Los Angeles Times - July 6, 2008
Mary Engel, mary.engel@latimes.com

" . . . for HIV?" finished Lakers basketball legend Earvin "Magic" Johnson.

As the most prominent African American face of HIV, Johnson, who is now a businessman and philanthropist, has long used his fame to raise public awareness of the virus that causes AIDS.

But the appearance of his usually camera-shy wife in the public service announcements that began airing last month on cable TV and YouTube is a sign of a growing outspokenness among African Americans about the community's disproportionately high HIV rates.

"We've got to get the word out about HIV and AIDS to minority communities," Johnson said during taping at the Beverly Hilton earlier this year. "Cookie's taken on the battle."

Local activists have worked for decades to draw attention to the toll of HIV in the black community. Now they are being joined by a growing number of African American celebrities and leaders nationwide.

In 2006, the heads of the National Assn. for the Advancement of Colored People, the nation's largest civil rights group, took HIV tests in public and made testing available at their annual convention. That same year, 16 mainstream black organizations, including 100 Black Men of America, the Congressional Black Caucus Foundation and the National Council of Negro Women, pledged to fight the epidemic.

"The black community is where the gay white community probably was in the late 1980s or early 1990s," said Dr. Wilbert C. Jordan, medical director of the OASIS Clinic at the Martin Luther King Jr. Multi-Service Ambulatory Care Center. "But we're not where we need to be still."

The numbers provide ample reason for alarm. According to the Centers for Disease Control and Prevention, blacks make up almost half the estimated 1.2 million Americans living with HIV today, though they are just 13% of the U.S. population overall.

Nearly 17 years after Johnson, with his wife at his side, announced to a stunned sports world that he was HIV-positive, blacks account for most of the country's new HIV and AIDS cases and of deaths from AIDS-related causes.

Among the reasons cited by public health experts is poverty, which can lead both to trouble finding healthcare and to high depression rates that sap the will to be careful.

Widespread distrust of the health system feeds conspiracy theories, such as one that holds that black people are deliberately infected with HIV when they get blood transfusions or have blood drawn.

Many African American leaders have come to believe that their early silence played a role in the spread of HIV.

Among many blacks, the early perception of AIDS as a disease particular to whites and gays created not only a sense of complacency but a stigma in a community with a strong tradition of denouncing homosexuality from the pulpit.

Blacks resist getting tested because they fear being outcasts in their community, Johnson said. Or they get tested and "run scared," often not telling their families.

"We African Americans can be homophobic," said moviemaker Spike Lee, who directed the public service ads. "There's a whole lot of re-education that needs to get started."

The "I Stand With Magic" campaign, a five-year, $60-million project financed by the drug firm Abbott, which makes HIV and AIDS drugs, urges blacks to be tested for HIV. Its goal is to halve the rate of new infections among U.S. blacks.

The CDC estimates that as many as a quarter of those with HIV in the United States are unaware that they are infected and inadvertently spread the virus through unprotected sex or shared needles.

Cookie Johnson, two months pregnant when her husband found out he had HIV in 1991, tested negative for the virus. But women accounted for more than a third of AIDS cases diagnosed among African Americans in 2006, according to the Henry J. Kaiser Family Foundation. (Among whites, women accounted for 15% of AIDS cases diagnosed in 2006.)

"There's still a small part of our community that thinks, 'It can't happen to me,' " Cookie Johnson said.

Many women don't even think about HIV because they don't practice such well-publicized risky behaviors as injecting drugs or having sex with multiple partners, said Carrie Broadus, executive director of Women Alive, a South Los Angeles-based organization for HIV-positive women.

Broadus said that making HIV tests a routine part of every medical examination rather than targeting "risk groups" would not only reach more of these women but also help remove the stigma surrounding the tests, she said.

Jordan, whose South Los Angeles clinic treats about 250 women, echoed that recommendation. "We found several middle-class ladies [with HIV] that way," he said.

But to prevent infections, Jordan said, women must learn how to talk to their partners about HIV.

In many poor neighborhoods, for example, high rates of incarceration contribute to the spread of HIV in both men and women. One in nine black men ages 20 to 34 is behind bars, according to the Washington D.C.-based Pew Center on the States, a nonpartisan research institution.

Men who contract the virus in prison can spread the virus to wives and girlfriends when they get out. "If he was in jail, just say, 'I'm concerned that there's a lot of HIV in prison. I just think you ought to get tested,' " Jordan said.

Testing also can find the virus before it develops into AIDS.

"I've been living 16 years with it now," Magic Johnson said. "There are 27 drugs now. There was only one when I was diagnosed. You can live for a long time with early detection and getting care from a doctor."

Lifesaving drugs developed since 1996 keep the virus in check in Jordan and others with HIV. But African Americans, along with Latinos, are more likely than whites to die of AIDS, often because they weren't tested in time.

In addition to pushing for more testing, black leaders need to press for more primary care doctors and low-cost healthcare, said Phill Wilson, director of the Black AIDS Institute, an L.A.-based nonprofit policy center that mobilized the national groups.

"We need a mass, coordinated initiative that really engages black institutions all over America, from churches to civil rights organization to media to fraternities and sororities," he said. "The good news is that we are starting down that path. The bad news is that we're just starting."

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