that includes similar studies in Botswana and Thailand and elsewhere to determine if a drug that suppresses the AIDS virus could one day be used as a prophylactic to prevent people from contracting it.
Researchers said one reason for the reluctance of blacks to participate in the study is the legacy of the notorious 40-year-long Tuskegee experiment, which was exposed in 1972 and led to an apology by President Bill Clinton on behalf of the government to the victims.
In that experiment, the U.S. Public Health Service starting in 1932 told 400 blacks with syphilis in Alabama they had “bad blood,” leaving the syphilis untreated to study its long-term effects on the body.
Some 43 percent of men enrolled in the AIDS drug study are black but many others were reluctant to take part because of misunderstandings about what the study entails and fear within the black community about clinical trials, Thompson said.
“My first question was ‘Wait, are you going to inject me with the HIV virus?,”‘ said Dorrington Poitier, who is now taking part.
Atlanta is considered by some the gay capital of black America and gays organize an annual gay black pride festival on the Labor Day weekend.
Despite the large numbers of at-risk men, researchers said lack of organization within the gay black community had made it harder to promote awareness and mobilize against AIDS, which in addition had killed some community leaders.
“AIDS has sucked so much energy out of the community. The leaders started dropping dead, started getting sick. And we have been trying to replace them but against the odds,” Teague said.
Another underlying reason for the prevalence of HIV infection was the stigma still attached to homosexuality within some parts of the black community, which left some gay men vulnerable to a degree of social isolation that made poor choices on safe sex easier.
“People within the black community say: ‘It’s fine to be gay but … don’t wear it on your sleeve. They see black as something you can’t really hide but they don’t want you to be gay in public,” said Anthony McWilliams, a project organizer.
Filed under: Africian American, Georgia, HIV Treatment, HIV/AIDS Stigma, The South and HIV
http://kellylowenstein.wordpress.com/2009/02/07/jacob-levenson-on-aids-in-americas-black-community/
Jacob Levenson on AIDS in America’s black community.
February 7, 2009 · No Comments
Jacob Levenson discusses the rise of HIV and AIDS in black America.
Today is National Black HIV/AIDS Awareness Day, and it is sorely needed as the virus has had a devastating effect on the nation’s black communities.
The Chicago Reporter, the publication where I work, dedicated its entire January/Feburary issue to the subject of HIV and AIDS in Illinois’ black community.
The news was mixed.
On the one hand, the state has dedicated an increasing amount of resources to combat the epidemic-the total of federal and state spending has risen from $45 to $73 million from 2003 to 2007-and has also created two separate funding streams to combat the virus among the state’s black residents. A third funding stream, the Red Ribbon Lottery Ticket, in which a percentage of revenue from lottery tickests is set aside for black non profits, was created last year.
On the other hand, though, the state has set aside a lower percentage of money to prevention for black people-this figure dropped from 46 percent in 2002 to 30 percent in 2007-and has also not identified funding outside of Chicago for that part of the community that is hardest hit by the epidemic, men who have sex with men.
It is important to note both that HIV and AIDS is not an exclusively gay disease, that the rates of infection are going up among black women, and, at the same time, that the number of cases is highest among men who have sex with men of all different races.
During the period from 2003 to 2007, the percentage of black people who have been diagnosed with the virus has been greater than 50 percent, far greater than the 15 percent of the state’s population that is black. During that time, too, men who have sex with men have been the largest risk factor and a growing share of those people who are diagnosed with the virus.
These findings are consistent with national data, which show African Americans highly overrepresented among people living with the virus and struggling as a community to get resources into organizations that can effectively combat the epidemic.
Jacob Levenson has explored how the virus spread among black America as well as the reasons why meaningful support has been slow in forthcoming in The Secret Epidemic: The Story of AIDS and Black America.
Levenson is a former student of master teacher Samuel G. Freedman, the Columbia University professor considered by many to be the top long-form narrative journalism educator in the country, and the work bears the imprint of having been in Freedman’s class.
The Secret Epidemic is rich in individual characters who illustrate the book’s broader points, sections that provide background and context, and a narrative arc that begins and end with the same family.
Levenson argues that many factors have contributed to the rapid spread of the virus among black communities. He talks at length about the incease in crack cocaine and heroin use during the ’80s and the role sharing needles played in the virus’ making inroads in the communities.
Post World War II housing policies, often known as urban renewal, that led to residents of poor communities of color living in extremely close proximity to each other, get attention, too. To his credit, Levenson also talks about the spread of the virus in more rural southern black communities, where the housing policy part of his analysis does not apply as much as in urban centers.
Levenson also takes political and scientific leaders to task for their ignorance about, and indifference to, the virus’ growth in black communities.
The black church, with its repeated pronouncements about homosexuality and often tepid embrace of all members of the community, comes in for scrutiny, as does the role of individuals’ behavior, even though the public health community was less willing to directly confront the potentially controversial issue of why it was so difficult to change black people’s sexual behavior.
Close to three quarters of the way through the book, Levenson summarizes the reasons in the following section:
“The causes of the AIDS epidemic in black America cannot and should not be reduced to urban renewal, public housing policy, the fires that devastated the Bronx, or contagious housing destruction. The set of forces that fueled the spread of the virus through the African American population clearly also included such complex factors as the nuances of black sexuality, the architecture of the drug wars, gaps in the CDC’s prevention and surveillance plan, the crack and heroin scourges, the contours of black church culture and the aftermath of the great southern black migrations.”
This quote encapsulates the value and limitations of the work.
On the one hand, the list of reasons is extensive provides insight into the multi-faceted nature of the virus’ growth. On the other hand, though, the items on the list, their relative importance and their linkages are not explored in particular depth. As a result, The Secret Epidemic does little more than surface issues, which, while a contribution in itself, does not truly offer an analysis or argument about its subject.
The individual stories suffer from much of the same problem.
While engaging enough on their own right-Levenson displays some powers of description, scene setting and attention to detail throughout the book-they don’t connect meaningfully with the myriad of reasons Levenson offers to explain the epidemic.
The book has some minor factual errors-the University of San Francisco men’s basketball team is listed as winning the national championship in 1959 and 1960 when they actually won in 1955 and 1956-and Levenson operates on an unfortunately narrow and inaccurate racial axis. In his final sentence, for instance, he writes about whether “member of both races” are willing to make the changes necessary to stop the epidemic as well as social conditions in urban and rural America.
While the question is a valid one, his omission of all other racial or ethnic groups-enter here Latinos and Asians, for starters-seems to be a glaring one as both groups have been hard hit by the virus and deal with many of the same issues Levenson describes black America contending with on a daily basis.
As a result, The Secret Epidemic, while perhaps an important first step in chronicling the rise of HIV and AIDS in the black community, is just that-an initial look. Readers looking to get a basic orientation to the issue may feel rewarded; those looking for a more exhaustive or comprehensive look may well be disappointed.