The HIV/AIDS Epidemic: Why It’s Still Taboo

By Karla Robinson, MD
 
V/AIDS remains a huge burden in the Black community.  According to recent estimates from the Centers for Disease Control (CDC) roughly one-half of all new HIV/AIDS diagnoses are in African Americans.  The infection rate statistics are sobering.  1 in every 16 Black men and 1 in every 30 Black women will be infected with HIV in their lifetime.
 
In an effort to increase HIV/AIDS awareness in the African American community we interviewed Ainka C. Gonzalez, MPH, Prevention Programs Manager in the Department of Education and Volunteer Services at AID Atlanta, Inc. to gain some insight into the epidemic that is ravaging our community.  She is responsible for ensuring that HIV awareness and prevention programs are tailored to the specific needs of the community through the successful management of the Latino/Hispanic Outreach Program, the Youth Outreach Program (Ask Us), and the African American Women’s Outreach Program (Sista Sol) at AID Atlanta.
  
UHM:  First of all, I would just like to say thank you so much for agreeing to shed some light on the HIV/AIDS epidemic in our community and the efforts of AID Atlanta to increase awareness.  What do you think is the most startling fact about HIV/AIDS that most people don’t know?
 
AG: According to the Centers for Disease Control and Prevention, 21% of people in the United States that are infected with HIV do not even know that they are positive.
 
UHM: What a frightening reality we are facing.  Why do you think the community at large is not aware of their status?  What are the biggest barriers to HIV screening in the Black community?
 
AG: There are several barriers to people taking an HIV test, especially in the Black community.  I would have to say two of the biggest are the stigma and a lack of access to care. Unfortunately, HIV is still seen as a disease caused by “dirty” or “wrong” behaviors. Some people may feel judged by their healthcare provider or community based organization if they request a test. Also, those that are HIV positive are so fearful of negative reactions by their families and community that they remain silent. As the activists in the ’80s screamed, “silence = death”.
In terms of access to care, African Americans have significantly less resources and are more likely to live in poverty. There may be limited testing sites or opportunities for testing in black communities.
 
UHM: In addition to the barriers to screening for HIV/AIDS that you mentioned, it also seems as though there are many myths and misconceptions about HIV/AIDS circulating in our community.  What are some of the more common myths about HIV/AIDS?
 
AG:
1) There is a cure for HIV/AIDS.
2) All you have to do is take a pill now, and it’s not as dangerous as it used to be.
3) Women cannot transmit the virus to men.
4) HIV is really only impacting people in Africa, but the epidemic is pretty much over in the US.
5) Only promiscuous people and drug users get HIV.
6) You can take an AIDS test.
 
UHM: It seems many people in our community also have the misconception that there is only a certain demographic that can fall victim to HIV/AIDS instead of the truth that anyone that is sexually active is susceptible to contracting the disease.  What flaws do you see in the way we are dealing with HIV/AIDS in our community as a whole?
 
AG: I would like to see more dialogue going on in our community about the impact of HIV. I think we are doing an excellent job of promoting HIV testing, but often we lack the opportunity to have an honest dialogue about the behaviors that lead to HIV transmission. For example, how many of us have conversations about HIV status prior to consummating relationships? Or go to get tested with proof of each other’s STD/HIV results?
Also, I feel that it’s easier to say that “these kinds of people” get HIV, when in reality “these kinds of people” is anyone that has unprotected sex or shares contaminated needles.  HIV does not care if someone is well educated with a great career, religious and married. It’s basic: all that’s needed is an exchange of four bodily fluids with an infected person (blood, semen, vaginal secretions, and/or breastmilk)
 
 
UHM: What are your thoughts on how can we change the perception on what the “face” of HIV looks like?
 
AG: I think we need more diverse representation on a national level. However, it’s extremely tiring for those that are open with their status because they are in such high demand. I feel if we start having more conversations about HIV, then more people will feel comfortable disclosing their status, and people will be able to see that their neighbor, teacher, church member, sister, brother, and even mother is infected.  In other words, allowing people to see the humanity again.
  
UHM: Black women have one of the fastest growing rates of HIV infection.  What do you think is contributing to this demographic being so affected?
 
AG: I think some of the things I mentioned before still apply. However, I think as women, we often put others’ needs before our own. This includes asking specific questions about our partners’ status, not going to the doctor when we feel ill, because of our kids, and being afraid to end a relationship.
 
UHM: What can we do as a community to improve the HIV/AIDS crisis we are facing in the Black community?
 
AG: Each person should get tested and learn their status. With the rapid test available, you can learn your results in 20 minutes.
Start the conversation with your friends, faith community, children, sorority/fraternity members, family, and co-workers about how HIV is transmitted and how it impacts our community.
Get involved with your local AIDS Service Organization to ensure there is input from the Black community about our needs.
Write your legislators to make sure they know HIV is important to you and to increase funding for HIV prevention and care (e.g. CDC Prevention dollars and Ryan White Care and ADAP funds).
Finally, talk to someone who is HIV positive and ask them about their experiences.
 
 
UHM: I thank you so much for your work in helping to improve the HIV/AIDS crisis in our community.  Can you please tell us where people get more information on HIV/AIDS screening, testing centers, prevention and treatment?
 
AG: Some great websites include:
Also, the Georgia AIDS and STD Info line is another great resource: 1.800.551.2728
 
HIV/AIDS-Urban Legends
 
1.  There is a cure for HIV/AIDS.  This is untrue.  While research is ongoing, there is still no cure at this time.  Due to great strides and advancements in medical treatments, often time medications can help to control the virus and slow the progression of HIV, but there is no cure for the disease.  There also is no “virgin cure” whereby having sex with a virgin cures HIV.  Once infected and HIV positive, the virus always lives in the body.
 
2.  All you have to do is take a pill now, and it’s not as dangerous as it used to be. This can’t be farther from the truth.  In fact, even with the advancements in treatments HIV is just as dangerous, and just as deadly as when it was first discovered.  According to the Centers for Disease Control (CDC) more than 18,000 people die as a result of HIV/AIDS in this country every year.  There are approximately 56,300 new HIV infections in the U.S. every year. 
 
3. Women cannot transmit the virus to men.  This is false.  There have been many well documented cases of HIV positive women infecting men with the virus.  Vaginal fluids and menstrual blood are potential sources of HIV infection.
 
4. HIV is really only impacting people in Africa, but the epidemic is pretty much over in the US.  It is estimated that over 1 million people are living with HIV in this country.  Over 21%, or 1 in 5 of those infected and living with the disease in this country are not even aware of their HIV positive status.   HIV remains a huge health concern worldwide.
 
5. Only promiscuous people and drug users get HIV.  Anyone having unprotected sex is at risk of becoming infected with HIV.  The number of sexual partners or level of “promiscuity” is not a factor in determining if you are at risk.  The more people you have unprotected sex with, the more opportunities there are to become infected.  But the risk of infection is the same for everyone.  Sharing needles is also a source of infection for HIV.
 
6. You can take an AIDS test.   There is no “AIDS” test.  The tests that are available are HIV antibody tests.  These are tests determining if you have been exposed to the HIV virus which we know can lead to AIDS if it progresses.  Regular screenings with prompt diagnosis of an HIV positive infection and appropriate treatment can slow the risk of progression to other HIV related diseases and AIDS.
 
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This was printed in the December 18, 2011 – December 31, 2011 Edition