In an effort to address increasingly high STD and HIV/AIDS rates among African-American communities, dozens of local activists and public health employees met Oct. 5 a the Chicago Urban League for a "Stop Transmitting Silence" community discussion.
"People talk about 'The new face of HIV' as if all of a sudden it started to be a high prevalence among people of color in the last few years," said Rush Medical Center's Dr. Kimberly Smith. "The reality is we've been the majority for a really long time."
Smith was one of six panelists tapped to speak at the event. Others included: Chris Brown, assistant commissioner of public health for Chicago's STI/HIV/AIDS division; Illinois state Rep. Camille Lilly, a Democrat from Chicago's 78th District; the Reverend Michelle D. Hughes of the Congregational Church of Park Manor; Tamela Milan of the Access Community Health Network; and Kendra Jones, a junior at Curie High School.
It's estimated that there are more than 25,000 people living with HIV in Chicago, Brown said. While African Americans constitute about a third of the city's population, they account for 56 percent of HIV-positive residents. Additionally, about 4 percent of those living with HIV are youth aged 13-24.
According to Brown, Chicago saw a 19 percent decrease in new HIV diagnoses between 2005 and 2009. However, during that same period, there was an 85 percent increase among youth aged 13-24. Of these, 75 percent were male; 80 percent were Black; and 60 percent were men who have sex with men.
"The health disparities in these new cases are really outrageous," Brown said. "African-American youth and LGBT youth are being seriously affected."
When it comes to other sexually transmitted diseases, the city isn't doing much better. Compared to other urban areas, Chicago ranks No. 1 for cases of gonorrhea, No. 2 for chlamydia cases, No. 3 for syphilis, and in the top 5 for HIV cases, Brown said.
Panelists uniformly identified four key factors that could help abate these rates: comprehensive sex education, increased STD and HIV testing, reduced stigma and adherence to medication.
"The real tragedy is that we're on the precipice of such incredible hope," said AIDS Foundation of Chicago President David Ernesto Munar, who provided opening remarks. "This year was a watershed year for research. We now have empirical evidence that … good adherence to [ antiretroviral therapy ] medications can render a person with HIV virtually un-infectious."
Strict adherence reduces chances of transmitting by 96 percent, Munar said. That's a rate of reduction greater than correct, consistent condom use. "The real tragedy is that we actually have the tools now," he said.
One of the biggest barriers to accessing medication is testing. Brown estimates that about 20 percent of the people living with HIV in Chicago don't know they're positive. That translates to roughly 5,000 people.
Fear of stigma is a major deterrent to medical testing and care. "The misinformation is out there that you have to be promiscuous or doing something that's out of the box," Smith said. "You don't have to have a lot of partners. You don't have to use drugs. You don't have to do anything out of the ordinary. You just have to come across the wrong person and not use protection."
Comprehensive sex education could abate that stigma, said Rep. Lilly, an Illinois House co-sponsor of the Accurate Sexual Health Education Bill, or H.B. 3027. The bill, which was presented at Wednesday night's event, would allow individual school boards to update their sexual education programs as they see fit.
The current Illinois School Code on Sex Education does not require sex ed, but urges schools that do teach it to opt for an abstinence-only program. The codes mandates courses "shall teach honor and respect for monogamous heterosexual marriage."
A recent study by the Cook County of Public Health shows this approach isn't working. A survey asked 1,718 students in 20 public high schools in suburban Cook County a variety of questions about sexual health and practices. About 37 percent of the teens who answered have had sex. Of these, 61 percent were Black, 49 percent were Latino, and 24 percent were white.
Furthermore, only 62 percent of the teens who had had sex in the past three months reported using condoms the last time they had sex. And 19 percent said they used alcohol before their last encounter.
H.B. 3027 wouldn't require comprehensive sex education in every Illinois school. It would merely allow schools that want to teach sex education to do so. The abstinence-only clause would be removed, and school districts would be given a choice.
"Why would it not be common sense to educate our children in grades 6 through 12, when we're talking about medically accurate information, where we are designing it where it's age appropriate, where we are emphasizing abstinence as a way of avoiding and preventing unintended pregnancies and STDs?" Lilly said. "Why wouldn't we begin this information early?"
Lilly said she's received a lot of backlash in the House from members who don't think children should learn about sex. Khadine Bennett, an ACLU of Illinois staff attorney who helped draft the bill, argued sex education is about holistic health.
"Sex ed talks about healthy relationships," Bennett said. "How do you create boundaries? How do you learn about your body? How do you love yourself? How do you talk to your parents about sex? How do you identify who in your community you can go to with questions? It's not just about sex … . We're teaching life lesson skills."
During a Q&A session, some audience members charged the bill didn't go far enough, arguing sex education should be mandatory.
"We updated the school code in the minimal way that would allow this to be passed with the idea this is a first step and not the ideal," Bennett said. "If we were in California, this bill would look radically different. California has the Cadillac version of sex-ed, and we're trying to get a Pinto. It's better than what we have right now."
Panelists urged audience members to encourage their state representatives to vote for the bill as a necessary first step in abating high STD and HIV/AIDS rates.
"I think we have to get past all this moral crap, and really focus on the reality: Kids are having sex, and they're experimenting," Smith said, arguing that testing and education are critical. "We can stem the tide of future infections by identifying who's infected now and making sure they're on therapy. If you're on therapy, not only are you living a long life, but you don't have to worry about passing it on to your partner."
"Stop Transmitting Silence" was co-sponsored by the ACLU, AIDS Foundation of Chicago, Black Women for Reproductive Justice, Chicago Black Gay Men's Caucus, Chicago Abortion Fund, Chicago Urban League, Illinois Caucus for Adolescent Health, and the Illinois Maternal and Child Health Coalition.
