- WASHINGTON (AP) _ Black Americans are becoming infected with AIDS at record
rates, receiving poorer care than whites and dying faster.
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- Now, almost two decades into the AIDS
epidemic, about 1,000 health care providers and activists gathered for
the first medical conference on AIDS among black Americans _ a frantic
hunt for ways to fight the exploding racial divide.
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- AIDS in the United States is evolving
from a disease that once mostly affected white homosexuals into one largely
of poor blacks, often infected from dirty drug needles or heterosexual
encounters.
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- Blacks make up 12 percent of the U.S.
population but a devastating 45 percent of new AIDS cases. AIDS has been
the leading killer of blacks between 25 to 44 for most of the decade. One
in 50 black men and one in 160 black women are estimated to be infected.
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- ``This is an historic event,'' Phill
Wilson of the National Black Lesbian and Gay Leadership Forum told the
conference Thursday. ``What we do ... will determine whether or not we
make a difference.''
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- ``This is no less a daunting challenge
than we faced in the civil rights movement,'' added Dr. Stephen Thomas
of Emory University.
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- The doctors, social workers and activists
sought practical, day-to-day advice on fighting HIV, the AIDS virus, in
communities often wracked by poverty and drugs, where a legacy of racism
has left distrust of the medical system.
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- How do you get a drug user or a homeless
person tested for HIV? How do you treat the hotel maid who can't afford
the time off to go to a clinic only open weekdays? You're surprised that
the bus driver quit taking the AIDS medicine you prescribed _ even though
the main side effect was diarrhea?
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- ``We're talking about reaching ... people
who might not have had a meal since noon yesterday, and they're still sitting
in the clinic'' for four hours because the doctor overbooked, complained
Debra Hickman of Baltimore's Sisters Together and Reaching.
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- Then came the thorny issue of preventing
and treating HIV in prisons. ``Our men are in the jails. They do come home
to their wives and girlfriends,'' warned a California AIDS worker, describing
one reason HIV infection is growing fast among black women.
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- Nor do many black doctors specialize
in AIDS, complained a Colorado nurse who described herself as the only
black AIDS health worker in her town. White doctors ``do care, but they
don't understand when I say, 'Patients don't trust you.'''
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- President Clinton has declared AIDS among
minorities a crisis.
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- The administration is spending $156 million
this year and seeking $171 million next year to fight back.
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- But Clinton last year refused to use
federal money to buy clean needles for drug addicts, one way to prevent
HIV's spread. Frustrated at the ban, administration doctors urged local
communities Thursday to raise the money themselves for needle exchanges.
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- And critics questioned if the government's
work is fair: One new program calls for 35 percent of AIDS research sites
to be in minority communities, but two-thirds of new infections now occur
in those communities.
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- The conference's main goal was to empower
workers on the front lines of AIDS, providing information and resources
to help their communities, said Cornelius Baker of the National Association
of People With AIDS.
-
- He said, ``We need to make care more
culturally appropriate. Maybe clinics need Sunday hours, or you could give
health care at church after Sunday services.''
-
- And grass-roots doctors who don't often
get to the fancy international AIDS meetings hungered for the latest data,
questioning experts on which drugs to use.
-
- ``We can be flexible,'' said Dr. Joel
Gallant of Johns Hopkins University. Not everyone needs that much-publicized
but expensive ``protease inhibitor'' cocktail right away, he said. Newly
infected patients with low HIV levels might be all right not starting drugs
for a while. Got a patient who won't swallow 15 pills a day? Some new drugs
require far fewer.
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- But there were no easy solutions.
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- Take Gallant's advice for doctors to
test even newly diagnosed patients' blood to see if their HIV will resist
certain drugs. The immediate response: Medicaid and other programs don't
pay for those tests, so how can we use them?
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