AIDS and Black Denial

By Mike Males, AlterNet
Posted on June 12, 2001, Printed on February 13, 2012
http://www.alternet.org/story/11013/aids_and_black_denial

Are white kids or black kids wrecking their communities the worst? This month, the pendulum swung back to blaming young black men after the release of a new report on the 20th anniversary of the AIDS epidemic showing 15 percent of young, urban, gay black men are HIV-positive.

Perhaps in another 20 years, varied interests will finally decide that the only effective way to fight this deadly epidemic is to confront the whole truth about it, as opposed to just the parts that suit their needs. The facts are that AIDS in America increasingly afflicts older victims, poorer victims, and female victims. In 1993, when the Centers for Disease Control's HIV/AIDS Surveillance Report first tabulated new HIV infectees, only one-third were over 35. For the latest HIV infectees diagnosed in 2000, nearly half are now over 35. Conversely, the proportion of new HIV diagnoses among persons under age 25 has dropped from nearly half in 1993 to fewer than one-third today. HIV rates have risen most among females (21 percent of new infections in 1993; 34 percent in 2000), growing fastest of all among older women.

AIDS has evolved into a complex epidemic rooted primarily in the ongoing health crises plaguing aging baby boomers and, secondarily, in severe poverty afflicting the young. So, why does everyone from the White House Office of National AIDS Policy and former Second Lady Tipper Gore to AIDS prevention activists and the media miscast HIV victims as getting younger? Because this allows interest groups to misrepresent AIDS as a simple matter of youthful ignorance, immorality, and recklessness. That is, AIDS provides an occasion for interests to engage in what passes for health policy in America: ignoring serious issues in order to deliver self-satisfied sermons and stern, moralistic remedies to "rescue" the wayward young.

Bob Herbert, an African American columnist for the New York Times, exemplifies this thinking. In a recent column on the AIDS anniversary, Herbert called for black leaders to issue "thundering" demands to halt "the self-destructive sexual behavior and drug use ... that have inflicted gruesome damage on one generation after another of young black Americans." For Herbert, as for many of his white counterparts, the main issue is bad attitude and behavior: "One of the biggest obstacles to controlling the spread of the AIDS virus among young blacks is denial."

As with older whites who pretend no generation until today's had guns, dope, or suicide, older African Americans harbor the illusion that drugs, AIDS, and irresponsibility are scourges of "young blacks." Many older blacks, even progressives such as Herbert, posit character and behavior flaws in younger blacks today that are disturbingly similar to those Jim Crow segregationists in decades past blamed for the disadvantages of African Americans in general.

Young African Americans certainly ought to be showing more self-destructive behaviors as their conditions and opportunities have deteriorated. As among whites, the "wealth gap" between African-American generations is massive and growing. Since 1970, the real, median family income of blacks 45 and older has leaped 70 percent while blacks under 25 suffered a staggering 40 percent drop in real income. Today, the average black 50-year-old has a family income of $45,000; the average black 21 year-old, $13,000 -- the largest age gap on record. The rising black education and employment achievements won by civil rights activism and sacrifice in the 1950s and 1960s eventually rewarded older blacks with rising incomes. Yet, trends among younger blacks have gone backward: the lowest real incomes in four decades.

Yet, it is not younger blacks, but better-off, older African Americans who display serious personal behavior crises -- a trend paralleling that of whites. Four-fifths of drug-related deaths among blacks today occur to those 35 and older -- the same age group showing escalating felony arrest and imprisonment rates. HIV rates (allowing for a five-year lag between infection and diagnosis) rose 110 percent among younger blacks over the past decade, but they escalated even faster among blacks 35 and older -- up 140 percent. (Among Anglo whites, HIV also strikes older and older victims: up 80 percent among under-35 and 110 percent among over-35 ages).

The "generation gap" in drug abuse is even more stark. During the 1990s, drug overdose deaths dropped by 50 percent among black teenagers (only 20 were recorded in the entire nation in 1998) but soared 250 percent among blacks 35 and older (1,850 drug deaths in 1998). In California, imprisonments among baby-boom blacks rose by 134 per 100,000 population -- the largest increase of any group (older Anglo whites showed similar increases).

Meanwhile, defying perception and theory alike, young black men also showed huge declines in crime and imprisonment during the 1990s. Among California black teens and young adults, drug deaths fell to near zero in the late 1990s and imprisonment rates dropped by an astounding 690 per 100,000 population -- by far the most rapid improvements of any age or racial group. Overall, per-capita felony arrest rates among black teens declined 30 percent over the last generation -- but their parent generation's felony rates soared 70 percent.

To be sure, racist policing and sentencing, especially War on Drugs crackdowns, explain much of the imprisonment surge among older blacks -- but how did younger blacks escape the onslaught? The encouraging resilience of younger African Americans in the face of worsening economic and family conditions merits serious contemplation.

Instead, Herbert voices a common, relentlessly pessimistic view: "Thousands upon thousands of young blacks (are) succumbing to the ravages of destructive sexual behavior, drug use and (in so many of these cases) the emotional pain of self-loathing, depression and despair." Herbert is evidently referring to black psychiatrist Alvin Poussaint's assertion that suicide doubled among black male teens from 1980 to 1995, creating "a mental health crisis." However, this trend is dubious. Poussaint acknowledges today's "improved reporting methods" may have created the appearance of an "increase" in black youth suicides by correcting for "historic underreporting." In fact, deaths from suicidal causes (self-inflicted gunshot, drug overdose, hanging, and undetermined deaths) among black males has followed a cyclical, generally declining pattern for 30 years. By the late 1990s, a black male teen was only half as likely to die by his/her own hand as his 1970 counterpart.

Contrary to dire claims, black teens today appear less self-destructive -- in terms of drug abuse, serious crime, suicidal behavior, and sexual risk-taking -- than their elders were as youths and are grownups. The serious problems that do afflict young blacks appear directly traceable to the worsening attitudes and behaviors of middle-aged Americans of all colors. Industrial abandonment of inner cities led to high unemployment and widespread poverty among younger African Americans in the 1980s and 1990s. Skyrocketing hard-drug abuse and family disarray among baby-boom blacks and whites created a massive demand for services such as drugs and prostitution. These trends together fueled the 1980s and early-'90s increases in inner-city drug gangs, gun violence, and HIV infection.

Studies repeatedly show the highest rates of HIV are found among those suffering extreme poverty, homelessness, prostitution, "survival sex" (trading sex for necessities), and violent abuses. HIV-positive young people tend to be "our nation's most disadvantaged youth," CDC reported in 2000. "Rates of HIV infection among (low-income) Job Corps participants are more than 2 times higher than rates among youth seen in adolescent health clinics and more than 8 times higher than among young people of the same age applying for military service." Further, San Francisco/Berkeley Young Men's surveys found infected gay men of all colors disproportionately reported older partners and histories of rape and abuse. (They also revealed high HIV infection rates a decade ago: 21 percent among young gay black men, above the 15 percent triggering today's alarms).

And this reveals a major limitation in American prevention strategies, which (with few exceptions) address AIDS as the result of fully consensual, personal behavior choices amenable to education, safe-sex services, and "thundering" morality sermons. However, impoverished, often homeless prostitutes and sexual violence victims most at risk of infection often do not have completely free choices about sex. Contrary to popular image, HIV in the young is a product of the conditions of poverty and the abuses that accompany them, not an attitude problem of willfully self-destructive youngsters.

Herbert is correct that blacks (and all races) will only confront AIDS effectively when homosexuality is openly acknowledged and accepted. However, that's only part of the solution. It's also crucial that older blacks and whites frankly admit their own generation's risky conduct, confront the unconscionable poverty and family disarray imposed on young people, and stop reflexively blaming social problems on youth's supposedly unhealthy morals and behaviors.

Read more about Mike Males' writings.

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