AIDS: Why are people of color hit so hard?

Last summer I finally got around to reading Edward Hooper's fascinating work, The River: A Journey to the Source of HIV and AIDS. First published in 1999, investigative journalist Hooper goes where scientists feared to tread, proposing alternative theories about how a little known virus transmuted into a global epidemic. The book elicited memories of Johnny R., a black Vietnam veteran who may have been my first AIDS patient. In an urban Catholic hospital serving the indigent in Philadelphia in the 1980's, we were not yet cognizant of AIDS. My colleagues and I watched Mr. R. waste away as we raced to try to figure out why. He was finally diagnosed with pulmonary aspergillosis, a wicked, invasive fungal infection that attacks people with immune system deficiencies. Despite our efforts and his will to live, Johnny died. I still have a picture of him, joking with Jolene, one of my coworkers, as he lay emaciated, with a large bandage covering the hole in his chest where the surgical team tried to excise the infected tissue.

Over the past 20 years, AIDS has continued to devastate lives and communities, and the number of people infected with HIV has proliferated to almost 40 million worldwide. The World Health Organization (WHO) reports 2.6 million new cases in the past two years. In March of 2005, a Lancet Infectious Disease brief by Marilynn Larkin reported that a significant percentage of black Americans believe that the US Government created AIDS to control the black population and was produced in a government laboratory. Researchers conclude that these beliefs and lack of trust prevent minority populations from feeling empowered and lead to a sense of fatalism, contributing to unsafe practices.

Clearly, people of color and minorities are hardest hit by the epidemic. Sub-Saharan Africa and South Asia reported 3 million new cases last year while the number of new cases in North America and Western Europe combined was under 100,000. In the US, blacks and whites account for 40% each of the reported AIDS cases. Latinos account for almost 20% of US cases but comprise only 8% of the total population. Only 12% of the US population is black, yet almost half of new AIDS cases were black people in 2005, while whites were 30%. Researchers at UC Berkeley have concluded this is due to the high percentage of blacks in prison. Other researchers report that 50% of prisoners engage in homosexual relationships, but distribution of condoms is illegal in most prisons. Condoms have been available in Canadian prisons for 10 years. Ralf Jurgens, JD states the case most succinctly in The AIDS Reader, "...a sentence of imprisonment should not carry with it a sentence of AIDS." We need to examine the justice of a world in which people of color are dying from an epidemic that can be prevented.

Image courtesy of wayfaring stranger

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