By William J. Cromie
Once considered a white epidemic in the United States, AIDS has now changed color.
From 1985 until 1996, whites accounted for the highest percentage of AIDS infections, but the line was crossed in 1996. Cases among whites dropped from 60 percent of the total in 1985 to about 35 percent in 1997. Among blacks, cases have almost doubled, from about 25 percent to 45 percent, in the same period.
During 1996 and the first half of 1997, the incidence of AIDS fell for the first time in this country. But it didn't fall equally. In 1996-97 AIDS among whites dropped 23 percent, but among blacks it decreased only 5.6 percent.
These statistics were brought out during a two-day meeting at Harvard this week called "The Untold Story: AIDS and Black Americans." It was cosponsored by the Harvard AIDS institute, the Kaiser Family Foundation, and Leading for Life, a black activist organization.
At a press conference in conjunction with the meeting, Henry Louis Gates Jr., director of the W.E.B. Du Bois Institute for Afro-American Research, summed up the situation this way: "While blacks make up only 12 percent of the U.S. population they account for almost half of the cases of AIDS."
Helene Gayle of the Centers for Disease Control and Prevention (CDC) noted that new drugs have been cutting down the death toll from AIDS. Again, the cut is uneven. Among whites, deaths decreased 32 percent, while among blacks they fell only 13 percent. AIDS deaths among Hispanics are down 20 percent.
The numbers are especially bleak for black women and children. A survey conducted by the Kaiser Family Foundation and released at the meeting concludes that black women represent the highest percentage (56 percent) of all AIDS cases reported among women, and an increasing proportion of new cases (60 percent). Fifty-five percent of new infections with the AIDS virus among 20- to 24-year-olds occurs among blacks.
Among those between the ages of 24 and 44 years, three times as many black as white men died of AIDS in 1996. Five young black women died for every white woman in the same year, the latest for which full-year data in available.
The CDC also reported that black children currently account for 58 percent of the AIDS cases among newborns, compared to 18 percent for whites, and 23 percent for Hispanics.
Needle Exchange Favored
Most women, black and white, have contracted AIDS either through illegal drug use (about 45 percent) or heterosexual contact (about 38 percent). Many of the latter cases are due to having sex with men who have gotten the disease from contaminated needles.
CDC statistics show that 22 percent of all AIDS infections among men were caused by dirty needles. Black males account for 36 percent of such cases.
To reduce this toll, about half of the 811 black adults in the Kaiser survey favor programs that offer clean needles in exchange for used ones. Those who oppose these programs do so because they fear it will increase drug use by sending a message that it's okay to use illegal drugs.
"That point of view is not supported by scientific research," noted Sophie Chang of the Kaiser Family Foundation.
According to the Kaiser survey, more than half of blacks believe (wrongly) that AIDS is the nation's leading health problem. However, that idea has helped shape an increased concern about the problem and has spurred more people to take action.
One in every two blacks has been tested for infection with HIV -- the AIDS virus -- compared with 38 percent of all Americans. Among blacks younger than 30 years the testing rate is 65 percent. Most of the testing was done during the past 12 to 18 months.
Most of the blacks surveyed (66 percent) say the government spends too little money on AIDS. They also want more practical help with everyday questions such as where to go for help if exposed to the HIV virus, and what they should tell their kids about AIDS prevention.
Gayle of CDC called this a hopeful turn of events. "AIDS, after all, is a preventable epidemic," she said. "It can be prevented by the right behavior."
Professor Gates feels that black leaders should play a stronger role. "We're at war with a terrible disease, but it's not galvanizing our leaders," he said. "They don't know how to deal with this epidemic."
The Kaiser survey determined that most blacks get their information about AIDS from the media, particularly television. Gates noted that black journalists and entertainers should be playing a larger role in informing black Americans about how to deal with the epidemic.
Mario Cooper of Leading for Life agreed with Gates. "We don't need more studies," he said. "We know what needs to be done. We need our leaders to lead."
Copyright 1998 President and Fellows of Harvard College