Black America in a State of Emergency

By IMANI EVANS
Special to the NNPA from The Dallas Examiner

The 2012 International AIDS Conference in Washington, D.C., can be a bewildering experience for a first-timer, even for veteran AIDS activists, like Marsha Jones of the Aafiya Center in Dallas. There are dozens of sessions, hundreds of participating organizations, as well as exhibitors, protestors, policymakers, scientists and celebrities, all brought together by a disease pandemic that in many ways defines the modern era – its long-simmering conflicts, its inequalities, its tension between the hope brought by dizzying scientific discoveries and the seemingly intractable realities of practical politics.

In spite of the challenges, there is guarded optimism among activists, like the Black AIDS Institute’s Phill Wilson who has been living with HIV for more than 30 years, that the special experience of the Black diaspora living with this disease – African Americans in the United States and African descendants worldwide – has finally begun to creep toward the center of official policymaking.

“Thirty-one years after this disease was discovered right here in this country, we finally have the right combination of tools and knowledge to stop the epidemic,” Wilson boldly declared in front of a large audience at the conference’s Monday plenary session. “Our tools are not perfect, but they are good enough to get the job done if – and this is a big .if’ – we use them efficiently, effectively, expeditiously and compassionately.”

“What I think that Black people need to come here looking to get out of it is some answers from policymakers on how we’re going to curb this epidemic in the Black community,” said Jones, about what she hopes to gain from this year’s conference. “Whatever questions I’m going to ask people, whatever I’m going to be listening for, as to the Black community collectively, I’m going to know: what are we going to do, realistically, to curb this epidemic in the Black community?”

Jones considers high-profile events like the AIDS Conference a rare opportunity for Black persons living with HIV and AIDS – those with the direst need for information and guidance – to compare notes, and, whenever possible, place their concerns before experts and activists they don’t normally get the chance to interact with.

“If we don’t get an answer at this conference, we should continue to ask that question of the people we need to ask it to,” Jones said. “So we at least come here and know who has that answer, because the answer is here. So who has that answer, and how do you continue to follow up with them and ask those questions, those key questions?”

For the sake of African Americans living with HIV/AIDS, including those in Dallas, the more people there are asking the right questions, the better. Within Dallas County, there are currently 14,000 people living with HIV/AIDS, more than a third of whom are Black. Blacks are 48 percent of the newly-diagnosed, compared with 28 percent for Whites and 23 percent for non-White Hispanics.

Nationally, Black women represent 67 percent of all new HIV infections among women. Despite being just 13 percent of the U.S. population, African Americans are 50 percent of all of those living with HIV.

AIDSVu.org, an interactive online map where one views the prevalence of HIV in geographic regions across the United States, offers a picture of HIV in Dallas that is easy to grasp for non-experts. HIV prevalence rates are color-coded from bright yellow (a rate of 0-33 persons living with HIV or AIDS per 100,000 population) to deep purple – a rate of 2,296 or more per 100,000. By filtering the data by race, a user can watch as the map takes on a distinctly reddish and purple hue when displaying prevalence rates for Blacks – which are just shy of 5,000 per 100,000 persons in several zip codes.

“I think it’s the lack of compassion, or the lack of caring, that we see with so many people,” said Ashley Innes, a young AIDS activist, when asked about the biggest challenge faced by those on the front lines. “Social stigma, homophobia, all of those things play a part in that. So you have people who say things like, .Well if they weren’t engaging in this behavior, they wouldn’t have gotten sick,’ and that’s frustrating.”

“I’m constantly amazed at the fact that people really don’t care. They would rather be silent, they would rather turn a deaf ear to it, act like it’s not happening around them – it’s always .those’ people, it’s affecting .those’ people, it’s not really my issue,” Innes said.

Innes, a native of St. Louis, Mo., is a graduate of the Black AIDS Institute’s African American HIV University, where she received intensive training in community mobilization and advocacy. Her experience with AAHU led her directly into the Black AIDS Institute’s Black Advocates Delegation, essentially a platoon of activists working cooperatively to navigate the bewildering complexity of the International AIDS Conference and carry the BAI banner.

Innes brought the lessons she learned under the BAI aegis with her when she moved to Dallas last year.

“Since moving to Dallas, I was able to expand and reach people, I think, on a greater scale. Obviously, being in Dallas has allowed me to be set up with the Black AIDS Institute, so really it allowed me to expand what I’m doing, reach more people and it allowed me to do some things on a personal level that I wanted to do as it revolves around HIV and AIDS,” Innes said.

Another challenge for Black community organizations that are combating the pandemic is keeping abreast of the latest science and the ever-shifting paradigms of prevention and treatment. For instance, activists are just now beginning to come to grips with PrEP – pre-exposure prophylaxis – a new preventive approach that involves administering drugs to non-infected persons who are considered high risk.

According to Jones, organizations such as hers will face a challenge in convincing the populations they serve to try PrEP, given the wariness on the part of many in the Black community towards the medical establishment because of cultural barriers and past history. For her, the jury is still out on this brand-new paradigm.

“For me, I have ambivalence around PrEP,” Jones said. “My ambivalence lies around the very fact that I know that PrEP is really a strong tool, but access – will the community that needs it the most be able to access it? And when we look at PrEP, how extensive has that research been around women? How included have women been in that research around PrEP?”

PrEP also raises the thorny issue of promoting an HIV-related treatment to healthy individuals who have nevertheless been deemed at-risk due to behavioral and socioeconomic factors. And no treatment, regardless of how effective, can overcome a lack of strict adherence on the part of those on whom the treatment is urged.

The all-hands-on-deck message which dominates the International AIDS Conference may have the effect of echoing far and wide despite these challenges. For African Americans in particular, it is a question of whether HIV and AIDS can manage to stand out against a background of other problems that plague the community, such as joblessness, mass incarceration and lack of quality education – to say nothing of health crises such as diabetes and heart diseases.

“I think we have become complacent in the United States as it relates to HIV and AIDS,” Innes said.

Seconding remarks given by Secretary of State Hillary Clinton at the Monday plenary session, Innes worries that it’s not seen as an emergency anymore.

“Black America is in a state of emergency when we’re talking about HIV and AIDS,” she concluded. “And I think the average person doesn’t see it that way.”