Oregon County Puts AIDS on Table

Responding to disproportionately high STD rates among African-American youths, the Multnomah County (Oregon) Health Department recently called a community meeting that drew more than 100 people.

Tricia Tillman manages the department's STD disparity project. "We have to ask why these numbers exist," she said of statistics showing that chlamydia and gonorrhea rates for county residents ages 15-24 are almost six times higher among blacks than among whites. And blacks make up 9 percent of Portland-area HIV/AIDS cases but only 2 percent of the population. "We haven't talked about sex, and it doesn't serve us. It just lets this continue to get worse," she said.

Tillman cited a number of reasons for the disparity: These included poverty, lack of access to health care, and the disproportionate number of incarcerated black men. She noted that even for black youths who are heterosexual and have few partners, STD rates are disproportionate -- a phenomenon she explained by saying that because the black community is so small, diseases circulate more easily among its members.

Doug Kirby, a social scientist, said comprehensive sex education programs have been shown to raise the age of first intercourse, lower teen pregnancy rates, and increase condom use among black youths. The most effective efforts, he said, focus on teens' sense of responsibility to their communities, not just on individual behavior.

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