Minority Groups Facing a Tougher Fight With AIDS
Charles was young and attractive and viewed the world in a way that would baffle some.
AIDS simply did not frighten him. Charles believed in what he saw: His brother had the illness, but his brother took medications and still appeared well and healthy.
Charles simply didn’t see himself as being at risk. He had a steady girlfriend, and although he occasionally had sex with a man, he did not identify himself as gay or even bisexual. Nor did his family and friends.
So the young South Los Angeles man passed on using condoms--and in 1996, at the age of 24, gave himself a one-way pass to an incurable illness.
“The condom was right there,” said Charles, who is now 28 and HIV-positive. “I just didn’t use it. I felt pretty invincible. I figured, it’ll be all right this time. That’s how I ended up becoming infected.”
Nearly 20 years after the AIDS epidemic struck the nation, one in 10 young gay or bisexual men is infected with the disease, according to a study of six major cities released this week by the U.S. Centers for Disease Control and Prevention.
But infection is far more widespread in communities of color. The CDC study found that the rate of infection among African American men who have sex with men is 30%. In Los Angeles the rate is 25% for that group and 15% for Latinos.
Those who have long fought the disease in the African American community say that the methods used to stem the tide in the gay white community are simply not as effective among African Americans.
“HIV/AIDS must have new and innovative approaches . . . so things can change,” said Cleo Manago, head of the AMASSI Center in Inglewood.
“The CDC and the public health departments need to reevaluate who they’re funding and why they’re funding people to do this work, because clearly it’s not working.”
One difference in the African American community is that, like Charles, people who engage in homosexual activity may not consider themselves gay. Different terms, such as “down low,” “homo thug” and “same gender loving,” are sometimes used.
But the issue goes beyond semantics.
These are men who are not likely to be in West Hollywood or anywhere else where information about AIDS is available. They are part of an underground world living in dangerous ways. And they are hard to reach.
In their world, perception is everything. AIDS medicines allow those who are infected to live longer and healthier lives and to continue attracting partners.
“If men who are 18, 21, 25 saw the number of men I saw die, it would be very different,” said Wendell Carmichael, 45, who has been HIV-positive since 1986. “They’re not seeing that anymore. People are walking around looking healthy. They’re in the gym. They’re working.”
The continuing taboo on homosexual behavior in some communities has led many men to hide their gay or bisexual behavior by dating and marrying women--with devastating effects.
In Los Angeles County, 20% of HIV-positive African American men said they had had sex with women in the past six months, according to a recent county study. That is compared to 9% of HIV-positive white men who reported sex with women, and 4% of infected Latino men.
As a result, the number of black women with HIV and AIDS has skyrocketed.
“Most women don’t even know they’re at risk,” said Cynthia Davis, an assistant professor at Charles R. Drew University in Los Angeles. “They find out when their spouse dies, or when they deliver a sick baby.”
Sylvia Drew-Ivie, director of T.H.E. Clinic, a women’s health center in South Los Angeles, said six women came for treatment of HIV infection just last week.
“Married women come in with a string of children behind them,” Drew-Ivie said. “They’re infected by their husbands, and they had no idea.”
But even when black men identify themselves as gay or bisexual, they still may have little or no connection with the white gay community.
“There’s no place for [black] bisexual men to go,” said Carmichael. “The reality is . . . they need programs developed exclusively for them.”
Even locating the men at risk is difficult. “A lot of men are not meeting in bars,” Carmichael said. “There’s a whole different mentality of how we engage each other.”
The meeting places are often smaller settings such as coffeehouses, home gatherings and workplaces, and the information needed to save lives is not there, Carmichael said.
The problem is complicated when ex-convicts engage in high-risk behavior.
“They come back into the mainstream,” said Kevin Spears, 41, who sits on a county HIV commission. “They have female partners and they may or may not reveal to their female partners that they were involved in risky behavior. . . . The authorities who oversee the penal system don’t want to have that conversation. According to their policy, the men are not having sex. If you talk to the men, they are.”
Reaching Out to Women
Because of the way the epidemic seems to be spreading among gay and bisexual men in the county, officials have cut back on efforts to reach out to women and drug addicts, said Chuck Henry, director of the Los Angeles County office of AIDS programs and policy.
But that, unfortunately, feeds the idea that AIDS is not a threat to people who are not gay. Overcoming that misperception would require outreach workers to go beyond the usual tactics of talking to men at known homosexual haunts, such as parks and gay bars. Instead, the subject would have to be broached at soccer games and church choir rehearsals.
“That sense of alarm that propelled the white gay male community to organize against the disease so well in the beginning of the epidemic simply has not exploded yet in the Latino and African American communities,” Drew-Ivie said. “It just hasn’t happened yet.”
But if Charles has any say in the matter, that will begin to change. He has stopped using drugs and plans to tell his story to young people. In 1998, his brother died of AIDS, and his death changed Charles’ view of the world.
“I think if I would have seen that before, I would have used a condom every time,” he said. “Because it’s not a pretty thing to see somebody die.”
