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).