Spiral of Invisibility Hides the Continuing Peril of AIDS in Silicon Valley, Calif.

" ... One of the biggest reasons for [HIV's] success is our refusal to look at AIDS right here, right in the eye. We can't blame pleasure-seekers in Los Angeles or San Francisco for bringing it home. 'No, it's homegrown,' said Jim McPherson, the STD and HIV Prevention and Control Program manager for Santa Clara County. ... 'If we want to stop this, we have to stop this in our own neighborhoods.'

"The problem is the silence. 'We're not talking about it in our schools, we're not talking about it in church, we're not talking about it in social situations,' said Cynthia Carey-Grant, executive director of Women Organized to Respond to Life-Threatening Diseases [WORLD]. ...

"'I was denied testing twice before I tested positive,' said Naina Khanna, WORLD policy director. Her answers about sexual activity and drug use didn't fit the at-risk profile. Many of WORLD's clients are African Americans, Latinas and Asians, older mothers and grandmothers who were tested for HIV as much as a decade after being infected. 'You've had the same doctor for years, you're just not on their list of who should be talked to about HIV,' Carey-Grant explained. ...

"In Silicon Valley, AIDS claims two distinct populations, said Fred Ferrer, [CEO] of The Health Trust. There are those who have plenty of support, and those who are unseen. Many of the latter are homeless or addicted to drugs and have exhausted all their resources. Many are in our own families and communities, yet we choose not to see them. Some don't see themselves as at risk.

"Black, brown or white, this spiral of silence and invisibility hurts us all. We add to the isolation of those who are sick, perhaps prompting them to spurn their doctors and medications to avoid being found out. We make it harder to get tested, adding to the spread of infection. To fully address AIDS around the world, it's time we stop averting our eyes.

"Let's be real: Our communities have HIV. We've got to talk."

The author holds the Knight Ridder/San Jose Mercury News Endowed Chair for Journalism in the Public Interest at Santa Clara University.

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