In 1981, the U.S. medical community noticed a significant number of gay men living in urban areas with rare forms of pneumonia, cancer, and lymph disorders. The cluster of ailments was initially dubbed Gay-Related Immune Disease (GRID), but when similar illnesses increased in other groups, the name changed to Acquired Immune Deficiency Syndrome (AIDS). The mid-1980s saw a number of advances toward understanding and treating the disease, but no vaccine or cure was forthcoming. Gay advocacy and community-based organizations began providing services and pressuring government to increase funding for finding a cure and helping victims. As two representatives of AIDS health services organizations stated in the following 1987 testimony to Congress, AIDS spread in disproportionately high numbers throughout U.S. minority and disadvantaged communities. They advocated increased federal funding for prevention efforts targeted at minority communities and administered by community-based organizations. Despite such efforts, the number of minority AIDS cases continued to rise sharply, and by 1996, African Americans accounted for a higher percentage of reported adult cases of AIDS (41%) than did whites.
STATEMENT OF RICHARD DUNNE, EXECUTIVE DIRECTOR, GAY MEN’S HEALTH CRISIS
Mr. DUNNE. Thank you, Mr. Chairman, for the opportunity to testify this afternoon before this subcommittee and for your leadership over the years on this issue.
I would like to talk today about AIDS information and education and the role voluntary community-based organizations such as Gay Men’s Health Crisis have played and continue to play in this important activity.
I believe that when future historians look back on this period, it will be the consensus judgment that AIDS was the most important event in this country in the second half of the century. Barring one or more medical miracles, by the year 1991, there will be 270,000 cumulative cases of AIDS; 180,000 people will have died of AIDS by then. Eighty percent or more of these cases have already been diagnosed or are already infected. For almost all of those 300,000 people, in other words, it is already too late. Those 180,000 almost certain fatalities by the year 1991 are more than three times the number of Americans who died in the Vietnam war.
I also believe that this epidemic has been ahead of us and certainly ahead of the Federal Government since the moment this virus arrived on these shores some 8 years or more ago. Despite very remarkable progress on the biomedical front, despite changes in the sexual behavior of the primary risk group, and despite the heroic effort of many individuals, this epidemic is still out of control more than 5 years after it was first recognized.
One need only look at the mortality figures in New York City where AIDS is now the leading cause of death for all men between the ages of 25 and 49 and for women between the ages of 25 and 29. In certain health districts in New York City, as many as one of every four deaths in the last 5 years was caused by AIDS.
Even after nearly 6 years of an epidemic, we still look for national leadership from the administration. We have heard today, as we have heard in the past, of the administration’s plans to begin a national education campaign. Yet, despite the best efforts of the scientific community, biomedical research cannot eliminate AIDS in the short term and education is the only preventive tool.
The fact is, however, that we require no new technological breakthroughs to limit the spread of AIDS. We already understand enough about the cause and transmission of the AIDS virus to give people the knowledge they need to protect themselves. . . .
Special efforts need to be made in minority communities. We usually perceive AIDS as an illness that mostly affects gay men and intravenous drug users. From another perspective, AIDS is an illness of people of color. Blacks and Hispanics represent 53 percent of the cases in New York City and 45 percent nationally. According to a recent report from the Centers for Disease Control, blacks and Hispanics are overrepresented in every single risk group for AIDS except hemophiliacs. Clearly, the minority community should be targeted for special education efforts. . . .
STATEMENT OF GILBERTO GERALD, DIRECTOR OF MINORITY AFFAIRS, NATIONAL AIDS NETWORK
Mr. GERALD. Mr. Chairman and members of the Human Resources and Intergovernmental Relations Subcommittee, my name is Gil Gerald and I’m the director of minority affairs for the National AIDS Network. I appreciate this opportunity to present my views on how the Federal Government should respond to the need for educational programs on AIDS prevention, targeted toward minority communities.
I have professional experience with the desperate need for educational efforts on AIDS and AIDS prevention for minority communities. I wish to convey to the Chair and the subcommittee the thanks and appreciation of community-based AIDS service providers for your recognition of the seriousness of the AIDS problem early in the crisis and for having continued to pursue an end to this health problem.
As this committee knows, AIDS does not discriminate. Nevertheless, the minority community has been disproportionately affected by this devastating health crisis. The AIDS weekly surveillance reports for the Centers for Disease Control show that while blacks make up only 12 percent of the Nation’s population, blacks comprise 25 percent of all people with AIDS. Similarly, Hispancs make up 6 percent of the population yet represent 14 percent of all people with AIDS. Minority children represent 80 percent of all children with AIDS in this country and black women constitute one-half of all women with AIDS—statistically, a black woman is 13 times more likely than a white woman to contract AIDS.
These staggering statistics have led more than one observer to note that among minorities, AIDS is a heterosexual disease. This pattern combined with a health system that puts minorities at a great disadvantage is documented in the Federal Government’s report of the Secretary’s Task Force on Black and Minority Health of January 1986, creates a very bleak picture for the future of the minority community with respect to the AIDS crisis.
Fears of increased societal stigma and discrimination and the persistent myth that AIDS is a white gay male disease reinforces the perception within the minority community that AIDS is of no particular concern to people of color. . . .
Several corrective measures can and should be undertaken in response to the situation as I have outlined it. In the time allotted to me, I would like to elaborate on three points. First, educational strategies must account for specific linguistic, cultural, and ethnic characteristics. As well, these campaigns must be sensitively waged to account for various literacy levels among audiences if they are to be effective in changing behaviors within minority communities, which like in other communities, places individuals at higher risk for AIDS.
Funding must be specifically allocated for targeted campaigns, otherwise affected minority communities will not be reached.
Second, too few community-based minority institutions are receiving Federal or State support for AIDS prevention programs. Minority AIDS service providers are among the poorest organizations affiliated with the National AIDS Network. Yet they have the best access to their respective communities.
For the health of the community, the Government must find creative ways to see that minority organizations with broad access to their community receive support for their work.
Third, the Federal Government should monitor the impact and efficacy of educational programs with respect to targeted groups including minorities.
The National AIDS Network has just completed a study that demonstrates there is practically no evaluation of the effectiveness of existing educational programs in terms of their ability to reach minority communities to change high risk behaviors.
The AIDS crisis poses an additional burden on minorities who are already economically, politically and socially disadvantaged. It will take concerted and immediate action by the Federal Government to insure that these factors do not contribute to the continued spread of the AIDS virus in our society, but it will first require understanding.
For this reason, the National AIDS Network appreciates the attention that you are giving the matter today and calls upon you to take the necessary steps to respond to this epidemic. We ask you to hold hearings in congressional districts where minority people are disproportionately affected by this virus. In order to understand the importance of education, we feel it is important for you to hear firsthand the human suffering brought on by AIDS.
Source: Congress, House, Committee on Government Operations, The Federal Response to the AIDS Epidemic: Information and Public Education. Hearing before a Subcommittee of the Committee on Government Operations, House of Representatives, 100th Cong., 1st Sess., March 16, 1987 (Washington, DC: U.S. Government Printing Office, 1987).
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