
Phill Wilson, executive director of the Black AIDS Institute, utters
five words that send people into a frenzy: AIDS is a black disease. "Everytime
I say 'AIDS is a black disease,' it irks everyone," he explains.
"Whites call me racist, and blacks say, 'You have stigmatized us. We're
not the only people with AIDS.' " Wilson says critics from both
camps miss the larger point. He is trying to rally the black community
to confront the raging epidemic, he says. "What's more disturbing
is there are so many people more concerned about what other people
think of us than whether we survive or not," he says. And because the
African American share of AIDS diagnoses has nearly doubled from 25
percent in 1985 to 49 percent in 2006, some white AIDS organizations
fear that funding will now shift from them to black groups, Wilson says. There is no question that African Americans are disproportionately represented among the ranks of those with HIV and AIDS: Though
blacks represent only 13 percent of the population, nearly 50 percent
of all people living with HIV, the virus that causes AIDS, are African
Americans. Although black teens represent only 16 percent of U.S. teenagers, they account for 69 percent of all new AIDS cases among teens. A
recent study in five major cities found that 46 percent of black men
having sex with other men were infected with HIV, compared with 21
percent of white men in the same category. AIDS is the leading
cause of death among black women between ages 25 and 34 and the
second-leading cause of death in black men between 35 and 44. To
dramatize the depth of the virus on African Americans, the Black AIDS
Institute released a study titled "Left Behind," which paints a
portrait of what black America would look like if it were a separate
country. With nearly 39 million people, black America would be
the 35th most-populous country in the world. It would have the 28th
largest economy in the world. In life expectancy, black America
would rank 105th (73.1 years, 5.2 years less than U.S. whites), lower
than in Algeria, Dominican Republic and Sri Lanka. The infant-mortality
rate of blacks (13.6 per 100,000 live births) is twice as high as the
rate in Cuba and considerably higher than the rates in Belarus, Bosnia
and Herzegovina, ranking 88th. With a poverty rate of 24.3
percent - a rate three times higher than for whites - blacks are
substantially more impoverished than any of the 27 countries in the
European Union. Black unemployment, at 8.6 percent, is higher than
joblessness in Laos, the Philippines and Russia. One-tenth of blacks
are incarcerated, with more blacks in prison than in every country but
the United States, China and Russia. A freestanding black America
would rank 16th in the world in the number of people living with HIV,
exceeding the HIV population of such heavily affected countries as
Botswana, Swaziland and Ukraine. There are more black Americans
infected with HIV than the total population in seven of the 15
countries in the President's Emergency Plan for AIDS Relief (PEPFAR), a
program that devotes $3 billion a year to the countries hardest hit by
HIV. Some worry that not enough money is being spent at home. "Over
the last five years, the White House and Congress have increased
spending on HIV prevention, treatment and support programs for
low-income countries dramatically - at the same time that domestic
spending has remained all but flat," according to the Left Behind
study. For example, PEPFAR spending increased 46 percent in
2007 as domestic spending on AIDS increased 2.5 percent. This year,
global funding is expected to increase 34 percent, while domestic
funding will rise only 1.2 percent. Any effort to lower the
prevalence of HIV/AIDS in the United States must take into account the
different ways black men and black women get infected. Of black men
living with HIV, 49 percent were infected as a result of having sex
with other men; 22 percent from women; 22 percent from injection drug
use; and 7 percent from a combination of drugs and having sex with
other men. The overwhelming majority of black women - 75 percent
- were infected by having sex with men; 23 percent from drug use; and 2
percent from other causes. Wilson says he will continue calling
AIDS a black disease: "I think it's better if they think ill of us and
we're alive, instead of thinking well of us and we're dead."
Next Column:
Feds Run HIV/AIDS Numbers Game
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