TOPICS > Health

AIDS at Twenty Years

May 30, 2001 at 12:00 AM EDT
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JIM LEHRER: Twenty years ago this week the Centers for Disease Control first reported on a health problem that would become to be known as AIDS. Well, tomorrow the agency will issue a new report on AIDS in America highlighting a growing new concern. Betty Ann Bowser has that story.

BETTY ANN BOWSER: Basil Lucas and the men in this HIV support group are becoming the new face of AIDS in America.

BASIL LUCAS: We are able to laugh and cry and learn new things about this disease and what’s really going on…

BETTY ANN BOWSER: Today, African Americans make up more than half of all new HIV cases. Twenty years ago when the HIV virus was first discovered white gay men accounted for the overwhelming number. While white men still make up the bulk of existing cases, health officials are now concerned that data on new HIV infections show AIDS becoming a disease of color. Dr. Helene Gayle heads the HIV prevention program at the Centers for Disease Control.

DR. HELENE GAYLE, Centers for Disease Control: We’re seeing staggering rates of HIV infection among young African American and also young Latino men who have sex with men. This is where increasingly the problem is going to lie.

BETTY ANN BOWSER: While some men will contract the HIV virus from IV drug use, most get the disease from having sex with other men. That makes support groups like this one — at Gay Men of African Descent in New York’s Harlem neighborhood — crucial.

MAN: There were groups for black men, groups for gay men, groups for HIV positive, but there was never a group that allowed me to be a whole person…

MAURICE FRANKLIN, Gay Men of African Descent: We want to create a safe space that they can come to, this is a home, this is a space that’s nonjudgmental.

BETTY ANN BOWSER: Maurice Franklin, program director for Gay Men of African Descent, says AIDS prevention messages have failed in the black community because gay life style is often seen by African Americans as a white lifestyle.

MAURICE FRANKLIN: There’s no black neighborhood that you could say, that’s where the gay people live. I mean we live in our community and we want to be a part of the community, and you know the history of racism and all the other “isms” that have happened to the African American communities, have, I think, created a sort of defense mechanism within the community so that in order to be part of it you have to be a certain way.

BETTY ANN BOWSER: Phil Wilson says that may be because the message has so often come from the gay white world. Wilson runs an HIV think tank for African Americans.

PHIL WILSON, African-American AIDS Policy & Training Institute: Still the messenger overwhelmingly continues to be white, and that’s a problem for black people, I think, that unless we are explicitly included we’re implicitly excluded. Now if the messenger doesn’t look like me, why can I trust, how can I trust that message will be relevant to me?

BETTY ANN BOWSER: So outreach associates like Jamal Roots and William Harris who work for Gay Men of African Descent go to places where they believe they’ll find black gay men, places like New York City’s West Village. Here, there may be less of a stigma about being gay and black.

MAURICE FRANKLIN: Well, the stigma plays out in many ways within the black community. I think as a child, you are taught that it’s not okay to be a sissy; that being gay makes you not part of the community, of the family, that you’re less then a man; regardless of you know, education, or what you know, value you may bring to the community, there’s this underlying or undercurrent of what is gay.

BETTY ANN BOWSER: William talks to guys on street they try to dismantle the stigma of gay life by offering activities — and by reassuring men that they can be both gay and a credit to the black culture.

MAURICE FRANKLIN: I think there’s this emphasis on being a credit to your family or a credit to the race and that in order to be that credit, there’s certain characteristics that are more acceptable. And, you know, I’ve heard mothers say that they’d much rather their son be, you know, a drug dealer than be gay.

BETTY ANN BOWSER: In some cases the stigma is so great that black men who have sex with men don’t want to consider themselves gay , or even bisexual, and end up living a double life. J.L. King is one of those men — for years, he was married, raising three children — all the while secretly having sex with men, or as he calls it — living life on the down low.

J. L. KING: Most down low brothers look at themselves at being nothing but a heterosexual man — with a twist, every now and then wanting to have sex with another man. To a down low brother, it’s more gratification and not orientation. It’s all about, let’s get together do the sexual thing, then I’m outta here. Don’t ask me any questions whatsoever. That’s what makes it so dangerous.

BETTY ANN BOWSER: Dangerous because someone who is in denial about their own sexual orientation is unlikely to hear safe-sex messages.

J. L. KING: When I look at gay men, when I look at what they call their culture, how they have their own churches, and they have their own clubs, and bars, and they do their own thing — I don’t relate to that. You will not find a down low brother in a gay bar — a real, true down, bona fide low brother. You will not find a true down low brother going to gay pride events, or hanging out with gay people, or doing things that are part of the gay culture.

BETTY ANN BOWSER: King says he went public about his life when he saw women in his community get sick and die from AIDS after sleeping with partners they never knew were HIV infected.

J. L. KING: The black community refuses to deal with this because we are so scared of it; we’re too scared to face it.

BETTY ANN BOWSER: He now addresses woman’s groups about HIV prevention and is writing a book about “Life on the Down Low.”

J. L. KING: Because I have a daughter and nieces that I don’t want to send to an early grave because I kept my mouth shut.

BETTY ANN BOWSER: King’s worries may be well founded. According to the Centers for Disease Control, 64 percent of all women who get new HIV infections are African American.

J. L. KING: The message so far has been to the gay community. They have not sent those messages out to where “down low,” or men who don’t relate to or are labeled. You don’t see safe sex messages at barber shops in most American cities, but you don’t see practice safe messages at the mall or at the beauty salons or the barber shops or at the Foot Locker or at the gym.

BETTY ANN BOWSER: Young black men pose the toughest challenge for prevention workers. Young people of all races tend to take more risks, but a recent federal study of six cities shows one in three young black gay men are HIV infected.

DR. HELENE GAYLE: Young people did not see — were not part of the first wave of the epidemic where they saw so many of they’re friends dying and took this epidemic seriously.

BETTY ANN BOWSER: And how serious AIDS is thought to be — may also be diluted by the discovery of combination drug therapies.

DR. HELENE GAYLE: With the new therapies, we’ve had a tremendous successes; on the other hand I think that people have begun to think that HIV or AIDS is not so serious anymore. We see people returning to risk behaviors that could lead to increases in new HIV infections

BETTY ANN BOWSER: You mean, unprotected sex?

DR. HELENE GAYLE: Unprotected sex.

BETTY ANN BOWSER: Maurice Franklin worries that in communities of color, particularly lower income communities, the young can be even more cynical about their future.

MAURICE FRANKLIN: We hear from young men that they don’t expect to live. It’s either, you know, violence is going to take them out — or AIDS.

BETTY ANN BOWSER: For health care professionals it is a complicated picture which calls for complex solutions.

PHIL WILSON: We keep looking for a magic bullet. You know, we keep thinking that well, if the church gets involved, then AIDS will go away. That’s not true. The church has a role to play. Civil rights organizations have a role to play. Families have a role to play. Social organizations and fraternities and black healthcare providers and the black media. Within the African American communities there are all these institutions, and there is something for all of them to do.

BETTY ANN BOWSER: This summer the Centers for Disease Control is developing new strategies that better target individual communities in AIDS prevention.