March 16, 2007
IT’S GETTING HOT IN HERE
Dr. Julie Gerberding, Director of the CDC.
In response to its own, startling new statistics about HIV infections in the black community, the Centers for Disease Control (CDC) laid out a much-anticipated plan of attack with great fanfare on March 8. But advocates on the front lines of treatment and prevention were not celebrating. Many lambasted the CDC and Bush administration for not taking a comprehensive approach to addressing the community’s needs, failing to commit real resources to the plan and egregiously neglecting the black community’s highest-risk populations: women and gay men.
“This is nothing new, and the CDC has not come up with any out-of-the-box strategies of dealing with the epidemic,” says terri smith-caronia, director of New York City public policy for Housing Works. “Basically, the plan uses the same tools that we’ve been using for the last five years.”
The CDC’s “Heightened Response to the Ongoing Crisis of HIV/AIDS among African Americans” outlined four ways to combat AIDS within the community: Expand the reach of prevention services; increase opportunities for HIV testing and treatment; develop new and effective prevention interventions; and mobilize broader community action.
When it unveiled “Heightened Response,” the CDC also released shocking stats about HIV in the black community in its Morbidity and Mortality Weekly Report. Of the 184,991 adult and adolescent HIV infections between 2001 and 2005, 51 percent were among African Americans—more than all other racial or ethnic groups combined. In 2005 alone, the rates of HIV diagnosis among black men were seven times higher than white men, and 21 times higher for black women than their white counterparts. The report also revealed that the primary method of transmission for black men was male-to-male sexual contact. For black women, it was high-risk heterosexual contact.
Advocates cited numerous reasons that “Heightened Response” falls short.
One is that it focuses largely on testing, instead of outlining a comprehensive array of efforts. Judith Dillard, board secretary of Community HIV/AIDS Mobilization Project (CHAMP), asks “[When] will the CDC realize that HIV, as a state of emergency in the black community, needs new approaches? Where’s the housing, the prison sentencing reform, the programs for women, gay men and drug users—the programs we so desperately need?
The plan is also short on cold, hard cash. Despite CDC Director Dr. Julie Gerberding’s statement during the star-studded rollout--featuring 100 community leaders and celebrities—that “you can’t solve big problems with small investments, you need big investments to solve big problems,” the new plan offers no additional money to fight the epidemic. In fact, with the funds for the Minority AIDS Initiative being withheld until the fall, community-based organizations serving people of color are suffering more now than ever.
“It’s a case where one hand doesn’t know what the other is doing,” says Mark McLaurin, executive director of the New York Black Gay Network. “Without additional resources the plan rings kind of hollow.”
Black gay men ignored
The plan also rings hollow because, while gay men are leading the black community in new infections, “Heightened Response” had no response for the black gay community. “This is the first time that the Bush administration and CDC have acknowledged that a majority of new HIV infections in the black community are among gay men,” McLaurin says. “But they have presented no targeted strategies for how to address this shocking reality.”
McLaurin believes prevention strategies for white gay men are not always effective in the black community: “If they are serious about addressing this community, we would see initiatives that address the homophobia in the black community, racism in the white gay community, and homelessness among gay black youth,” he says.
Black women ignored
The CDC also seemed to go out of its way not to map out initiatives for African-American women despite the agency’s own devastating stats about their infection rates.
The CDC had been scheduled to meet with black women community leaders but postponed until the end of April. Despite the postponement, the Black Women’s HIV/AIDS Network presented the CDC with 10 strategies last September for addressing the epidemic among black women. These suggestions included the creation of gender-specific program announcements and social marketing campaigns targeting black women, and the collection and sharing of data specific to black women in all states. None of the recommendations were included in the “Heightened Response” plan.
“We see an escalating number of infections in black women. How are these women getting infected? We now know that it’s not men on the down low, so we just don’t know,” says A. Toni Young, convener of the Black Women’s HIV/AIDS network in Washington DC. “Heterosexual black women are understudied. We need a better understanding of disease transmission among black women’s social and sexual networks. We already know more about black gay men because they have been studied.”
As Young says, since the report is already out, “the horse has already left the barn.” Ultimately, though, she believes this isn’t about plans with fancy titles from toothless government agencies. “What we really need more than anything is, regardless of race, gender, or sexual orientation, people who will stand up and say, ‘We deserve more and deserve better. We deserve respect and acknowledgement in this epidemic.’ ”