Minorities’ AIDS Help Insufficient, Officials Say : Cultural Gap, Funding Cited

Sometimes it is the sirens from a nearby firehouse that rouse Donald Manns in the middle of the night, sometimes it is the angry shouts of men fighting outside the corner bar. But most often he is awakened by a cold, bed-drenching sweat, a symptom of AIDS made worse by the fact that his tiny hotel room near MacArthur Park has no heating.

Manns, a 38-year-old black man, learned that he has AIDS a year and a half ago, and his health has been failing steadily since. The disease has left him gaunt, nearly blind and so weak he returns to bed, exhausted, barely an hour after waking each morning.

Verge of Eviction

He lives alone in a 10-by-20-foot room with no stove or refrigerator. Each time he wants a bowl of cereal, he must walk to the grocery store across the street for milk, careful to avoid the drunks and junkies who may want to fight him and take his money.

It is not a comfortable existence, but it is one that Manns is struggling to hold on to. He said he has fallen behind in his rent, and is now on the verge of eviction.

“If I don’t hurry up and get some help,” he said, “I’m going to be out in the street,” a prospect that frightens him.

Manns has slept on sidewalks before, but never without an immune system.

Although minorities--blacks, Latinos and Asians--make up only about 20% of the U.S. population, they account for more than 40% of AIDS cases, according to the Centers for Disease Control in Atlanta.

30% Are Minority Members

AIDS experts do not have any concrete answers for why the disease has afflicted minorities disproportionately, but they have many theories--minorities do not think AIDS affects them and have not been taking precautions against it; minority communities have relatively large numbers of intravenous drug users, a group highly susceptible to AIDS; AIDS has struck primarily in large cities, where many minorities live.

In Los Angeles, which ranks third among U.S. cities in the number of reported AIDS cases with about 2,000, the county Department of Health Services’ July report showed that nearly 30% of AIDS sufferers are minorities.

But local minority AIDS workers and members of the minority gay communities say the disease is still thought of, and depicted by the media, as a gay, white, middle-class disease. Consequently, they say, the social service institutions set up to help AIDS sufferers have not adequately addressed the problems of minority victims nor educated minority communities about the disease.

The Rev. Carl Bean, director of the Minority AIDS Project, said the lead character in the television movie “An Early Frost”--a young, gay, white lawyer--is typical of the way the media portrays AIDS sufferers.

Perception Hampers Effort

By contrast, Bean said most of his clients are black or Latino, poor, uneducated and have little or no insurance.

Bean, who said his organization is the only one in Los Angeles devoted solely to addressing the problems of AIDS in the minority communities, said the perception that AIDS only afflicts white gays has hampered efforts to fight the disease among minorities.

AIDS, or acquired immune deficiency syndrome, is an invariably fatal viral disease that destroys the body’s immune system, leaving the sufferer defenseless against infection and rare forms of cancer. It is known to be transmitted through transfusions of contaminated blood products, the sharing of needles by drug users and through intimate sexual contact, particularly among homosexual men. There is no known treatment or cure.

A report published in the July 17 issue of the New England Journal of Medicine states that while nearly 90% of white AIDS sufferers nationwide are homosexual or bisexual, most blacks with AIDS are heterosexual, many of them intravenous drug users.

The report by four Georgia doctors, based on Centers for Disease Control statistics, concluded that AIDS education efforts aimed at the gay community are not likely to reach the majority of blacks who are at risk for the disease.

And when people do not think they are in danger of catching a disease, they will not take precautions to prevent it, Bean said.

Dr. Neil Schram, chairman of the Los Angeles City-County AIDS Task Force, agreed that black and Latino gays and intravenous drug users are not being reached by educational efforts aimed at the gay community, because most are not a part of it.

‘Effort Is Critical’

“It’s easy to reach white men in West Hollywood,” he said. “It’s not easy to reach Hispanic men in East Los Angeles. But that effort is critical.”

Eunice Diaz, director of health promotion and community affairs at White Memorial Medical Center in East Los Angeles, said there is a need for an education campaign that is sensitive to the differences between how the white community reacts to homosexuality, and the reaction in the Latino community.

“Our Hispanic culture cannot, and I don’t think will, recognize or accept an alternative sexual life style, such as homosexuality, in an open and unbiased manner,” she said.

Diaz, also a member of the city-county task force, said many Latino gays take on heterosexual life styles because of the cultural pressure to marry and have children.

Education, Warnings Needed

To reach these gays who live in traditional family households, education must be aimed at the general population and warnings issued against specific acts that place one at risk of contracting AIDS, she said.

Daniel Tsang, a member of The Gay Asian Rap, said there is a similar need to educate foreign-born Asians about the disease.

Although Asians account for only about 1% of AIDS cases in Los Angeles, he said he thinks that it is because many Asians are recent immigrants, and the gays among them have been too busy getting settled to be sexually active.

“I suspect the statistics will show an increase later, unless there is more education or outreach,” said the Hong Kong-born Tsang, a social services librarian at University of California, Irvine.

The problems of minority AIDS sufferers are compounded by the fact that homosexuality carries a greater stigma in minority communities, Bean said. Minority gays and lesbians are often ostracized from their families and shunned not only by the white gay community, but by their ethnic communities as well.

Avoid the Issue

“I think there is a tendency among gay Asians not to deal with the issue (of homosexuality) because they don’t want to be separated from the only community they know--the Asian community,” said a member of The Gay Asian Rap who asked that his name not be used.

Diaz said when AIDS strikes a young Latino man, his family is traumatized, not only by the disease, but by the implication that he is gay.

“One mother told me, ‘I hear my son has AIDS, all I pray is, Lord, I hope he got it either through a transfusion or from sharing needles with drugs,’ ” she said.

Bean said he tries to get governmental assistance such as MediCal, county welfare and food stamps for his clients, but it is not uncommon for him to get calls from AIDS sufferers, such as Manns, who are down to their last dollar and need money to pay the rent or buy food.

No One Turned Down

Although money is so short he often has trouble paying the rent for the project’s West Pico Boulevard office, Bean, who draws no salary, said he turns no one down.

Jose Vargas, 55, and his wife, Rosarita (not their real names), 48, are two of Bean’s latest clients.

They both have AIDS. Simultaneous cases of pneumonia, tuberculosis, meningitis and Kaposi’s sarcoma, a rare form of skin cancer, sent Jose Vargas to County-USC Medical Center last April and forced him to quit his job at a neighborhood hamburger stand. He has not worked since.

The Vargas’ are illegal immigrants and cannot get government assistance. They have been paying the rent for their small Los Angeles apartment by borrowing money from friends--friends they are afraid to tell they have AIDS.

‘Going to Abandon Us’

“None of the people really know what I’m sick from,” said Rosarita Vargas, speaking through an interpreter, “but when they do find out, they’re going to abandon us.”

When the rent came due last month and she was unable to think of a friend she had not already borrowed from, Rosarita Vargas turned to AIDS Project Los Angeles, the largest AIDS support organization in the city.

APLA, which has 50 paid staff members and a $3.4-million budget, referred her to the struggling Minority AIDS Project. Although the rent for his own office had not yet been paid, Bean gave her $100.

Based in West Hollywood, APLA concentrates on services for AIDS sufferers, such as transportation, mental health counseling and food vouchers, and an education program, which includes an information hot line and public speakers, said executive director Paula Van Ness.

Does Not Give Cash

Like the Minority AIDS Project, Van Ness said APLA, a nonprofit organization, tries to steer its clients toward whatever government assistance that they may be eligible for. But unlike the minority project, APLA does not give cash to clients, even in emergencies.

“We have tried to meet the needs of people without handing out money,” Van Ness said. “People’s needs are so great--$200 here, $300 there--our whole budget could be gone in a few months and only serve a few hundred people.”

Van Ness, 34, said she agrees that the needs of minority AIDS sufferers are not being met, but APLA does not have enough money to do it.

“We could spend 10 times or a 100 times our current budget and probably still not meet the needs of this community,” she said.

Cultural Ignorance

But Arturo Olivas, a Latino gay activist and founder of Gay and Lesbian Latinos Unidos, contends that APLA is ignorant of minority cultures.

He said the group showed its ignorance by hiring a female caseworker to counsel Latino men. The caseworker is Latina, but Olivas said Latino men usually will not discuss sexual matters with a woman.

Olivas said he is tired of fighting the lack of concern demonstrated by APLA and other West Hollywood-based programs. “I mean, APLA gets funding for AIDS education from San Luis Obispo to San Diego and they didn’t put up one billboard in Spanish,” he said.

John Mortimer, director of education for APLA, said no Spanish billboards were put up because the purpose of the state-funded campaign was to promote the APLA hot line, which does not have Spanish-speaking operators. He said a Spanish-language hot line will be started by the end of fall.

Frustration Lies Elsewhere

Bean said he, too, is often frustrated with APLA, but the real problem lies elsewhere. There has been little help from the government, the media and the public for minority AIDS victims, he said.

Bean said he has been granted $53,000 by the state and county this year to educate minorities about AIDS, but the money cannot be used to pay the office rent and phone bills or to feed clients.

The task force’s Schram agrees that not enough is being done by the county to help AIDS sufferers, citing the Board of Supervisors’ July vote to add just $60,000 this year to their budget for prevention and treatment of the rapidly spreading disease, bringing the total to just under $700,000.

“I think this shows that county supervisors have failed to realize the seriousness of the epidemic,” he said.

State Responding Well

However, Bruce Decker, chairman of the California AIDS Advisory Committee, said the state has been responding well to the problem of AIDS in minority communities, although he conceded that until recently not enough had been done for Spanish-speaking people.

“Clearly, with the exception of the Spanish-speaking community, the AIDS prevention programs that we have funded in Los Angeles don’t discriminate against anyone,” he said.

He said that the $28.7 million appropriated by the state for research, treatment and prevention of AIDS this year included $600,000 to fight AIDS in minority communities.

But Bean contends that not enough is being done, and he has no doubt about the reason behind it.

“Racism is so blatant now, it’s almost like in America now it’s comfortable to be racist again,” he said.

Plight Made Public

The plight of minority AIDS victims has been made public by the Centers for Disease Control for a long time, he said. “Yet, no one says, ‘Why don’t we do a major fund-raiser for Minority AIDS Project to help them with the problems in South-Central or East L.A. or downtown?’ ”

He said many people who support other minority causes, such as sickle cell anemia research, will not support AIDS work because it is associated with homosexuals and drug users.

“There’s no real desire to help anyone,” he said angrily. “It’s b.s.”

Meanwhile, Manns said, “People are dying because they don’t get the nourishment and the attentive medical treatment they need, because of a lack of funds, a lack of interested people.”

Manns said he spends most days alone in his room, worrying about how he will pay the rent, how he will cope with his impending blindness.

He worries, too, that the Minority AIDS Project, whose volunteers are the only friends he has, will fold.

If that happens, he said, “You’ve got a lot of people that’s hanging out there that might as well prepare themselves to go under all the way.”