AIDS in the 21st century—is it still a scourge, a pestilence and one of the world's deadliest viruses? While physicians, health researchers and social organizations entrusted with caring for those with HIV/AIDS would certainly say yes, those who can shape public opinion and access sorely needed dollars for treatment and research seem to have turned a deaf ear to cries for help.
Perhaps that is why the Center for The Study of Race & Bioethics, DePaul University College of Law, recently hosted its first AIDS Breakfast Colloquium, held at, and sponsored by, Northern Trust Bank, 50 S. LaSalle.
The theme for the program was Confronting the AIDS Crisis in Chicago: People of Color at Risk.
Under the guidance of The Center's Director, Professor Michele Goodwin, the conference provided an opportunity for Chicago agencies that provide services for HIV/AIDS patients of color to inform religious leaders and city officials about their organizations and the current plight of thousands of city residents. In many ways, it was a call to arms.
'Recent statistics from Chicago's public health authorities suggest that people of color represent the fastest growing population of those affected by the Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS). African-Americans' rate of infection nationwide for all age groups is five times higher than that of whites,' said Goodwin in her letter to the conference attendees.
'Secretary of Health and Human Services, Thomas Thompson, recently reported that AIDS is the leading killer of African-American women between the ages of 25 and 34, and Black men between the ages of 35 and 44. In Illinois, 48 percent of newly reported cases are African-Americans and the Latino rate of infection is twice that of whites, as they accounted for 12 percent of all the new reported cases. The need for communication about AIDS and its affect on communities of color seems more apparent than ever before.
'The Center for The Study of Race and Bioethics is committed to exploring new ways to meet the needs and challenges that are defined by this epidemic. Today's program is designed to break the silence too often associated with the disease by bringing together clergy, policy makers, public health officials, activists, students and scholars to discuss this problem.'
Glen Weissenberger, Dean of DePaul's Law School, agreed with Goodwin.
'This is law in action,' he said, referring to the conference. 'Given this crisis, we believe it is crucial to make the service rendered by our faculty, staff and students, relevant and meaningful for our community.'
In the first roundtable discussion, program leaders from five city agencies addressed the topic of AIDS in the 21st Century and noted its impact on people of color and youth. Speakers included: Maurice Chapman, AIDS program director, Cook County Westside Health Center, who addressed church and community responses to HIV/AIDS; Dr. Rob Garofalo, director of youth services, Howard Brown Health Center, and director, Adolescent HIV Services, Children's Memorial Hospital, whose remarks addressed children and adolescents who are affected by HIV/AIDS (either they have it or their parents do); Martin Gonzalez-Rojas, manager of Prevention Programs, CALOR, who addressed Latina and gay male HIV prevention initiatives; Dr. Jing Zhang, director Community Health, Asian Human Services Inc., who discussed Asian Americans with HIV/AIDS; and Grisel Robles, policy advocate, AIDS Foundation of Chicago, who shared information about The Beyond Latex Microbicides Project and other prevention efforts aimed at women.
'There are so many barriers to getting African Americans to even get tested and if necessary, treated,' Maurice Chapman said. 'One is what I call the AIDS phobia—a fear of being outed and ostracized. We are finding that a larger percentage—close to 80 percent—of our clients had past or have current problems with alcohol and drug abuse. Many still feel personal shame, particularly those who are homosexual. Then, our people are reluctant about seeking healthcare except in extreme emergencies because of our justified doubts about the medical community's concern for us. Ignorance, and competing interests, are additional barriers that must be overcome.'
Chapman noted the sense of nihilism that has overtaken a large number of Black youth. And he added that is something we must address.
'So many youth with whom I come in contact, say 'I'm going to die young anyway, so what difference does it make',' he said.
'They aren't worrying about AIDS because they don't believe they'll live long enough for it to matter if they're positive or not. A lot of them have already planned their own funerals, including the music they want played,' Chapman said.
Garofalo noted that in the battle against AIDS and as it relates to U.S. funding, adolescents and youth are getting 'the short end of the stick—especially those of color.'
'Among the 45,000 new infections last year in the U.S., individuals 25 and under represented half of the cases,' he said. 'It's clear that youth, and those of color in particular, make up a disproportionate number of the new cases. And in those young adults, 16 to 19, 60 percent of the new cases are women.'
But are youth of color more at-risk than their white counterparts? Again Garofolo points to numbers provided by the CDC's Young Men's Survey for MSM's [men who have sex with men].
'For the survey, young men 14-24 years of age were tested for the AIDS virus—14 percent tested positive and had no idea of their status,' he said. 'The situation is more grave when one considers that one-quarter to one-fifth of young people 18- to 20-years-old have no access to healthcare. In Chicago, there's a paucity of adolescent-specialized programs that address the unique development and psychosocial struggles of adolescents. We need a moral obligation to provide services to youth color.'
Garofolo added that Chicago Black youth, particularly on the South Side, need services in their communities, where they have unique needs and a higher risk factor than other city youth.
Rojas is employed by CALOR, an HIV/AIDS prevention and care agency that was started 11 years ago to target Latino men. He said one of the problems facing his community is how Latinos tend to be stereotyped.
'We don't all come from one country, which means we have different cultures,' he said. 'Some of us come from the Caribbean and North, South and Central America. And we don't all speak Spanish. Portuguese and French are also native tongues for some of us. CALOR focuses on Spanish-speaking men because for many of our clients, language remains the No. 1 barrier. I find that other agencies often fail to have the kind of sensitivity to our culture that is so important just to get people to come in, get tested and then remain, if necessary, for services.'
Rojas added that with the newest census figures that indicate Latinos as the largest U.S. minority, more programs will need to be developed that speak to their unique needs and way-of-life.
Zhang referred to three major barriers that affect the Asian community: stigma, silence and access to quality healthcare.
'In the Asian community, talking about STD's is taboo, but some changes are occurring,' she said. 'The image that we use for our community health programs is the Banyan tree—which in Asian culture represents shelter. It's also the name of our collective HIV services.
'One challenge we face in our community is the limited information about the HIV status of Asians and Asian Americans. In the U.S. we are often referred to as 'other,' but in some countries we are the majority and in some of those places AIDS has reached epidemic proportions.'
Zhang admits that when compared to Blacks and Latinos, Asian Americans comprise a much smaller percentage of those with HIV/AIDS [one percent with AIDS and three percent HIV+]. But she contends that for her the numbers are less important than the people who they represent.
'Asians are a group but we represent 40 different ethnic groups who speak over 100 languages and dialects,' she said. 'However, constant among all Asians is the importance of the family. There simply aren't discussions about sexual orientation or safe sex and certainly no one's taking about their HIV-status. So you find a lack of community and family support. In fact many of our clients request appointments at locations other than our own because they don't want to be seen coming in for services. Also complicating our job is the number of immigrants whose immune systems have already been compromised. They are afraid of being deported and often have problems communicating. The bottom line and similar to other people of color—once diagnosed as HIV-positive, in the Asian community it's tantamount to cancer—there's a stigma. Even those effected don't believe they have a future, so they give up on living.'
Can You Say Microbicides?
Robles is well known in the LGBT community for her one-woman advocacy of microbicides. She was the final speaker in the first roundtable discussion and in her remarks she highlighted developments on research into new HIV-prevention tools.
'There are 50 to 60 new products that are at the clinical trial stage—three are in the third clinical phase, which means that if the results are positive they will go before the FDA for approval,' she said. 'One of the more science fiction-like products is an invisible condom that eventually disintegrates and is passed out of the vagina. I remind people that microbicides are similar to spermicides and they're being developed to offer something other than condoms while maintaining the effectiveness of condoms to prevent the transmission of HIV/AIDS and other STD's. This is significant because many women are unable to use condoms because of religious reasons.'
But Robles warns that there are several misconceptions that need to be addressed for the sake of public health.
'Some people falsely believe that there is no risk of infection when one is engaged in oral sex, but there is a risk factor involved without protection,' she said. 'And in the case of the product N-9, in some doses the drug actually facilitates the transmission of HIV.'
She added that a different way of talking about prevention must happen now because advocating abstinence and the use of a condom do not appear to be working.
'Complacency is on the rise as are infection rates,' she lamented. 'We have to step up efforts of education and also become public advocates for products that are accessible—that means they are available on the global market and affordable.'
Religious and Responses
An alderman, an executive director, and a public health official, all from Chicago, were among those who responded to the presentations made in the morning's first discussion. Ald. Shirley Coleman, 16th Ward, represents a community where infection rates are at an all-time high. Five health centers also operate within her ward.
'In the past I have found myself in a reactionary mode,' she said. 'But I realize that it's time to change my stance—it's time to be proactive. People in Englewood find it tough enough just to get food and to make sure their gas and lights are on. AIDS is not a priority.'
Coleman, who is also a licensed preacher, said the conference opened her eyes and forced her to admit that many leaders have not done an adequate job in the battle against AIDS.
'As a local legislator I am saddened by the lack of funds that we have allocated, particularly in this region of the state where we have the highest infection rates,' she said. 'The truth is we have not done all we could do—at any level of government. I have been to Africa and seen the devastation there, but today I am seeing that Africa is right here in my own backyard. As you teach me more, we will do more as a community. This room needs to be filled with ministers because we have a serious problem. And so often we want to blame everyone else.'
Coleman promised to present a resolution in City Council and urged public health advocates to attend the meeting and show their support.
Mark Ishaug, executive director of the AIDS Foundation of Chicago, offered his analysis on the city's AIDS crisis among people of color.
'This conference is so important because it's one of the rare times where the AIDS community is talking to others instead of itself,' he said. 'The current reports indicate what many of us would rather ignore—that people of color are still receiving unequal treatment. Therefore our agency's No. 1 priority remains to eliminate the barriers and to target scarce resources to those communities that have the greatest needs—those disproportionately affected by HIV/AIDS.'
Among the Foundation's 7,600 clients, 58 and 17 percent are African American and Latino, respectively. They have also recently launched a campaign to convince the City of Chicago to increase its funding for AIDS programs by $1 million. And, they are developing a syringe access bill for the state legislature.
Illinois is one of only four U.S. states that prohibit pharmacies from selling clean syringes—90 percent of prenatal HIV transmission comes from injection drug users.
'There are other things we need to address if public health really matters to us,' Ishaug said. 'Our prisons need HIV-prevention programs including the availability of condoms. Officials say that sex isn't going on in the prisons. We say they need to talk to those who provide health service to inmates or just watch Oz [the HBO show on life in prison]. The current state of denial as it relates to the prison effects people of color most significantly as 85 percent of Illinois' prison population is people of color.'
The AIDS Foundation of Chicago again hosted its annual Lobby Days in Springfield March 24 and 25.
Lora Branch, director of the Office of Gay and Lesbian Health, Chicago Department of Health, began her remarks with sobering statistics just released in the AIDS Chicago third-quarter surveillance report. She reported that AIDS cases have now been documented in each of the state's 77 counties.
'It's a question of capacity, competence and the impact of the 'isms,' she said. 'It's wrong that the lion's share of funding continues to be allocated to white-run agencies when those most in need are people of color. Agency leaders need to develop some of their minority workers so that they can eventually assume upper-management positions.'
Branch also criticized the federal government's abstinence-only programs. 'The federal government has allocated $150 million to a program that is clearly not working and refuses to even talk about advocating safe-sex initiatives,' she said.
Rev. Jesse Jackson
The Rev. Jesse L. Jackson Sr. is often criticized for sticking his nose where it isn't needed—for being a publicity hound, if you will. But since last year when he spoke at a lunch meeting for Chicago Black Pride, he has become more outspoken about the needs for Blacks suffering from HIV/AIDS.
And the DePaul conference was no exception. In his remarks that closed the conference, he said the time has come for the church to enter into a discussion on AIDS and theology.
'Some see this disease as the rewards of sin. I believe there must be a moral imperative to address this crisis—no one is helped if we only point fingers at behavior and ignore those who are suffering,' he said. 'Our major churches remain silent and are in denial, while AIDS has escalated to our nation's No. 1 health problem. It's a human-rights/human family issue today. No longer can we afford to look at AIDS as a gay or straight issue. And the impact it continues to have on our babies threatens the next generation.'
Jackson also pointed out that 80 percent of the men in Illinois prisons are young men who were convicted for non-violent drug charges. Young Black and Latino men who are at the height of their sexual activity and who upon their release take contracted STD's back to their communities.
'What can we do? First, our churches need to develop some sense of theology,' he said. 'All of our ministers need to take the HIV/AIDS test before their congregation. It's time to break the taboos and to encourage early detection. Second, the DJ's who our young people listen to faithfully need to be more educated about HIV/AIDS. They have tremendous influence on youth and are not being responsible in their on-air statements.
'Our people are sick and somewhere between their sickness and our moral imperative there is the opportunity for healing in the land.'