Science Yet to Soften HIV's Effect on Minorities, Poor; Real-Life Issues Hinder Treatment

While AIDS researchers speak optimistically of a cure and a vaccine, health workers and community organizations say those most at-risk for HIV are not getting the prevention information and treatment currently available.

"The science of HIV and treatment is coming along, and everyone is excited. We forget there's a real-life implementation that has to occur," said Yvette Calderon, adult urgent-care director at New York's Jacobi Medical Center.

The disease that primarily affected white gay men in its early years has taken hold in minority populations, especially gay and bisexual black and Latino men and heterosexual black women. Kaiser Family Foundation data show blacks are eight times more likely to contract HIV than whites, while Latinos have an infection rate three times that of whites. And though HIV remains an urban problem, increasingly it is impacting rural communities, particularly in the Deep South.

The groups most likely to be infected are the least likely to get treatment or have health insurance, advocates say. They also are the most likely to die of AIDS-related complications.

"No one should have to die of HIV anymore," said Janet Weinberg, COO of the Gay Men's Health Crisis in New York. "But we're not going to be able to get to that point in silence." Cultural barriers prevent communities from having open discussions about sex and sexuality, especially when young people are concerned.

Shavon Arline-Bradley, director of health programs for the NAACP, said her organization spent three years creating an AIDS manual for churches. The goal was not to change what pastors preach about homosexuality or extra-marital sex, but to help frame HIV/AIDS as a social justice issue, she said.

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