Chicago Tribune - July 10, 2002
Sabrina L. Miller, Tribune staff reporter

African-Americans are disproportionately affected by HIV and AIDS, accounting for 67 percent of all new cases in Chicago in 2000 despite representing just 36 percent of the population, according to a study presented to the City Council's Health Committee by the Chicago Department of Public Health. Latinos accounted for 15 percent of the new cases.

The study also found the rate of diagnosed AIDS cases among Chicago women has nearly tripled in the last decade, with African-American women accounting for nearly 80 percent of all women with AIDS in the city. Still, the AIDS rate among men--particularly those who have sex with men whether or not they identify themselves as gay--remains higher.

Although Chicago's statistics are in line with national trends, they were still so troubling to Ald. Billy Ocasio (26th), who called the hearing, and other committee members that they emerged committed to scheduling a series of citywide public hearings and vowing to pressure state and federal lawmakers to increase funding and services for people with AIDS.

Nationally, nearly half of all new AIDS cases reported in 2000 were among black people, and black women represent 63 percent of all women with AIDS, according to the U.S. Centers for Disease Control and Prevention.

Most cases in Chicago women are reported to be from injection drug use, but increasingly, sexual transmission also is a significant factor.

"Women are having heterosexual contact with men who are either injection drug users or at some time have had sex with another man and contracted the virus," said Alicia Bunton, site director of St. Stephan's Respite, which treats AIDS patients. "There's still an element of invincibility among a lot of women. Nobody thinks it will happen to them."

Committee members said they would increase pressure to improve city services to the hardest hit communities and urge their constituents to root out the discrimination that continues to dog people with AIDS.

A decade ago in Chicago, AIDS cases were heavily reported in North Side neighborhoods like Lakeview and Edgewater, with large populations of white, gay men. Now, predominantly black South and West Side neighborhoods like East Garfield Park and Grand Boulevard have among the highest rates of diagnosed AIDS cases.

An estimated 28,000 people in Chicago are living with HIV and AIDS.

"Everybody ought to be mad as hell and get on the subject of HIV and AIDS," said Ald. Carrie Austin (34th). "When it comes to an epidemic of something like this that affects us the most, we all should be outraged that the epidemic is climbing and we're not even being a focal point or a voice for our own."

Mandatory testing urged

Austin, whose West Side ward has among the highest AIDS rates in the city, gave the most compelling testimony Tuesday, and she urged the most radical and controversial solution: mandatory HIV testing.

She revealed that one of her sons learned he had AIDS only because he was subjected to mandatory testing at a drug rehabilitation facility. Given the escalating numbers in the African-American community and new findings released at the International AIDS Conference in Barcelona that most young gay and bisexual men with HIV did not know they were infected, voluntary testing is passe, Austin said.

"The epidemic is on such a rise now that it's too high of a consequence now to [test] voluntarily," she said.

"I feel that I'm more of an advocate now because it has hit my home. For those that it hasn't hit their home, they're not as concerned about it," Austin continued. "I'm sure all of my colleagues are concerned because it affects the people that they represent. But when it represents the one that you birthed, then it makes a bigger difference."

'They're dying every day'

Austin found an ally in Ald. Walter Burnett (27th), who revealed that his sister, a recovering drug addict, is HIV positive. He also advocated mandatory testing despite testimony from a local policy advocate who argued that such testing was counterproductive.

"People are dying. They're dying every day. Not only are they dying, they're spreading the disease, every day," Burnett said. "The thing is, I think it's more important that people get help. I think that's more important than the shame."

But Sean Smith, manager of public policy for Howard Brown Health Center, which provides medical services to much of Chicago's gay and lesbian community, countered: "From a public health standpoint, we still believe the best way to really tackle this epidemic is through informed, voluntary testing. If you get into a situation where you force people to get tested, you add more shame and you add more fear."

Austin said she has been tested "four or five times" just to be on the safe side, although she said she knows she is in a low-risk category because she does not take intravenous drugs and, "I know that I don't have unsafe sex--I don't have that at all."

As people in the City Hall committee room erupted in laughter, Austin added, "I have to be humorous in order not to cry."

Candid talk about sex difficult

Emotional pain is just one of many complex and culturally sensitive factors behind the increased rates of HIV and AIDS in communities of color, where frank talk about sexual orientation, in particular, can still be taboo.

"Socially speaking, it is not cool to be HIV-positive in the 'hood," said Maurice Chapman, project administrator with the Cook County Westside Health Center. "People will quickly identify you as somebody to avoid."

Additionally, African-Americans and Hispanics in economically depressed communities often have myriad woes to deal with--unemployment, homelessness, gang warfare, lack of access to health care, substance abuse--that HIV treatment doesn't rank high. Chapman said he has seen numerous African-Americans diagnosed with advanced stages of AIDS in the emergency room of a hospital.

"For a lot of people, it's just one more thing to deal with. Sometimes the hunger in your belly and the lack of housing is more important than dealing with HIV because you don't plan on living long anyway," Chapman said.

"And let's face it, from a legislative perspective, you're dealing with the fringes of society," he said. "These people are not valued. It's easy to dismiss it."

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