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AIDS at 30

June 27th was National HIV Testing Day. It commemorated the 30th anniversary of the first official recognition of HIV/AIDS by the U.S. Centers for Disease Control. Three decades ago, an unknown malady emerged on the world-historical stage. First in clinics and hospitals in San Francisco, Los Angeles and New York, and then spreading throughout the country, previously healthy gay men were reporting peculiar symptoms that, ultimately and inevitably, led to painful deaths.

Today, HIV/AIDS is a worldwide pandemic. The UNAIDS Global Report 2010 estimates that at the end of 2009 approximately 31 million adults and 2.5 million children were living with the disease. While there is no known cure for the disease, the U.S. and other advanced countries offer a “cocktail” of powerful drugs (known as protease inhibitors) that fights the infection. These drugs help reduce the HIV virus and keep the immune system as healthy as possible, decreasing the complications that may develop.

In the U.S., an estimated 1.1 million people live with the disease. The principle modes of transmission involve: unprotected male-to-male anal sexual intercourse; injection drug use; unprotected heterosexual sexual intercourse; and other means like contaminated medical syringes.

Nearly half (500,000) of those infected in the U.S. are African-Americans. A recent study by the Black AIDS Institute, “Deciding Moment: The State of AIDS in Black America,” notes: “Every year, 56,000 Americans become infected with HIV. Nearly one out of two newly infected people are Black.”

While New York, California and Florida have numerically greater numbers of people living with AIDS, Washington, DC, is the nation’s AIDS capital. Measured on the basis of those infected per 100,000 of the population, Washington has an estimated 119.8 AIDS cases compared to New York’s 24.6, Florida’s 23.7 and California’s 10.2.

While President Obama issued a video message encouraging Americans to get tested for HIV/AIDS to commemorate for National HIV Testing Day and First Lady Michelle Obama visited an HIV/AIDS clinic in Botswana (and even helped paint it) during her recent trip to Africa, these gestures seem pathetic as Washington faces an HIV/AIDS epidemic.

* * *

HIV/AIDS is ravaging minority communities in the U.S., especially the African-American and Hispanic. Black Americans account for 12.6 percent of the U.S. population; when those who identify with more than one race are included, the total is 13.6 percent. Hispanics/Latinos have become the nation’s largest “minority” group, accounting for 16.3 percent of the population. However, African-Americans account for:

? 45 percent of new HIV infections;

? 46 percent of people living with HIV;

? 48 percent of all new AIDS diagnoses; and

? 57 percent of all HIV-related deaths.

Digging deeper, these figures get even more alarming:

? Black women account for 61 percent of the HIV infections among women ? this is nearly 15 times greater than the rate for white women.

? Black youth aged 13 to 19 years are only 17 percent of U.S. teenager population, but represent 68 percent of all new AIDS diagnoses among teens.

? 46 percent of Black gay and bisexual men are infected with HIV, compared to 21 percent of white men and 17 percent of Hispanic males.

This situation is grimmest in Washington, DC. The District has a population of just over 600,000 pepole of which nearly 50 percent are black and 9 percent are Hispanic. A June 2011 D.C. Department of Health report found that the number of HIV/AIDS cases qualified as an epidemic under World Health Organization (WHO) criteria. Among its findings for 2009 are:

? An estimated 16,721 Washingtonians over the age of 12 were living with HIV/AIDS;

? 75.2 percent of these with HIV/AIDS were African-American;

? Residents between 40 and 49 years of age have the highest infection rate among District residents (7,393 per 100,000 residents).

The level of HIV/AIDS in Washington represents 3.2 percent of the population, an infection level greater than in many developing nations. The WHO places an epidemic rate at anything greater than 1 percent of the population.

It must be noted that over the last few years, the number of new HIV/AIS cases in Washington fell by 50 percent. In 2005 the number of deaths from HIV and AIDS was 326 and by 2009 it had fallen to 153 death. DC Mayor Vincent Gray took credit for these developments. “We are getting people diagnosed earlier and into care and treatment faster for their health,” he said, “thereby reducing the chances that others will get infected.”

A comparable pattern is found in New York City. As of yearend 2009, 108,886 people were reported living with HIV/AIDS, of which two-thirds were male. However, nearly 90 percent were minority people, including 52.4 percent Africian-Amerian and 35.5 Hispanic.

Amidst the intensifying economic restructurting and calls by (white) Republicans for fiscal austerity, one can only wonder if we will see a reduction in national (and especially federal) efforts to prevent the spead of HIV/AIDS. Sadly, the likely reduction in preventive efforts will lead to an increase in the number of those infected with HIV/AIDS, especially within minority communities.

* * *

“We pause to mark the thirty years we have been fighting HIV/AIDS,” President Obama recently proclaimed. “As we remember people in our own lives we have lost and stand by those living with HIV/AIDS, we must also rededicate ourselves to finally ending this pandemic ? in this country and around the world.”

In July 2010, the Obama administration introduced the National HIV/AIDS Strategy, the nation’s first comprehensive AIDS plan. It is organized around three core goals: to reduce new HIV infections; to increase access to care and improving health outcomes for people living with HIV; and to reduce HIV-related disparities and health inequities.

The U.S. spends $19 billion annually on domestic HIV/AIDS prevention, care and research. Last year, the U.S. Dept. of Health and Human Services allocated $30 million in a major initative to develop better HIV/AIDS prevention methods. The announcement was met with a ho-hum shrug by AIDS activists. Michael Weinstein of the AIDS Healthcare Foundation expressed the widely shared assessment: “This will be another report that will gather dust on the shelves of the Library of Congress.”

Sadly, any new federal effort will likely have only a marginal impact on the continuing spread of HIV/AIDS within the African-American community. Afrcan-Americans have been disproportionately affected by HIV/AIDS since the epidemic’s beginning and this disparity has only deepened over time.

HIV/AIDS among gay and bisexual black men is more than double that of white men, but the transmission patterns vary between both groups. The “down low” phenomenon has been much commented upon within the African-American media, but heterosexual transmission and injection drug use accounts for a greater share of infections among black men than white men; white men are more likely to have been infected through unprotected homoerotic anal sex.

Most disturbing, newly infected black gay and bisexual men are younger than their white counterparts; those aged 13?29 account for 52 percent of new infections among blacks compared to 25 percent among whites.

Social issues will likely play a secondary role in the 2012 election. Jobs, jobs and the deficit will increasingly dominate politial discource. Politicans are sharpening their knives aggressively in their quest for budgetary expendables. As 235 years of American history has taught us, the poorer and darker you are, the more expendable you are.

While Obama has maintained a relatively consistent support for gay rights (e.g., his effort to end Don’t Ask/Don’t Tell), issues like abortion rights, immigration and gay marriage (i.e., “marriage equality”) have been causalities of his compromiser’s half-step shuffle. In key domestic policy challenges, most acutely exemplified in the health-insurance battle, financial reform struggle and the BP-Gulf disaster, the “good” was sacrificed for the “possible” and the vast majority of Americans came out the loosers in the political sausage-making process.

Short of another major HIV/AIDS crisis similar to that which beset the U.S. in the early ’80s, the country will absorb the likely increase in HIV/AIDS infections over the next few years, especially within African-American and Hispanic communities. This will be one of the unintended consequences of new austerity economics imposed by Republican and complicit Democratic budget cut.

For eleected officials, and the corporate lobbyists who really run Washington, the lives of the poor, especially black and Hispanic, are merely collateral damage in the class war they are waging to maximize profit. Their efforts fit perfectly with the new 21st century American ethos, one in which prejudice has replaced reason and self-interest trumps the social good.

David Rosen is the author of “Sex Scandals America: Politics & the Ritual of Public Shaming” (Key, 2009). He can be reached at drosennyc@verizon.net.

 

 

 

 

 

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David Rosen is the author of Sex, Sin & Subversion:  The Transformation of 1950s New York’s Forbidden into America’s New Normal (Skyhorse, 2015).  He can be reached at drosennyc@verizon.net; check out www.DavidRosenWrites.com.

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