The plague still prowls in our communities. Many of us have turned away from the battle as if it has been won. Thirty years have passed since the discovery of GRID—later named AIDS—and the dead, some forgotten, others part of a patchwork quilt of remembrance, a warning to those who will soon be infected and affected.
Silence=Death was our battle cry across the nation and then around the world as we realized that this was not simply "a gay disease" but a global pandemic. With the discovery of expensive medications—a privilege not afforded to those in Africa, Asia, Latin America and the Caribbean—we grew complacent and the burning fervor of ACT-UP was replaced in the gay community with a desire to wed and to serve openly in the military. The subtle stigma of "the gay disease" was pushed to the side as somehow no longer symbolic of a community under siege, but a side issue to be back-shelved.
The survivors of those early years of funeral after funeral grew tired and spent their days coping with pharmaceutical side-affects and worries about health coverage for pre-existing conditions. As they lived on, they watched in dismay as younger generations of men disported themselves bare-backing as if they had not a care in the world because they could delude themselves with playing HIV-roulette and thinking that the only consequences would mean a daily regimen of pill-taking.
Meanwhile, in communities of color the denial of church people delayed a rapid response to discussions of sex and sexuality, especially those of young gay men, and few voices were raised to herald the uptick in heterosexual transmission. The statistics were clear: more and more young women and men fell victim and the massive army of activism failed them as well.
All this was complicated by massive introductions of drugs (heroin and cocaine) into already devastated low-income communities, and if anything, the War on Drugs increased the risks taken and lives ruined in pursuit of a set of works and a fix, or bodies sold on street corners and in crack houses to trade sex for drugs or the money to purchase them. A few intrepid warriors hit the streets and engaged in guerrilla needle exchange programs, and a Harm Reduction Coalition was formed, but junkies didn't elicit the sympathies of the pious among us—unless perhaps it was your son or daughter, and sometimes not even then.
I sat and watched tecatos (addicts) huddled in chutins (shooting galleries) as they turned themselves into human pincushions, drawing up dope from shared cookers, sharing jeringillas (syringes) filled with dope and blood. I went to Puerto Rico from East Harlem and entered scenes lifted from the night of the living dead as homeless junkies with open sores and abscesses hustled to get just one more bag of manteca and then went home to infect their wives, constrained by the Catholic Church from condom use. "Better to die of AIDS," counseled a bishop to a women seeking permission to protect herself, "than to commit a sin."
I returned to New York and watched young white men from New Jersey drive across the river to score better dope in El Barrio and to return home bearing a deadly gift. Every morning I observed a few well dressed Wall Street types hop off the Lexington Ave subway at 125th street, cop a bundle, buy some works and head downtown to shoot up in a luxury office, sharing infections with upper middle class co-workers. Who would suspect them anyway? Wealthy young white men are not junkies.
I spoke with homeless addicts who willingly shared syringes with those who were infected, hoping that perhaps if they tested positive they could get off the streets, get housing and regular meals. A deal with the devil. Get shelter now, worry about dying later.
As years passed and new drug markets for prescription pills like Oxycontin swept though suburban neighborhoods like a deadly white hail storm, those strung out on those expensive tablets who could no longer beg, borrow or steal the money to buy them were suckered into switching to heroin—so much cheaper and oh how satisfying to tie up your arm and ease the point of a needle into a vein and find relief. The hell with consequences. Those who get busted and go to jail or prison find no need to stop injecting. Syringes are often shared between many users since they are contraband. Sex is forbidden in these institutions, but it happens anyway and they aren't distributing condoms. If you didn't come in with the virus, you had a high chance of going home with it.
The Body reports:
The rate of HIV among prisoners is 5 to 7 times that of the general population. HIV rates are highest among African American prisoners.
In 2006, 16.9% of all people living with HIV in the US were in a correctional facility at some point.
In 2008, there were about 20,449 people with HIV in state and federal prisons. The rate of HIV infection is higher among female inmates (1.9%) than among male inmates (1.7%).
Risk factors while incarcerated also include rape.
Sexual transmission
One of the primary routes of HIV transmission is through sexual intercourse. In many prisons both consensual and non-consensual sexual activities are common among inmates even though they may be forbidden under prison rules. It is difficult to determine to what extent such activities occur, as those involved risk punishment if exposed to fellow inmates or prison officers. Therefore the majority of incidences go unreported. The need for prison and penal reform has been highlighted as an essential approach to preventing HIV transmission through sexual abuse. Reducing prison populations has been highlighted as one way in which this may be achieved.
A number of factors contribute to an increased risk of HIV transmission through sexual intercourse in prison:
Unavailability of condoms: Condoms, which can prevent HIV infection if used consistently and correctly, are often considered contraband within prisons. A study of HIV transmission among male prisoners in Georgia, America, found that only 30 percent of those who reported any consensual sex used condoms or improvised condoms.
Rape: The often violent nature of non-consensual sex can cause tearing and bleeding, which increases the risk of HIV transmission. Rape in prisons is rarely reported, but the WHO estimate that prevalence ranges from 0 to 16 percent. In 2003 in the United States it was estimated that over 1 million inmates had been sexually assaulted in the past 20 years.
When we think about the number of men who are or have been incarcerated, we must also be aware that those who are HIV positive who are paroled come back to the community and often infect wives, girlfriends or lovers. Female inmates who are drug injectors run the same risk of becoming transmission vectors once they get home.
Sine there is no major outcry about incarceration rates, and prison conditions here in the U.S., our silence contributes to yet another deadly factor in community destruction.
David Rosen recently wrote Things Will Likely Get Worse for the Most Vulnerable: AIDS at 30, taking a hard look at where we are now.
In the U.S., an estimated 1.1 million people live with the disease. The principle modes of transmission involve: unprotected male-to-male anal sexual intercourse; injection drug use; unprotected heterosexual sexual intercourse; and other means like contaminated medical syringes. Nearly half (500,000) of those infected in the U.S. are African-Americans. A recent study by the Black AIDS Institute, "Deciding Moment: The State of AIDS in Black America," notes: "Every year, 56,000 Americans become infected with HIV. Nearly one out of two newly infected people are Black." While New York, California and Florida have numerically greater numbers of people living with AIDS, Washington, DC, is the nation's AIDS capital. Measured on the basis of those infected per 100,000 of the population, Washington has an estimated 119.8 AIDS cases compared to New York's 24.6, Florida's 23.7 and California's 10.2.
HIV/AIDS is ravaging minority communities in the U.S., especially the African-American and Hispanic. Black Americans account for 12.6 percent of the U.S. population; when those who identify with more than one race are included, the total is 13.6 percent. Hispanics/Latinos have become the nation's largest "minority" group, accounting for 16.3 percent of the population. However, African-Americans account for:
§ 45 percent of new HIV infections;
§ 46 percent of people living with HIV;
§ 48 percent of all new AIDS diagnoses; and
§ 57 percent of all HIV-related deaths.
Digging deeper, these figures get even more alarming:
§ Black women account for 61 percent of the HIV infections among women – this is nearly 15 times greater than the rate for white women.
§ Black youth aged 13 to 19 years are only 17 percent of U.S. teenager population, but represent 68 percent of all new AIDS diagnoses among teens.
§ 46 percent of Black gay and bisexual men are infected with HIV, compared to 21 percent of white men and 17 percent of Hispanic males.
...
HIV/AIDS among gay and bisexual black men is more than double that of white men, but the transmission patterns vary between both groups. The "down low" phenomenon has been much commented upon within the African-American media, but heterosexual transmission and injection drug use accounts for a greater share of infections among black men than white men; white men are more likely to have been infected through unprotected homoerotic anal sex. Most disturbing, newly infected black gay and bisexual men are younger than their white counterparts; those aged 13–29 account for 52 percent of new infections among blacks compared to 25 percent among whites. Social issues will likely play a secondary role in the 2012 election. Jobs, jobs and the deficit will increasingly dominate political discourse. Politicians are sharpening their knives aggressively in their quest for budgetary expendables. As 235 years of American history has taught us, the poorer and darker you are, the more expendable you are.
We are expendable, like garbage thrown out into alleyways.
While many celebrate in New York over gaining marriage equality, drastic cutbacks were proposed to AIDS funding and housing and food services in the city. Community activists fought back against Bloomberg's Doomsday budget while he garnered praise for his support of same sex marital bliss.
I am angry.
Having lived through the early years, burying lovers, family members and friends, I don't know how I can bear watching yet another generation of loved ones dance with death. I cannot even begin to cope with the global nature of the pandemic; the sheer scope of the numbers has numbed my ability to respond.
Yes, there are those who soldier on in the struggle. Poz Magazine is still providing a wealth of information, medical anthropologist Paul Farmer is still a staunch advocate for PWAs living in poverty.
Phil Wilson
Phil Wilson still leads the Black AIDS Institute and the Latino Commission on AIDS is paying more attention to the plight of Latinas. So the struggle continues, but too many other progressive voices are silent.
Every once in a while, there is good news. For years, I've been frustrated by a lack of adequate response from organizations like the NAACP, but last week they announced a new initiative.
NAACP Joins Coalition to End the War on Drugs
The NAACP has come out forcefully against the War on Drugs:
The National Association for the Advancement of Colored People (NAACP) passed a resolution Tuesday calling for an end to the “War on Drugs” during their 102tn NAACP Annual Convention in Los Angeles, CA.“Today the NAACP has taken a major step towards equity, justice and effective law enforcement,” said NAACP president and CEO Benjamin Jealous. “These flawed drug policies that have been mostly enforced in African American communities must be stopped and replaced with evidenced-based practices that address the root causes of drug use and abuse in America.”
The resolution, titled “A Call to End the War on Drugs, Allocate Funding to Investigate Substance Abuse Treatment, Education, and Opportunities in Communities of Color for A Better Tomorrow” highlighted the fact that the United States spends $40 billion each year fighting the drug war and that African-Americans are 13 times more likely to end up in jail for drug-related crimes than their white counterparts.
“Studies show that all racial groups abuse drugs at similar rates, but the numbers also show that African Americans, Hispanics and other people of color are stopped, searched, arrested, charged, convicted, and sent to prison for drug-related charges at a much higher rate,” said Alice Huffman, president of the California State Conference of the NAACP. “This dual system of drug law enforcement that serves to keep African-Americans and other minorities under lock and key and in prison must be exposed and eradicated.”
This is good news because one year ago, when AIDS experts from around the world gathered in Vienna and issued a manifesto against The War on Drugs, few people listened.
Drug War Statement Upstaged at AIDS Gathering
VIENNA — Some of the world’s top AIDS experts issued a radical manifesto this week at the 18th International AIDS Conference: They declared the war on drugs a 50-year-old failure and called for it to be abandoned.
No one heard.
Officially, the theme of the AIDS meeting, the world’s largest public health gathering, is the need to attack the rapidly growing epidemic among addicts in Eastern Europe, Russia and Asia. It was held in Vienna because this city is the doorway to the East and, in this German-speaking country, all the conference signs are in English and Russian.
...
But the organizers’ efforts to get publicity for the Vienna Declaration, which calls for drug users to be spared arrest and offered clean needles, methadone and treatment if they have AIDS, have come to naught. Almost no one here talks about the war on drugs. Instead, everyone is publicly worrying that the war on AIDS is falling apart. Donor money is evaporating in the recession, and it is looking likely that only about a third of the 33 million infected people in the world will have any hope of treatment.
Frustration is high. Speakers like Bill Gates were interrupted by demonstrators in Sherwood Forest green calling for a “Robin Hood tax” — a tiny fee on the $4 trillion in currency transactions made daily by banks and hedge funds that could raise billions for AIDS.
Here's hoping that this year the silence in certain quarters will be broken.
Lest we forget.
Silence=Death