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It's More Than a Health Crisis: Economics Fuels HIV/AIDS for Black Americans; what drives the AIDS epidemic?
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From Jules: I think its more complicated. Injection drug use is a major cause for HIV transmission among African-Americans. The root causes for IDU are complicated and not only due to poverty and lack of education, although these certainly are causative. Injection drug use, in particular heroin and cocaine use, crosses all socioeconomic lines. Many well educated and people of means use and get addicted to IDU heroin & cocaine use. There is a large segment of MSM who are African-American so what are the factors that influence them in acquisition of HIV. This is also complicated: stigma against homosexuality and drug use can be strong in the African-American community; the churches have not played a good and positive role overall in helping this. The influences of risky sexual behavior and substance abuse that affect the gay community also comes into play in this community. I'm sure that I have not not provided a full discussion of the issues, but the crisis of HIV in African-Americans and Latinos and Whites is complicated. HIV prevention is one major issue but so is secondary prevention, that is how does one address HIV once infection has occurred. So, after one learns they have HIV do they take all the proper actions to promote their health, adhere to the best HIV care & treatment, and prevent further transmissions to others. There are many complicated issues here. Certainly, poverty or perhaps that's a surrogate for lack of education is an influence. But so is mistrust of the system which is not uncommon in the African-American community, but also although less common is an issue in Latino communities and also but less among whites. HIV rates appear to be increasing among the MSM communities, is it due to poverty? There are other influences at large here. Certainly one of the issues driving this appears to be a complacency that HIV is not the certain killer it once was, that it is a manageable disease. In general, people are tired of using condoms, tired of restrictions on sexual behavior, and perhaps the underlying reasons people use drugs has overwhelmed all the reasons and early lessons of HIV prevention that were taught to many. The psychosocial causes that drive individuals to abuse drugs and to have unsafe sex has become to strong and the reasons not to do tis have been forgotten: call it 'fatigue'. "Safe Lifestyle Fatigue" maybe is similar to adherence faigue. Maybe this is similar to smoking cigarettes. Although everyone in society at least in the USA knows smoking cigarettes can kill you and cause serious health conditions, many educated and people of means continue to smoke and many young people start smoking. How about obesity. Despite the clear messages of the dangers of obesity this epidemic continues. Why? The human psyche is more complicated than a simple reason; poverty contributes, lack of education contributes. But these are complicated epidemics.
http://www.louisianaweekly.com
By U. S. Rep. Keith Ellison (D-Minn.), NNPA Special Commentary
March 3, 2008 talkback
February 7, 2008, marked the eighth National Black HIV/AIDS Awareness Day; a time that was devoted particularly to building support for HIV prevention, care, and treatment among African Americans.
HIV and AIDS are grave health concerns for all Americans, but the Centers for Disease Control and Prevention (CDC) reports that African-Americans have more illness, shorter survival times, and more deaths than Americans of other races or ethnicities, and HIV/AIDS also affects Black children disproportionately more.
Nationally, African-Americans represent 42 percent of all people currently living with HIV/AIDS, despite only representing 12.3 percent of the population. African-American women accounted for 66 percent of all new HIV/AIDS cases among women in 2005. These troubling statistics are echoed in my home state of Minnesota.
We must take time to get involved in our local communities, urging our friends and families to get tested and get educated about transmission modes of HIV/AIDS. We must continue our efforts to ensure that treatment is accessible to all those who are currently living with HIV. It is essential that we see this crisis in its broader context if we hope to slow the spread of this epidemic in our communities. I also believe we must take a hard look at other factors that the experts tell us contribute to these high rates of infection among African Americans: economics, education, homophobia, incarceration, and faith in government.
America is currently awash with fears of recession, the foreclosure crisis and deepening unemployment. When the economy sours, those who earn the least typically suffer the most. Unfortunately, those same people are statistically more likely to be suffering, literally, from diseases such as HIV/AIDS.
In describing "Prevention Challenges" on its website, the CDC highlights the plain fact that in our country, people who don't have much money cannot always get good health care: "Day-to-day living may be more important than taking care of their health. Poor people may need to spend their time, energy, and money just to get food, shelter, and transportation. This can affect whether a person gets information about HIV and AIDS and whether they have access to HIV testing. If they become infected with HIV, they may not know it, they may not get treatment soon enough or they may not get treatment at all." These dilemmas are particularly acute for African-Americans, 1 in 4 of who were living in poverty in 1999.
We have got to do better, and that means we must start with economics. I'm proud to have supported the first minimum-wage raise in 10 years and to have sponsored legislation to bring relief for homeowners facing the prospect of foreclosure.
The economic stimulus measure that I supported in early February begins to address the broader economic troubles we are facing, but comprehensive changes to the federal government's spending priorities must come too. We can't budget to lift Americans out of poverty or significantly improve health care for those living with HIV/AIDS while we spend $10 billion per month on military activities in Iraq.
The consequence of the federal government's current spending priorities is, regrettably, that poor people can't access high-quality health care and that African-Americans don't encounter enough targeted outreach about HIV/AIDS. I am working to change these priorities.
There are of course other challenges facing African-American communities struggling with HIV/AIDS: education, incarceration, homophobia, and lack of confidence in our government and health care system. The CDC points out that "a history of racism, oppression, and lack of trust in governmental institutions make it more challenging for public health agencies to effectively reach African Americans."
Economics, though, is fundamental. I have addressed and will continue to address these interconnected challenges and invite the public to do the same.
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