What do you focus on in your HIV/AIDS advocacy work?
My own work relies on educating my staff so they in turn can educate and motivate their friends, family and peers. They are the ones who are the most effective at reaching the so-called hard to reach. I also serve in an advisory capacity with several organizations.
What are the biggest obstacles you encounter?
The biggest obstacles are working in our current fear-of-retaliation society. Speaking out will lead to negative feedback and possible investigations. Organizations have already faced the weight of the U.S. government for daring to accept taxpayer dollars and not eye to eye with the funder (as if they were not taxpayers themselves!).
What is the most critical AIDS issue facing the African- American community?
Key is understanding that blacks in America are not a monolithic group. Addressing any disease vector by assuming we share behaviors based solely or predominately on our skin color is a sure way of not addressing the causal factors of disease progression.
How would you best address that?
Perhaps the answer to this does not exist. If I were to hazard a guess, I would recommend a "class structure" of prevention education. "Classism" is a harder nut to crack than simply relying on race -- and neither approach would be simple.
Where do you think the most progress is being made in combating the epidemic in the black community?
The most progress is being made among poor blacks. As the government releases more resources to local community groups and helps them interpret the issues faced by the local community, more blacks are being tested, more are finding they are eligible for treatment earlier in disease progression, and more are sharing what they learn with others.
Where is the least progress being made?
The least progress is being made in the press. The darker this disease got, the more poor individuals fell victim to the virus, the worse the government response has gotten. The "Fourth Estate," while not responsible in and of itself, has dropped the ball with respect to reporting local disease-fighting progress as well as local challenges and failures. From Appalachia to Albany, the press is looking for the scandal but rarely reports on the victories.
What are the top myths about HIV that you encounter?
In this day and age I don't face too many myths. The epidemic in Baltimore is more like that in Southeast Asia than anyplace in the U.S. The primary way HIV is transmitted here is needle use. The primary myth is that simply because someone shoots up heroin or cocaine they are uninformed about the political and/or medical realities of their lives.
What could help African Americans get tested -- and therefore treated -- earlier?
Testing, as a prevention measure, is useless. I firmly believe everyone should know their HIV status. But is it not possible that so many more blacks have been tested in this country that the data cannot help but show that so many more of us are infected? Maybe, I don't know, but just maybe seven times more black women are getting tested than their white counterparts. Has anyone even asked that question or done any research to get the answer?
Do you think the down low is as serious a problem as the media has made of it?
Good God, no! It's yet another sound bite to place blame! Rarely was this excuse used to explain specifically why married black women were getting infected -- it was used to explain why almost all black women were getting infected! Forget the data that showed more black women were being infected because of their own injection drug use and/or sex with an injection-drug-using partner, forget looking at more black women than ever before being tested for HIV.
First it was, "Those gay people are doing it to the rest of us" -- forget the fact that in almost every other country in the world this is an overwhelmingly heterosexual disease! Then it was, "Those bisexual black men are doing it to black women." There is no doubt that bisexuality is a contributing factor to women getting infected, but the data does not support the blame-game technique!
What are your fears and hopes for the next generation of African Americans as they face the risks of HIV?
That they won't understand that HIV is not a "chronic, manageable illness" -- it is a terminal disease, and people suffer and die of AIDS-related causes today as badly as those who died of GRID ["Gay-Related Immune Disorder," the first misnomer for the disease] back in the early '80s.
Do you think activism is an effective way to fight the epidemic?
There was a time I would have sworn the only way to fight the epidemic is through activism. Today, there are political realities we have to face: a hostile federal government, looking to punish HIV-positive folks -- whether through not adequately funding the Ryan White CARE Act or by ignoring the fantastic work local community groups do in favor of funding ineffective programs.
Can you recommend one action that we all should take to end the epidemic?
Pray and act. This is not about compassion -- it's about action. Prayer is not the only answer, but it's a damn good start. When you finish praying, get off your collective butts and go to a local community group, and volunteer your expertise. The progress being made is being made at the grassroots level, and too many small black organizations don't even have legal representation or bookkeepers, much less CPAs!
Click here to e-mail J. Lawrence Miller.