What is the most critical AIDS issue facing the African- American community?
That the number of those diagnosed with HIV is very high in the African-American community. That in turn increases the spread of the disease, which has become endemic among those who are 18 to 40 years old. And even beyond the age of 50 there has been an upsurge. HIV affects the whole age spectrum.
What do you think is the best way to address it?
We need massive education programs. I don't think we've been very innovative with them. There are opportunities to educate in places where African Americans congregate -- in barbershops, hairdressers, Laundromats -- where they don't usually talk about HIV. The CDC ought to put out testing in these places, too.
Testing for HIV is a very simple thing to do -- we don't need any supercalifragilisticexpialidocious approaches to this problem. We just need to do it. I test drug users all the time, here in my program.
If run adequately, needle-exchange programs serve a purpose -- prevention of HIV. No question about it. If you used a clean needle and syringe every time you injected, you'd be safe. We do that all the time, giving injections as physicians in the health care arena.
We treat drug users right here in my program. Part of my practice is to make sure people are treated for HIV, hepatitis C and any other disease they may have.
Where is the most progress being made in combating the HIV epidemic in the black community? Where is the least progress being made?
African-American churches -- not just the organized church, but some other small churches too -- are embracing the fact that we have to do something. They are not being so homophobic as they were. I like what I see.
The least progress is among young people who feel that they are immune. About 75 percent of young people, by the time they reach 12th grade, have had oral sex. In most instances, it's unprotected. So there is a problem there. We have not reached those people. You're going to see more oral gonorrhea, oral syphilis and certainly HIV infections because of that.
What are the top myths about HIV you encounter in the African-American community? What is the best way to counter them?
That condoms don't work. That condoms have the virus in them already. That the medication itself will cause you to develop AIDS if you're infected. All kinds of nonsensical things that prevent people from following their prescriptions.
These myths come from conspiracy theories that abound in minority communities -- that the government wants to wipe them out. Asian, Hispanic and Native American communities also have them. These theories have their seed in the history of racism and sexism that abound in this country.
In what ways is the HIV epidemic different in the black community than other communities?
In our African-American community, people tend to stick to their own race. If we have many people infected with HIV, where people are sexually involved with one another almost exclusively, you have rapid spread of the disease. You see it in the ghettos of Harlem, East New York, Bedford Stuyvesant, for example.
What do you think we can do to help African Americans get tested earlier and therefore get better results from HIV treatment?
People need to begin to talk about it early. I'm talking about early in grammar school, not waiting until kids are 13 years old, when they're already sexually active.
What are your hopes and fears for the next generation of African Americans as they face the risks of HIV?
I hope we have learned that sexually transmitted diseases can completely wipe out the race if we do not heed the message to be abstinent, and certainly to use condoms, and not to use drugs. Those messages have to be gotten out in a sustained fashion, starting at a very early age and not stopping even when people become septuagenarians.
Can you recommend one action everyone can take to end the epidemic?
Know your HIV status. Get tested. Practice safe sex.