AIDS: D.C.'s Silent Stalker of Women

By Courtland Milloy
Wednesday, December 3, 2008; B01

Washington Post

Can we talk frankly about HIV/AIDS and black women?

No? I didn't think so.

After all, who cares to tell sassy little Keisha that if she doesn't stop mistaking sex for love, her next mistake could be her last. Of course, that wouldn't be "age appropriate," now, would it?

What about the Widow Jones? Since her husband passed, she has been dating again. Will somebody please tell her that her new dude is on the down low -- surreptitiously having sex with men -- then bringing it to bed with her?

Can't do that, either. Why meddle in her business? After all, AIDS is only the fourth-leading cause of death for black women ages 45 to 54. Let the good sister have her fun -- while it lasts.

You might have noticed that I'm focusing on women and AIDS. Speaking frankly, that's because it's up to women to save their own lives. When it comes to sexually transmitted diseases, too many men are not trying to protect you. Most of the time, they are just trying to have sex.

Quite frankly, you would have thought more women would have caught on by now.

In the District, the number of women living with AIDS increased by more than 76 percent in six years -- nine out of 10 of them black women. The primary modes of transmission: heterosexual men who turned out to be IV drug users, ex-convicts who'd been having sex with men in prison, bisexual men posing as heterosexuals and outright dogs who make a sport of sexual conquest.

Here's another reason I'm talking to women: The District accounts for 9 percent of all pediatric AIDS cases in the United States. Blame the man all you want, but it's the mother and child who suffer most.

Despite two decades of advancement in the treatment of HIV/AIDS, "we're still struggling with how to teach people not to get infected," Don Blanchon, chief executive of the Whitman-Walker Clinic in Washington, said Monday at a candlelight vigil marking the 20th anniversary of World AIDS Day.

But how can we teach if we can't talk frankly?

There's certainly no shortage of public service announcements aimed at reducing infection rates among African Americans. But most consist of preachy platitudes, politically correct and "culturally sensitive" pablum: "Stay healthy." "AIDS is preventable."

The results should not be surprising.

"People know how to espouse what they heard, but for some reason it does not stick with them," Barbara Chinn, director of Whitman Walker Clinic's Max Robinson Center in Southeast Washington, told me recently. "They still look at prospective sex partners and say, 'They don't look infected.' "

Failure to tell it like it is -- that's what's really killing us.

"When assessing the HIV risk factors associated with African Americans, one particularly difficult area of debate is that of sexual behavior," said a recent report by Avert, an international AIDS charity. "For example, could the epidemic among African Americans be because, on average, they have more sex partners than Caucasians? Or because they have different, more risky, types of sex? Such questions may seem obvious, but trying to establish answers can be hard, especially when there is a danger that they could be interpreted as racist, or used in racist propaganda."

So let's just forget about the 2005 study by the Centers for Disease Control and Prevention that found that black teenagers were more likely to have had four or more sex partners than whites and Hispanics by the time they graduated from high school (or should have graduated), and that African American girls were more likely to have had partners who were significantly older than them. African Americans are also more likely to have concurrent partners -- that is, more than one partner at a time, which can make HIV transmission more likely to be passed on to more than one person, the study found.

If ever there was a case for unvarnished sex education in public schools, the ongoing AIDS epidemic in black America ought to be it. Instead of education, what we get more often than not is homophobic nonsense from the pulpits of our black churches.

The District has the highest rate of new reports of AIDS in the country, and the highest mortality rates to go along with it. But the horror of it all barely seeps into our collective conscience.

"While Africa is the global epicenter of HIV/AIDS infection," Chinn told me, "the District is the epicenter in this country, with infection rates in some neighborhoods east of the Anacostia River rivaling those in sub-Saharan Africa."

During a World AIDS Day interview with ABC News, President Bush called his international program to combat AIDS "one of the most important initiatives of my administration" and praised it as a success. More than 2 million people worldwide have received life-saving antiretroviral treatments since the initiative began in 2003, he said.

He made no mention of the AIDS epidemic raging in his own back yard.

Once again, mum's the word. Perhaps in the absence of frank talk, we could at least help young girls such as Keisha by getting them to serve a few weeks at an AIDS hospice. Careless sex would likely lose its sheen once they realize that their lovers could be the Grim Reaper in disguise.

The Momonomics of Healthcare

Health Care For All Kids

One of my best friends called me this week and told me that she just started clipping coupons for the first time in her life. All across the country, moms and dads are sitting down at their kitchen tables and figuring out how to make their money stretch farther. If we are thinking carefully about our money, it's only fair that our leaders do the same. How? By stretching our healthcare dollars farther by making sure that all kids have healthcare coverage.

There are close to 9 million children in the US who do not have health insurance. When children have gaps in coverage and do not get timely preventive care, they often end up requiring more expensive health care, such as hospitalizations and emergency room visits.
In California, a study of 9 local Children's Health Initiatives (CHI) found that providing children health insurance reduced hospitalizations in the CHI counties by 25 percent and saved up to $7.35 million annually in preventable hospitalizations. If all low-income children had health insurance, the state could save $24.3 million per year in preventable hospitalizations. Not enough to convince you?

Not only does healthcare for all kids save money now, it can affect kids' long-term educational outcomes. Children covered by Healthy Families (low-cost health insurance for kids living just above the federal poverty level) showed a 63% improvement in "paying attention" and a 64% improvement in "keeping up with school activities" over their performance when uninsured. The result? Fewer children will need costly educational interventions.

Covering all kids is something that we can do now. Children are the least expensive population to insure. Children make up over half of the Medicaid population, but they account for only 23% of the total Medicaid spending. But when primary care is delayed because mom and dad can't afford to take their child to the doctor, a toothache can become a serious infection, pink eye can leave a child blind, and kids who should be home for a day miss weeks of school.

So what are we waiting for? Move over Ben Bernanke. Our leaders need a lesson in Momonomics 101 from moms and dads who know that we can't just blindly cut essential programs, we need to spend wisely. MomsRising.org is asking its members to tell our leaders that covering all kids makes economic sense.