Miami Herald - Tuesday, August 4, 1998
Tony Pugh, Herald Washington Bureau

That's a far cry from just over a decade ago, when white, homosexual men were virtually alone in the United States at the epicenter of one of the most dangerous and frightening diseases of this generation. How things changed so dramatically and so quickly is a complex story of access and exclusion, acceptance and denial, education and ignorance, action and complacency, political clout and political impotence.

In the mix of all these factors swirls the undeniable fact that very soon, the stigma of AIDS as a gay men's disease will give way to the equally burdensome weight of race. And where race is an issue, many believe racism will result.

Dr. Stephen Thomas, director of the Institute for Minority Health Research at the Rollins School of Public Health at Emory University in Atlanta, explained:

"There's a real concern that as soon as the disease is perceived as a `black or Hispanic thing,' that all the money we've seen for research and treatment thus far will start to dry up," Thomas said. "That's because there's a fear that blacks and Hispanics don't count in this society."

In 1986, more than 60 percent of known AIDS patients in the United States were white non-Hispanics. Since most either were gay or were intravenous drug users, there was little outward sympathy for a disease that seemed to target what many believed was an immoral lifestyle.

As the disease touched more and more families, pressure for action mounted. The image of young AIDS patient Ryan White, who acquired the disease through a tainted blood transfusion, showed the nation's true vulnerability to AIDS.

Soon afterward, the grass-roots AIDS political movement began to gain steam. Under intense lobbying from the gay, medical and social service communities, federal, state and local governments began to fund AIDS prevention, treatment, research and education programs. Drug companies began testing and marketing new, improved AIDS drugs.

Slowly, the death rates decreased and the numbers of new cases began to stabilize among gay white men and mainstream white America. But the disease simply took up shop in poorer minority communities, where a sizable homosexual population is seldom acknowledged and less often discussed. Higher rates of intravenous drug use, limited access to health services, poor education and complacency made minorities even more vulnerable.

Issue on back burner

Black leaders, more concerned with affirmative action, equal employment and drug-related crime, kept AIDS on the back burner of important issues. The black clergy, a historical engine for social change in the black community, turned a deaf ear to the AIDS problem, unable to reconcile its connection with drugs and homosexuality.

Hispanic leaders faced a different problem. The diversity of Hispanic populations made it difficult to mobilize an effective national awareness campaign. Meanwhile, massive immigration made other issues much more important to the mushrooming Hispanic population.

Inattention to AIDS has proved devastating for both groups. While blacks and Hispanics make up 13 percent and 11 percent of the U.S. population, respectively, both are overrepresented in just about every aspect of the AIDS epidemic.

Of the nation's 641,086 known AIDS patients, the Centers for Disease Control and Prevention reports that 230,029, or 36 percent, are black. About 18 percent are Hispanic. Last year, blacks made up 45 percent, or 27,075, of the nation's new AIDS cases, while Hispanics numbered 12,466, or 21 percent.

The figures put the AIDS incidence rate among blacks at about 84 per 100,000 people, and for Hispanics at 38 per 100,000. Whites have an incidence rate of about 10.4 per 100,000.

No. 1 problem

The numbers make a strong case that AIDS and HIV infection are the No. 1 health problem facing blacks and Hispanics. In the face of the seemingly unchecked epidemic, leaders from both groups have shown a recent willingness to tackle the issue.

At a summit meeting in May, about 70 Hispanic leaders, at the invitation of the Harvard AIDS Institute at Harvard University, launched a national advocacy campaign dubbed "Unidos Para La Vida," or "United for Life." The project is the counterpart to "Leading for Life," a similar effort begun by the Harvard institute in 1996 to mobilize the black community.

Advocates say the 1996 meeting directed at the black community is paying dividends. The Congressional Black Caucus has stepped up its visibility on the problem, urging the President to declare the AIDS crisis a national health emergency and calling for federally funded needle-exchange programs.

Always watch for outdated information. This article first appeared in 1998. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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