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Less Talk, More Action

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As the country adjusts to changes presented by the Affordable Care Act, some activists are hoping that it can help combat a serious health epidemic in the African-American community.

HIV/AIDS, experts note, is a worsening challenge that could have a catastrophic impact on Blacks if it is not discussed more frequently in communities across the country.

“We are dealing with a serious crisis and now we need less talk and more community-based action to address it,” said C. Virginia Fields, president and CEO of the National Black Leadership Commission on AIDS.

The challenge

Shortly after the HIV/AIDS virus was first clinically observed in 1981, a large number of Americans, including many Blacks, viewed the disease as one that primarily affected homosexual men.

However, that perception began to change by the early 1990’s, as prominent heterosexual African-Americans such as tennis star Arthur Ashe, basketball great Earvin “Magic” Johnson, singer Bobby Debarge and rapper Eric “Eazy-E” Wright announced their diagnosis.

Today, nationally, statewide and locally, statistics point to an alarming trend that shows HIV/AIDS cases occurring among African-Americans at a higher rate than other ethnicities.

More than 1.1. million Americans currently live with the HIV/AIDS virus, and about 510,000 are Black, according to the Centers for Disease Control and Prevention. Although they only represent a little more than 12 percent of the population, African-Americans account for a staggering 49 percent of all new HIV/AIDS cases.

Black women in the United States are 15 times more likely than white women to become infected with HIV.

In Indiana, the scenario is also disturbing. By the end of 2011, a total of 10,279 people were living with HIV/AIDS, up from 9,893 the previous year. Thirty-five percent, about a third, of those living with the virus are African-American.

“Blacks continue to have a rate that is almost three times the rate of Hispanics and more than eight times that of whites,” said William VanNess II, Indiana state health commissioner.

State officials also note that the rate of new diagnosis is especially high among African-American males at 63.5 percent, compared to Hispanics (18.5 percent) and whites, 7.3 percent.

Dr. Virginia Caine, director of the Marion County Public Health Department, said local data reflects what is happening statewide. Of the 160 new HIV/AIDS cases reported among males in Marion County so far this year, 124 are African-American.

When asked about possible reasons behind the spike in HIV/AIDS cases among Blacks, she noted that barriers in health care prevent many from getting the diagnosis, testing and treatment needed to fight the virus.

“I think there’s a higher percentage of us who don’t have access to health care, compared to other races,” said Caine, who is also an infectious disease physician. “If someone doesn’t have a primary care provider seeing them regularly, then they probably don’t have an expert telling them what needs to be done to prevent HIV/AIDS.”

Caine believes that as more individuals obtain health care coverage as a result of options available under the Affordable Care Act, the number of HIV/AIDS cases will decrease.

“More preventative education is needed on an individual basis. People might see that information on television and on billboards, but when they have specific questions they need to have someone who can provide an answer.”

Research by the CDC indicates that HIV in Black men is spread most often through not using a condom or other protection when having sex with a man who is infected with HIV; sharing drug needles or syringes with an infected person; and not using protection when having sex with an infected woman.

Among African-American women, the most common ways HIV is spread include not using a condom or other protection when having sex with a man who is infected with HIV; and sharing injection drug needles or syringes with those who are infected. 

The promise

Some may argue that the Indianapolis area may not have a large network of providers offering HIV/AIDS related services, but there are still places where infected Hoosiers and those who need testing can go.

Organizations located in Indianapolis such as the Damien Center, the Indiana Minority AIDS Coalition and Brothers United provide assistance in various forms, including counseling, support groups, medical insight and advice for caregivers.

Also, Caine noted, medications that are prescribed to treat HIV/AIDS have been improved and can now slow the progression of the disease, extending a person’s life.

Still, she said, the best way to prevent HIV/AIDS or reduce the severity of its symptoms is testing and early detection.

“It is important for anyone who has ever been sexually active to at least get tested for HIV annually and to know the HIV/AIDS status of their sexual partners to stop the spread of the disease,” Caine said. “If they are diagnosed early they can get useful, life prolonging treatment.”

Fields believes that not only should there be an expansion of social programs to support HIV/AIDS awareness initiatives, but more outreach should be done to groups that have often been overlooked.

“Are we doing enough to reach people who are uninformed and don’t have any idea they’re at risk, or the domestic violence victims who are too scared to bring up the subject of protection with their sexual partners,” she asked. “Are we providing enough on-the-ground support for the mothers who can’t get tested or receive basic health services because they don’t have child care or transportation? Those are real-life problems. Our HIV/AIDS strategy, must continually evolve to support community-based mobilization.”

People living with HIV/AIDS

An estimated 1 million people are living with HIV in the U.S., according to government statistics. Not only are they alive, but are living full, rich lives with a disease, that in its infancy, was considered a death sentence.

Times have changed. Advancements in HIV/AIDS care and educational efforts have changed the course of the disease, but sufferers say more is needed.

Following are the stores of Indianapolis residents infected with HIV/AIDS. Learn about how they acquired the disease, how they’ve learned to cope and their message to the community.

Living optimistically

A native of Memphis, Tenn., Larmarques Smith always knew he was gay. As a man in his 30’s, he grew up during the ‘80s and ‘90s, the era when “wrap it up” was a constant public service announcement.

“I knew about HIV. Since I was gay, I knew it was a possibility. Other than (Earvin) Magic Johnson, it was always the gay person to get it,” said Smith.

In Tennessee at that time, according to Smith, teens under 18 had to have their parents’ permission to get an HIV test. Although his sexual activity was low, as soon as he turned 18 he began getting tested annually.

In his early 20s, like most young men regardless of their sexual orientation Smith said, his sexual activity increased. However, he made sure he was safe.

In the mid-2000s, Smith moved to Evansville and began a relationship. He and his partner decided to both get tested, which was no big deal for Smith.

On Feb. 12, 2008, he went to the health department for his results. Because he was in the waiting room longer than normal, Smith began to get nervous. After a while, he was called into a private room. There, the physician told Smith he was HIV positive.

“I was a bit devastated. I didn’t say anything for a few minutes then I started crying,” said Smith. “The HIV counselor was not very comforting at all. The thing he said to me after was, ‘OK, who have you slept with.’ Rather than taking an extra minute for me to get myself together, he asked me that. He could have said ‘it’s not the end of the world’ or something.”

Smith left the health department thinking about how he was going to explain his status to his parents, friends and partner. He took a few days to gather his thoughts, but became proactive. He contacted a HIV care coordinator, found a doctor and began a medication regimen.

Smith said the merciless physician who delivered his news inspired him to work in HIV/AIDS outreach. He moved to Indianapolis and is currently the food pantry and housing support coordinator at the Damien Center.

“I didn’t want someone to have that kind of experience. Telling someone they have HIV is hard enough and that’s enough for them to chew on in that moment,” Smith said.

Today, Smith’s HIV status is undetectable, meaning his blood cell levels are so low that HIV would be difficult to detect on a test.

Smith is optimistic about his life, but is doubtful about the lives of today’s youth. He claims that while advancements in drugs have helped those living with HIV and AIDS, today’s youth are ignorant about what the disease really does to one’s life and don’t take HIV/AIDS seriously.

“They think they can take a pill and be fine. What they don’t know is that if you miss a dose, your body can build up resistance, which means the medication won’t work as well. This medication is expensive and has side effects. If you don’t have insurance, you’re in trouble,” Smith said.

He also thinks the Black community is still fearful of the disease. He hopes one day HIV/AIDS is cured, but in the meantime, wishes people remain vigilant about HIV/AIDS education.

Accepting reality

Clarence Hatcher had children and was divorced, but was happy and had a financially lucrative career. This all changed when he acquired HIV from having sex with men.

“They told me I had problems with my liver. They did blood work and the doctor told me I had HIV and would be dead in six months. It was the late ‘80s, early ‘90s and I had no idea what it was,” said Hatcher.

Believing he would die, Hatcher took a leave of absence from his job, withdrew all of his money from his savings and began living every day truly like it was his last.

A year later, he was still alive, was broke and became sicker which manifested itself as irritability, fatigue, diarrhea, vomiting and loss of appetite.

Throughout this time, Hatcher was pastoring a church. When it became evident his health was declining, he decided to tell his family and his church members the truth.

“I got tired of hiding,” he said. “The first Sunday of July 1997, I told my congregation. That next Wednesday, I came to the church and all my things were in the parking lot and the locks were changed.”

Hatcher then decided to care for his ailing parents. While being a caregiver, he said he had time to think about his life and the path it was on. Hatcher began to educate himself on HIV, go to support groups and found a job as an HIV tester and counselor.

Hatcher became a staunch supporter of HIV/AIDS awareness and while he was spreading the word about the disease, his HIV transitioned into AIDS. The news made him suicidal. He said he got through this period with help from God and today is living well with his illness.

“I don’t live my life by others’ standards – I keep my stress low. I get my rest and take my meds,” said Hatcher. “I live a very prosperous life.”

As someone who’s seen the course of HIV and AIDS from its infancy, Hatcher is also grateful for the advancement of medications resulting in those infected living longer, healthier lives. The downside is that he believes today’s youth focus more on pregnancy and not the dangers of HIV/AIDS and other sexual transmitted diseases.

He also thinks there are too many individuals who know they are HIV positive, but continue to spread the disease in addition to men who acquire the disease in prison and when released, spread it to women.

“This has never been a ‘gay disease’ but those stigmas still exist. It’s not ‘them’ and ‘they.’ Anyone can catch HIV/AIDS,” said Hatcher.

African-Americans and HIV/AIDS

– African-Americans make up 12 percent of the United States population, but they represent 44 percent of new HIV cases. HIV infections among Blacks overall have been roughly stable since the early 1990’s.

– The rate of new HIV infections per 100,000 among Black adults/adolescents (68.9) was nearly 8 times that of whites (8.7) and more than twice that of Latinos (27.5) in 2010.

– The number of Blacks living with HIV increased by 7 percent between 2008 and 2010, compared to a 5 percent increase among whites.

– In Indianapolis, 783 African-American men and 268 women are living with HIV/AIDS.

– Locally, the age groups that have the highest levels of infection include:

❚ 20-24

❚ 30-34

❚ 25-29

❚ 40-44

❚ Rates are on the rise among those 15-19

Sources: Centers for Disease Control and Prevention, Kaiser Family Foundation and Marion County Health Department.

Tips on preventing HIV/AIDS

– Get tested at least once a year.

– Abstinence.

– Fewer partners/monogamy in relationships

– Use of safe sex materials such as male and female condoms, dental dams and finger cots when engaging in sexual activity. Note: Do not use male and female condoms at the same time!

– Sober sex (without drinking or taking drugs).

– Do not reuse needles or syringes.

 

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