The Past-and the Future?-of the AIDS Crisis

By: Hugh B. Price

President

National Urban League

Under a sedate headline, "AIDS Services Slow in Reaching Latinos," the April 22 news report in the Washington Post on the growing impact of AIDS among the immigrant Latino population of Washington, D.C. told a grim, alarming story.

The Washington area's increasing Latino immigrant population is being hit hard by the AIDS virus, according to public health experts and AIDS caseworkers. They add that their ability to reduce the sweep of the scourge is being severely hampered by cultural and economic realities that make it difficult for them to provide and for Latino immigrants to seek out AIDS-care services.

At first glance, the numbers involved seem small. Washington's Latino population is just 8 percent; that of its neighbors, Virginia and Maryland, just 4 percent each; and Latinos make up no more than 6 percent of those infecting with the H.I.V., the virus that causes AIDS, or carrying full-blown AIDS in any of the three jurisdictions.

Yet, the story reports that Latino AIDS activists say those figures "vastly underestimate" the spread of the disease among immigrants and the seriousness of the problem.

Instead, they say the evidence for sounding an alarm lies in the fact that Washington-area AIDS clinics have experienced a small but rapid increase in the number of immigrants coming for services who are already near death.

"This tells us that they probably became infected 10 years ago, and certainly, they infected other people," said the director of one clinic in Northwest Washington, "Clearly, the numbers are going up, because we're full, but there's still a perception that Latinos are at a low risk."

That misperception is partly fed by cultural barriers-among them, the stricture of the Catholic Church against the use of condoms, and a deep-rooted bias against homosexuality in Latino culture, which is still heavily drawn to attitudes and displays of machismo.

The latter makes it difficult for many men, particularly those who are homosexual or bisexual, to speak truthfully about their sexual activities with health workers, let alone their families, friends and sexual partners.

Current data indicates that Latinos, 13 percent of the American population, now account for 19 percent of new H.I.V. infections, and that AIDS is the leading cause of death of Latino men ages 24 to 44.

Perhaps even more devastating in terms of stemming the disease's spread, the culture of machismo also makes it difficult for many Latinas, especially new immigrants, to discuss sex with their male partner, or even ask that he use a condom.

It will come as no surprise, then, that AIDS caseworkers and others who track the scourge, say that the H.I.V. infection rate among Latinas is rising noticeably-as it is among women everywhere.

But this increase is also fed by economic barriers.

Because they're largely confined to low-wage service jobs that rarely offer health insurance, many immigrants feel they can't afford to seek even basic health care. When a catastrophic illness like AIDS strikes, they feel they have no choice but to endure it in the forlorn hope it will just go away.

Does this grim tale sound familiar?

You bet it does.

Substitute for Latino immigrants: African Americans, who, though 12 percent of the American population, make up 54 percent of new H.I.V. inflections and 47 percent of AIDS cases.

Or, black Africans throughout sub-Saharan Africa, where 25 million people are now living with H.I.V., and where in the year 2000, more than 2.4 million died from AIDS.

But don't stop there.

Go to India, Indonesia, Cambodia, Vietnam, Thailand, and Myanmar on the Asian subcontinent, or the Ukraine and other former Soviet republics; or the Balkans, or various sections of Latin America.

Or China: where government estimates say that as many as 850,000 people may have H.I.V. (by comparison, U.S. officials estimate that as many as 950,000 in the U.S. have H.I.V.)-but where AIDS activists and international health experts contend that 1.5 million people likely have the virus, and that 200,000 have already died from AIDS.

In one sense, then, the Post report could be read as a stark retelling of how this devastating scourge has been able to cut into various demographic groups here in America and across the globe.

Beyond the boundaries of the highly-educated, resource-rich and well-connected middle classes, those mired in poverty (or ensnared in drug usage) for various reasons have few defenses against a disease for which no cure has yet been found.

Our recognizing the similarities of how and why the disease is rooting itself among another vulnerable population in America ought to-has to-stir us to action. That, the Post reports, is occurring among the governmental and private-sector health agencies in the metropolitan Washington area.

No matter where the AIDS scourge has rooted itself, the response of the healthy and those with resources has to be the same: More money and more resources have to be devoted to put in place the treatment and preventive programs that will beat back this disease.

It's no exaggeration to say that the future of humanity depends on it.

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