AIDS Emergency Declared Among County’s Minorities

Tacitly acknowledging that Los Angeles County has failed to stem the rapid spread of HIV and AIDS in minority communities, the Board of Supervisors unanimously declared an emergency Tuesday and called on the state and federal governments to pay for expanded medical care and social services.

The largely symbolic action followed a series published in The Times that cited the swift spread of HIV and AIDS in the county’s African American and Latino communities and the lack of housing services there.

“There is a need to bring resources into minority communities,” said Supervisor Yvonne Brathwaite Burke, who pushed for the declaration. “The problem has moved away from the male homosexual as the center of those who are being infected by HIV and AIDS to women, to minorities and to heterosexuals.”

Burke said the number of cases in minority communities across the nation’s most populous county is “truly approaching epidemic proportions.” She cited statistics that show that 68% of all the newly diagnosed cases in the county involve African Americans and Latinos.

Burke said some of the growth is attributable to the incarceration of large numbers of minorities who contract HIV in prison and then return to their communities.

Vanessa Baird, acting chief of the state’s Office of AIDS in Sacramento, said the department will consider the county’s request because “it is a very serious situation.” Los Angeles County accounts for one-third of all AIDS cases in California, she said.

“It doesn’t take a declaration to try to stem the epidemic. It is no longer an emerging epidemic, it is an epidemic among people of color.”

Melissa Skolfield, assistant secretary for public affairs at the U.S. Department of Health and Human Services, said she could not comment immediately on the supervisors’ action. But she agreed about the “changing face of AIDS” and said Secretary Donna Shalala had been working with the Congressional Black Caucus to provide $150 million in funding to help local communities such as Los Angeles.

Dr. Eric G. Bing, who heads HIV/AIDS services at Martin Luther King Jr./Drew Medical Center in Willowbrook, said he is disturbed that “communities of color” are not benefiting from the strong advances in drug treatments that have allowed, for example, white gay men infected with HIV and AIDS to live much longer.

Without access to adequate health care and prevention, Bing said, more AIDS patients from minority neighborhoods are arriving at county clinics and hospitals acutely ill. “More people are now dying,” he said.

Dr. Chuck Henry, director of the county Office of AIDS Programs and Policy, told the supervisors that the disease has shifted from one primarily afflicting white gay and bisexual males to African American and Latino men and women.

Using color charts, he showed the supervisors that the proportion of AIDS cases diagnosed in the county among whites has dropped from 55% in 1991 to 30% in 1998, while the share of cases among Latinos jumped from 26% to 43%. The proportion of African Americans diagnosed with AIDS grew from 18% to 25% during the same period. Cases in the Asian/Pacific Islander group and among Native Americans grew from 1% to 2%.

Henry said the county health department must challenge the perception that medical advances have stemmed the AIDS epidemic. More prevention and educational programs directed at African Americans and Latinos are needed, he said.

In a review of AIDS residential care facilities in Los Angeles County, The Times found almost none in communities with significant African American and Latino populations, including South Los Angeles.

The practice of placing housing outside these neighborhoods was rooted in the earliest days of the epidemic, when gay white men were the primary victims. To ensure that services were easily accessible to them, nearly all AIDS housing was created in Hollywood, West Hollywood, Silver Lake and the San Fernando Valley.

Shortage of Housing in Minority Areas

But as the epidemic has increased among African Americans and Latinos, the shortage of AIDS housing has complicated the ability of those who are sick to receive help. Residents must travel, sometimes long distances, to receive assistance.

Similarly, African American and Latino activists have long argued that decision-making power and funding have been slow to adjust to the changing demographics of the epidemic.

Even when funding is targeted to the African American and the Latino communities, it often is given to agencies using models of prevention designed for gay white men. Those prevention methods have not proved effective for others.

Representatives of African American, Latino and Asian communities told the supervisors that education efforts must be tailored to different racial and ethnic groups and must break down cultural taboos against the discussion of sexually transmitted diseases.

Alex Torrez said he became infected with HIV three years ago. “I wish I could have been more informed,” he said. Neither the public school system nor his family would address the sexual behavior that can lead to infection.

“My culture does not deal with this disease,” said Chris Campos, a Filipino diagnosed with HIV in 1993. “Denial is our greatest enemy.” Unfortunately, he said, many “don’t get tested until they are very sick.”

Messages about HIV and AIDS need to be printed and broadcast in many languages, Campos said. “The system needs to change to fit our needs,” he said.

In their declaration, the supervisors said the AIDS crisis among “people of color represents a countywide emergency.”

The county will send letters to the federal Department of Health and Human Services and the state Department of Health Services alerting them “to the need for appropriate funding in Los Angeles County to increase and sustain HIV/AIDS prevention, care and treatment services in African American, Latino, Asian, Pacific Islander and other communities severely impacted by the disease.”

The county’s Office of AIDS Programs and Policy was sharply criticized by the state auditor last year for mismanagement. The extensive audit released in May 1998 concluded that the county had used AIDS funds to pay for employees who do not provide AIDS services and failed to provide proper oversight and monitoring of contracts with service providers.

The office “cannot ensure that it spends funds appropriately or its contractors provide needed services to people living with AIDS,” the audit said.

Henry said that since taking over the office two days after the report was issued, he has worked to address the shortcomings and to implement the recommended changes to ensure that AIDS funds are being used for AIDS services.

Henry said the county is no longer spending AIDS funds on other programs, has increased oversight of service providers, and is aggressively lobbying for additional state and federal funds.

“We have sort of been the sleeping giant,” he said. “We haven’t had that kind of visibility on the federal and state scene.”

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AIDS Cases Diagnosed in Los Angeles County

*

1991

White: 55%

Latino: 26%

Black: 18%

Other: 1%

*

1998

White: 30%

Latino: 43%

Black: 25%

Other: 2%

*

Source: Los Angeles County Department of

Health Services