Figures released by the Centers for Disease Control reveal that a disproportionately high number of AIDS cases reported in the United States since 1981 have occurred in blacks and Hispanics. These groups represent just 18 percent of the overall population but 39 percent of the AIDS cases. When one considers AIDS cases among children, the figures are much higher; fully 80 percent of children reported with AIDS are nonwhite. In the overwhelming majority of cases, the cause of their disease may be traced to intravenous drug use by their parents.
Unfortunately, many blacks and Hispanics have been slow to recognize the real dangers that the spread of AIDS poses to their communities. There has been too much of a tendency to view AIDS as a "gay white male disease."
A few snapshots from the statistics reveal the magnitude of the problem for minorities:
AIDS cases are occurring nearly three times more frequently among black and Hispanic men than among white men. For black women, the rate is 14 times that of white women.
Ninety percent of the children who have acquired AIDS by transmission from their mothers have been black or Hispanic.
In two selected groups that have been tested for the presence of AIDS antibodies (military recruit applicants and blood donors), the infection rate was four to seven times higher in blacks than in whites.
The most important factor behind these statistics is drug abuse. Of the black and Hispanic AIDS patients from New York and New Jersey, for example, about half are intravenous drug users. Reported AIDS patients who are IV drug users are predominantly black (51 percent) or Hispanic (30 percent). Among black and Hispanic women with AIDS, one-third have acquired the infection through heterosexual contact. The majority (62 percent) of persons acquiring AIDS through heterosexual contact have had sex with an IV drug user.
But drug abuse is not the whole story. Another important route of spread of the AIDS virus to minority women is through sexual relations with men who, sometimes without the woman's knowledge, are bisexual. Homosexuality does not fit in with the macho image desired in many segments of the black and Hispanic communities. Therefore, many minority men who are gay conceal their preferences by maintaining a bisexual life style. Women who may find themselves in relationships with such men need to be educated about their potential risks of infection and counseled on precautions they should be taking.
A particular group at risk among minorities is teen-agers, who may be starting to experiment sexually and may not be getting the message about AIDS. Sexually active adolescents need to be warned, in language they will listen to, about the dangers of having multiple partners and about transmission of the AIDS virus from infected mothers to their babies.
Coping with the AIDS epidemic, especially as it affects minorities, will require coordinated effort and careful planning. Social services for minority people with AIDS, people who may be poor and poorly informed about the dangers of the disease, have lagged far behind those available for more affluent victims. We may, for instance, need to develop special programs tailored for bisexual men and their families. There is also a need to study differences in the social and sexual practices of gay men who are white, black and Hispanic.
We must have better drug abuse treatment and control programs. Outreach programs to drug abusers must take into account the social and educational differences involved. For example, in a study in New York City, needle-sharing practices differed among white, black and Hispanic drug users, with blacks and Hispanics reporting more re-use of needles. These two groups also had a much higher rate of infection with the AIDS virus (42 percent) than did white IV drug abusers (14 percent).
It is time for organized minority groups to take a more active role in containing the spread of AIDS. The Southern Christian Leadership Conference has demonstrated its commitment by sponsoring a series of state conferences on AIDS and its impact on blacks, including a recent two-day meeting at Howard University. Our churches should also be a powerful force for education within their communities. Many, unfortunately, have been slow to respond to the AIDS crisis, deterred in part by the stigma of the link to homosexuality.
The federal government has spent over $850 million on AIDS research and education in the years since 1981. It is possible that an equal or greater amount will be appropriated by Congress for the upcoming fiscal year alone. Congress is also addressing the design of a comprehensive national program for AIDS, covering education, prevention, research, treatment and the care of AIDS patients. Along with Sen. Edward Kennedy, Reps. Benjamin Gilman, Frank Guarini and 37 other members of Congress, I have introduced legislation authorizing such a program, including money to combat AIDS in intravenous drug abusers. Many thoughtful people have sound ideas to contribute to the formulation of a comprehensive plan on AIDS. Now is the time for the nation to make a commitment.
The writer is a Democratic representative from New York and chairman of the House Select Committee on Narcotics Abuse and Control.