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On Friday, Jaime Cunningham of NEWSWEEK’s “Human Condition” blog responded to a December NEWSWEEK mag story about “new signs of life” in the AIDS activism movement. She says she hopes the information found by her print counterpart is right, because new numbers from the The New England Journal of Medicine are scary:
More than 1 in 30 adults in Washington, D.C., are HIV-infected—a prevalence higher than that reported in Ethiopia, Nigeria, or Rwanda. Certain U.S. subpopulations are particularly hard hit. In New York City, 1 in 40 blacks, 1 in 10 men who have sex with men, and 1 in 8 injection-drug users are HIV-infected, as are 1 in 16 black men in Washington, D.C. In several U.S. urban areas, the HIV prevalence among men who have sex with men is as high as 30%—as compared with a general-population prevalence of 7.8% in Kenya and 16.9% in South Africa.
Cunningham says the research shows that an individual’s sexual network has more bearing on his or her risk of infection than sexual preference or lifestyle choice. According to Cunningham, black and hispanic women have a greater chance of infection because of the ”instability of their sexual relationships —which is attributed to the high rate of incarceration of men in their networks—and their vulnerable or dependent economic situation, which may cause them to be fearful of suggesting safer-sex options to their companions.” She says black men who have sex with men are at great risk because of the natural proclivity to be attracted to “racially similar” individuals “and because of the prevalence of HIV within their sexual networks.”
To be honest, I couldn’t believe how racist this all sounded as I was reading it, but it then occurred to me that neither Cunningham nor the researchers were trying to be bigoted: What they’re pointing out is the result of racism and classicism. America obviously failed to educate certain groups, and though efforts today may be increased, it will be years before we see the results. My college professors talked about the AIDS epidemic like it was a thing of the past. At present:
More than 20 percent of the estimated 1 million HIV-positive Americans are unaware of their status. Additional behavioral studies, better communication, and preventive education need to be directed toward the identified at-risk communities. It’s time to admit that HIV is still a major threat to Americans.
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This didn’t strike me as racism, it’s just brutally honest. Yes, certain racial/ethnic groups like to associate with other people in their group, so higher rates of STD are probably likely to result within groups. It sucks, yes, but unfortunately it’s true.
Yeah, it didn’t strike me as racist either. It would be racist if they said “there’s more HIV among blacks and hispanics because the poor dumb things aren’t as intelligent or responsible as us white folk!” but that’s not at all what they said (I’d be wigging out if they had!). They simply pointed out that a higher number of black and hispanic men are in prison – where prison rape and unsafe conditions create a breeding ground for the spread of STDs – and the women dating them are thus more likely to pick those diseases up. In addition, being in a more vulnerable position, they’re less likely to demand safer sex because from their perspective, they’ve got bigger problems to worry about. It makes perfect sense to me, and is ultimately not a racial trait but a social and economic one; since they never acted like it was a racial trait, and instead discussed the statistical breakdown of different racial communities as it currently exists as a reason for the disparity, I’m pretty sure there were no bigoted intentions involved.
If they narrowed the white people in their study down to only whites living in similar conditions to the impoverished black and hispanic communities surveyed, I’m betting you’d see similar numbers.
(This isn’t to say that it’s NORMAL that a higher proportion of blacks and hispanics are in poor economic conditions than whites, or that it’s the way that it should stay, or even that there were no well-off blacks or hispanics involved in their study, but it’s a can of worms I don’t even wanna open for discussion, personally. I was just focusing in on whether or not the findings presented in the study sounded racist to me or not.)
Agreed. Stating facts isn’t racist–facts are facts.
HIV may still be a threat to americans, but it’s still no threat to people who take the simple steps to avoidance. It’s not like people are going around coughing HIV at you.
I’m interested in the definition of ’sexual network’. Is this the actual people that you have sex with? Or the people the researchers think you are likely to be able to have sex with?
“In several U.S. urban areas, the HIV prevalence among men who have sex with men is as high as 30%—as compared with a general-population prevalence of 7.8% in Kenya and 16.9% in South Africa.”
This is comparing apples with oranges. HIV prevalence amongst men who have sex with men and amongst IV drug users is always going to be much higher because these two groups engage in high-risk behaviors. I’m not saying “wrong” or “bad” behaviors (at least in the case of men having sex with each other), just high-risk.
If you compare the general prevalence of HIV in the US city with the highest rate (DC, at 3%) with the general prevalence numbers in Africa, the picture is much different. Especially if you look more closely at the prevalence numbers available. The latest study of Ethiopia showed a general prevalence of 3.5%, higher than DC. And the prevalence in “urban” areas of Rwanda is 7.7%, more than twice that of DC, which is also an urban area.
In NYC, the general prevalence is estimated at 1.2-1.8% of the population. Not even close to the numbers in Africa.
This whole post reminds me of a book we read in my college statistics course, called “How To Lie With Statistics”.
I’m not insinuating that the author was attempting to lie, but that it was not thought out properly and a false impression was made.
I can’t tell if it’s the fault of NEWSWEEK, Ashley, or The New England Journal of Medicine from the way the post was written.
I noticed that too, but forgot to mention. They say that the infection rate in DC is higher than in certain countries, but leave out that it is the infection rate in DC *among certain parts of the population* that is higher.
Well gee, I’m sure I could write a study to find that the infection rate of malaria is higher in Alberta than in Botswana if I chose my population as carefully…
I think this study is flawed for one reason. i don’t think that the level of education, treatment or awareness are equal in these areas.
There is simply no way that you can compare the USA to Rwanda and Ethiopia.
Let’s get serious.
Does the education, awareness, or treatment matter?
I agree that given treatment options and such, it’s still a lot worse to be infected with HIV in Africa than America, but I don’t think that’s the point they were going after.
What I got is that ‘even with the education and awareness we think is common here, people are being infected at insane rates (though as noted, not actually the statistics advertised). And that is something to be concerned about. I don’t think it’s meant to go any further than that.
The education could matter… there is a belief by some in South Africa (and much of Africa for that matter) that the cure for HIV is unprotected sex with a virgin. This has led to an increase in child and infant rape specifically in the South African region. It’s called “The Virgin Cure”.
Pretty fuckin sick. I’m not making things up, check this out-
http://www.scienceinafrica.co.za/2002/april/virgin.htm
I’m pretty sure no matter how dumb those “at risk” individuals are here in the states, they know enough to not seek out virgins to defile as a form of cure… they are just leading hopeless lives and don’t really care what happens to themselves.
Besides that, in Africa, is there really a way to know how many are infected by the disease? Dormancy periods, rural living, reluctance to seek treatment, cost of testing, I think would all hinder any true numbers…
I’ve wondered about that, too. I mean, in places where healthcare, ANY healthcare, is practically non-existant, how can someone come up with realistic statistics on the HIV/AIDS rate?
Treatments do matter because in some cases the better treatments lead to more risky behaviors. I read a study a year or two ago that said more gay men are engaging in risky behaviors like not using condoms because HIV just isn’t as big a deal as it once was. Back in the 80s and even 90s it was a horrible disease and once you were infected you were going to die fairly quickly and quite horribly. Nowadays there are so many treatments that allow the infected to live relatively long and healthy lives. A young gay man who is diagnosed with HIV is going to get a cocktail of drugs to hold it at bay and it probably won’t affect his life all that much for a good long time. For some people that risk is worth is to have better sex.
If you tell people that having unprotected sex is very likely to infect them with a disease that will kill them quickly and painfully then the vast majority will take steps to prevent it. If you tell them they might catch an infection that will require a lot of meds and shorten their lifespan a bit then a fair number will still protect against it but many won’t bother.
i maintain, as below, that while that *affects* infection rates, it isn’t necessary to include just to *compare* infection rates.
I think that’s one of the big problems these days. People don’t realize how bad some things are. I was really frustrated when they started calling STDs STIs, as though the diseases were no longer troublesome, but just infections that can be cleared up. When we did sex ed in high school, my teacher had a book that was used a long time previously, that had colour photos of various venereal diseases. It was awesome. I’m all for graphic honesty when it comes to this stuff.
Tell the kids exactly what is at risk. Show the pictures. Bring in someone living with full-blown AIDS to explain how much fun it isn’t, and the side effects of all the drugs. Tell them the truth about what can hurt you, and how you can prevent it.
This glossing over of the bad things is not helping anyone.
Of course it does matter – in many parts of Africa using condoms is a very rare practice because the Catholic missioners have made everyone believe it’s a sin, as they prevent women from getting pregnant. I suppose therefore there isn’t even access to condoms, so yeah, it’s a matter of education, because as someone as pointed out before, these statistics are not talking about the same groups. The prevalence of AIDS infection in Africa within the average population is way higher than in the US, and education and awareness has played a big part.
Sure, but I think the point of the study is ‘education and awareness and all that are so much higher here – why is it not getting through, and why is our infection rate (even among just specific groups) so high?’
That is a valid question, and you don’t have to compare likes for it. They’re trying to see what’s going on, and have simply used another group that would normally be thought in much worse straights as a ‘pay attention, this is crazy!’ comparison.
Kai, what kind of reporting system do they have in Ethiopia and Rwanda?
Exactly.
That was not your original mention, unless I read very poorly.
I would not dispute that at all. Chances are that any numbers coming out are estimates at best, and none of it is very reliable. That is a big problem in comparing infection rates, but the other issues are still separate.
No, Kai – it wasn’t you. It was more of an afterthought.
My brain isn’t thinking in complete sentences lately.
I was insufficiently clear. I don’t mean that those things *don’t matter* at all. I meant that they don’t matter when it comes to infection numbers. Yes, they have an effect, but if you’re looking at the numbers, they are a good enough thing to discuss on their own. The rest is useful information as well, but it is not necessary to address the rest all as one. It is still reasonable to do a study solely on infection rates.
Okay, I know I might get a lot of flack for this, but I have to take to task the the comment that “America obviously failed to educate certain groups.” I went to a rather large inner city public school, where I learned the same stats about STDs that everyone else did. Though I am heterosexual and a non-needle user, I have definitely engaged in unsafe sexual behavior, but I didn’t learn anything different in the same health class than my homosexual, intravaneous drug-using peers.
Granted everyone has a different background, upbringing, etc, but you get to a slippery slope and run the risk of calling every US citizen a stupid sheep when you start blaming the government for not keeping people from contracting HIV.
Very true,its gotten easy to blame the government for all our problems. The true message in this article isn’t that HIV is higher amongst blacks,its higher amongst poor ghetto populations,which I believe are the result of poor personal decisions. At least for now,being born poor in America can be overcome. That should piss-off a few people on a sunday morning!
Man being poor better be something you can overcome because I’m broke as shit at the moment.
More importantly than overcoming, being poor doesn’t mean infection with HIV. It’s not like it lives in the water. It’s still a question of choices, and all people can make good ones.
[...] we’ve discussed on Zelda Lily before, the HIV infection rate in Washington D.C. is sky high — and 30% of those infected in the [...]