In Black America; Aids In The Black Community, Part 1

. In this country, 25% of all A's cases reported come from the black community. I'm John Hanson. Join me this week on in Black America. And there are laws that says that if a person has A's or diagnosed with a disease, that it must be reported to the Texas Department of Health. A's in the black community this week on in Black America. This is in Black America, reflections of the black experience in American society.

Our blood supplies I said before are safe now, so that's all being tested. So it's easy to prevent the transmission and people should keep in mind unless you are putting yourself at risk by not using the condom in the process of sexual contact or if you're engaging in practices that we don't describe as not being safe, then you're putting yourself at risk to being either the recipient of a product that's contaminated or the transmitter of a product that's contaminated. And definitely for those people who have been tested and have noted their positive for the HIV virus, it is extremely, extremely important that they refrain from passing a particular infection on to someone else. And they know how it can be transmitted through sexual contact or through sharing an evil that's contaminated. Mr. Charles Wallace with the Texas Department of Health. In recent months, there has been plenty of heat over the dreaded disease called AIDS.

The argument over mandatory testing is indeed filled with emotion. For those who are afflicted, are almost sure to die. Today, public health officials are making decisions concerning the protection of the health of the general public while at the same time ensuring the rights of the individual AIDS patient. In this country, more than 36,000 AIDS cases have been diagnosed and more than 21,000 have died from the disease. Responding to widespread anxiety and wound-their constituents, politicians across this nation have introduced a number of AIDS legislation, most of which are sensitive moral and medical questions. What concerns many black officials is how the test results will be used and whether the privacy of the individual will be protected. I'm John Hanson. This week, AIDS in the black community in black America. AIDS is a disease that kills. It does not discriminate.

It doesn't care if you're purple with green spots, AIDS is a disease that kills. If you put yourself at risk, participate in high risk behavior, unprotected, sex, sharing needles, IV needles, then you may be exposed to the virus. You may be infected and go on to infect other people. So my advice to anyone that's listening is to be informed. Education is our only weapon against AIDS. Find out how you can protect yourself against being exposed and if you are exposed, how can you protect others from that exposure? If you don't know that you're infected with the virus, you're going to go on to infect someone else. So don't participate in high risk behaviors and if you don't know what they are, find out. Ms. Dorsey Gibson, coordinator, AIDS surveillance, AIDS division, the Texas Department of Health. In the next half hour, this program will attempt to give you a better understanding concerning

AIDS. We will attempt to answer many of the questions you may have on your mind, such as, what is AIDS, what are the symptoms of AIDS, which disorders are usually associated with AIDS, and how can I reduce my risk of contracting AIDS? First, Mr. Charles Wallace. Mr. Wallace has spent the last three years dealing with AIDS for the Texas Department of Health. Since the interview, Mr. Wallace has transferred into another department within the Texas Department of Health. Mr. Charles Wallace. AIDS, the AIDS, stands for a quality immune deficiency syndrome and it's just that it's a syndrome that's been brought on by a particular virus and I won't get real technical but the short term for this virus is called HIV and that means human immunodeficiency virus and it's been named so many different things since it was first identified until it's a bit commas and put a label on it as a particular virus except that it is a condition which can

kill and this particular virus HIV affects the immune system and when it impacts the immune system it tends to destroy it over the course of time and we will know that once the immune system is destroyed, a person's body loses its ability to fight off various kinds of infections and we have seen various kinds of infections impact the body because the immune system has been destroyed by this particular syndrome or particular virus. So it's crucial to keep in mind I think that this particular syndrome, AIDS, AIDS as we see it, is impacted by a virus is called HIV or human immunodeficiency virus and this particular virus is devastating to the immune system. And the health officials in this country become aware of what we know as AIDS today. Well I think it dates back to about 1978 when the first cases were seen and they were first identified in the East and West coast of this particular country, young homosexual men were coming down with a very unusual pattern of illness and it was seeing conditions

like nemesis to curinear pneumonia which is fairly rare as a condition which can kill killing people and a very rare cancer called capacities sarcoma which usually occur in older men occurring in young 20 to 30 year old males and because of this particular pattern of similarities occurring on the East coast and West coast, the Centers for Disease Control which monitors our particular disease conditions as they appear in certain patterns picked up on this occurrence and as a result of identifying this particular syndrome or condition appearing in both the East and West coast decided to explore further what was going on. And it was about that time that the first cases were identified but it became even later as the cases as time progressed the cases even occurred in higher numbers and it then became a real area of concern and we see it's ballooned that into a massive area of concern. Approximately how many persons in this country have acquired the AIDS virus and the AIDS itself?

In this country we're vastly approaching 40,000 cases in this country. That's a very large number of individuals as you can well see and the devastating thing about the condition itself is that roughly 50% of those individuals who have been affected by this particular virus or this particular syndrome AIDS have died so we can see that the mortality rate is extremely high and there's another area of massive concern. Besides being concerned for the total community at large there's also a great concern about AIDS in the black community. There has been study showing that besides homosexual activities AIDS can be transferred by IV drug users. There's a known fact in black America that you know black Americans are IV drug users. How is this affecting the black community as you know it today?

John, as a public citizen and an individual who worked in the area of AIDS activity, AIDS in the black community is an area of particular concern of mine. Not only because this condition is impacting our organization, our people but because it is one that we have a tendency to overlook as a condition which is impacting us. It's often said that people don't realize how devastating a disease can be until it's hit home. Well I'm here to tell you right now that this particular condition is one that has hit home and whether or not we are aware of it is going to hit even closer to home unless some certain conditions are brought to pass. My first concern is that the black folk have a tendency to overlook the need to do certain things in order to prevent this particular infection from being transmitted. I'd like to stress that those individuals who are sexually active and that's probably every young man and woman at some point or another should use condoms. That is the safest way next to absence that can prevent the spread and transmission of

this particular disease. Are there any numbers on the number of black Americans contracting this disease? Well let me focus in on Texas if I can, excuse me, and you'll probably be seeing these statistics and hearing them as time goes along. But in Texas there are roughly 188 males who are affected with this particular virus, who are labeled as being homosexual or bisexual. That's a fair number of people I think. But if you go a little bit farther you'll see that there are roughly 22 black males who are ivy drug abusers who are classified into this particular case range and I'm looking at statistics that date back to September 11th. You're looking at also a population of roughly 2200 cases that have been reported in the state when it comes to male homosexual, bisexual individuals. And roughly 62 of the 64 individuals reported who are male are ivy drug abusers and that's

the fair number of people that we're talking about. We could go a little farther and look at the combinations of homosexual ivy drug abusers and you find that roughly 31 individuals who are male fall into this particular category. So we're looking at a fairly devastating disease. I should also say that out of the cases we're looking at 10 of the females that are black, 10 females who are black or ivy drug abusers who have been identified as cases. And there are other breakdowns in the subgroups that we can look at. But the massive number of cases that we're seeing in Texas are primarily homosexual bisexual males in the black population. There's a fair number of ladies who are ivy drug abusers who also fall into these categories. In researching the data, our physicians better equipped or better trained to detect some of the symptoms of warning symptoms of aides or is there such a thing as a warning system? A warning sign. Well, I think there are some warning signs and let me back up and try to answer the

first part of your question, our physicians better equipped. I think in this day and time, with AIDS being as prevalent as it is, that physicians have geared themselves to start to look at for risk conditions, be the person homosexual or an ivy drug abuse or bisexual. And for that reason, if the person identifies himself as falling into this particular category, with then look at that person closer for some of the conditions that we see in AIDS patients. Some of the things like swollen lymph nodes in the neck and in the groin area are persistent fever for one reason or the other that has gone on for a period of time. Persistent diarrhea. Persons, bodies, not able to fight off infections, the doctor may be seeing them a lot more regular because of a cold condition that just doesn't seem to go away. Some of the early signs, now don't misunderstand me. There are other conditions we present with the same signs and probably someone at the listening now started saying, you know, I've got this fever, I've got this cough that I can't seem to get rid of, I must have AIDS. Well, that's not exactly the way it is, but persons should always keep a close check on

themselves to see whether or not they're, if they're especially at dead risk, if something occurs, which is unusual, like a change in the pigmentation of the skin at their patches, the spots which are dark in color, purplish looking, that may be an indication that the person is developing the cancer, capatrice or coma. But there are a number of other conditions that present themselves that would warn a person that they may be at risk of developing this particular infection. Now, I think it's important to keep in mind that there are an awful lot of people who, at least we think there are an awful lot of people who are around, who may be infected with the HIV virus, who may go on and not develop AIDS, but have the capacity to transmit this particular infection to other individuals who may go on to develop AIDS. It goes back to my comments about the use of condoms, and individuals who at risk must find it extremely necessary in order to prevent becoming infected or prevent passing on this particular infection to someone else must find it absolutely necessary to use condoms.

And a person with the HIV virus, the human immunodeficiency virus, may not ever break down with AIDS, but definitely the chances of percentages are very high at this time that if that person is infected with that particular virus, they stand a greater chance of developing the condition. Being informed, a public health was still a public health official, but in a different area of expertise at the present time, what are public health organizations doing to better inform the public of the people you're informing receptive to the information, or are we just taking a laissez-faire attitude towards this particular problem, medical health problem? Well, excuse me, John, that's a real important question, because first of all, I don't think the general public is going to let those of us who are working in public health take a laissez-faire attitude toward this particular condition. We can't afford to take a laissez-faire attitude toward this particular condition.

The Texas Department of Health, who I'm not representing here today, but who happened to be my employer in a different capacity, as you mentioned, and AIDS, has asked for and received from the Centers for Disease Control $425,000 to do what we described as information and education projects within minority populations to deal with AIDS. This money is available to organizations who have shown interest, risk of all, and concern in this particular area, and who have no difficulties focusing in on minority communities to provide risk reduction education and information about AIDS. The state of Texas, as you may recall from the last laissez-faire, did allocate funds about $1.4 million to deal with the AIDS problem in the state. This money is primarily administered throughout Texas Department of Health, and that's good. I think the other thing, although the money's may not be available.

There are other agencies which should be involved in doing risk reduction education. Although there may not be big bucks available to these organizations, I think there should be an all-out effort on our part to try to educate as many people as we can about AIDS. AIDS is one of those conditions which if you don't get educated about, we'll definitely have an impact on our lives. I already have an impact on our lives, so we must try to get it on the control. I mean, to say one thing, the statistics, according to the country, over the country, that you're running about 25% of the AIDS cases that are occurring in the black population, 25% of the Hispanic population, as a national statistic. In Texas, those statistics are roughly 10% black, 10% Hispanic. In my mind, that's a grand opportunity for us to really do some very hard selling of education, risk reduction education. And at this kind of education that's presented early on, we can cut back our numbers and prevent people from reaching the point of having this condition and even being affected by the virus.

But if we sit back and let it go as the status quo remains as it is, that 10% will quickly go into a 25% ratio. So we need to be impacting our populations now. Mr. Charles Wallace. I also spoke with Ms. Dorothy Gibson, coordinator, AIDS surveillance, AIDS division, the Texas Department of Health. Ms. Gibson. I am the coordinator with the AIDS surveillance section of the AIDS division with the Texas Department of Health. And there are four of us on staff with the AIDS surveillance division or project. It's really what we're called. And our task is to get the cases that are diagnosed in the state of Texas, report it to the Centers for Disease Control in Atlanta, Georgia. How long have Texas been taking notice of the problem of AIDS? Okay. The first involvement here in Texas was with a pediatric case in Dallas. A child developed AIDS and they thought that it was through blood transfusions.

And the CDC contacted the state and asked them to investigate. And the state did, and after that the CDC developed a cooperative agreement with the state of Texas. And I started with this AIDS program in 1984, April of 1984. Were you aware of somewhat familiar with the task before you? No, not really. In fact, in the interview, they asked me how much that I know about AIDS. And I said, I know what AIDS stands for, a quality immune deficiency syndrome. And that's all I know about AIDS. I had spent 10 years prior in the cancer registry program. Is there an assertive effort to make black Americans aware of the problem of AIDS and could you expound on the seriousness of this particular disease? Yes, for a long time, we as blacks have thought that AIDS was not a problem for us.

We thought that AIDS was a disease of white homosexual, bisexual men, but that's not true. The virus does not discriminate. And I think it's black people. We must recognize that we are also at risk if we participate in high risk behavior. And some of the high risk behaviors include having sex with someone you don't know. And if you do have sex with that person, it should be protected as a search in general, see if it could say it. The best protection against AIDS is not to have sex, but if you do, you should use condoms. And I think it's black people. We must recognize that if we do participate in high risk behavior, we will be exposed to the disease. How is this particular disease having effect on the black community, but particularly young

blacks growing up in society with the disease that can kill you? Well, I see it affecting the young blacks in the area of drug involvement because one of the modes of transmission is through the sharing of IV needles. And traditionally, when it comes to drugs, our young youths have been encouraged to sell drugs as a means of making fast money. And when they sell these drugs to other blacks, they're not going to have the money to buy clean needles all the time. They're going to share needles. And that's where you get AIDS. You don't get it from the drugs themselves. You get it from sharing contaminated needles. And so I think that we should educate and encourage our youths not to participate in that type of behavior.

How is the health department here in Texas going about disseminating information to the black community about AIDS? Until recently, it had not. But recently, the CDC just offered a lump sum of money to the state of Texas and to other states, specifically for minority education. And in this grant, they are encouraging minority organizations to apply for the money because they feel that a black will be more receptive to a black, that Hispanic will be more receptive to a Hispanic. So they're asking the minority organizations to apply for the money and take it back to their own people. And the Texas Department of Health, as I said, is participating in this program. And pretty soon, the announcement will be made in the Texas Register and Community Organizations can apply for the money. There will be $425,000 offered here in the state of Texas.

I'm glad you brought up the point about black's being receptive to other blacks. So your knowledge, how many blacks are working with the health department here in Texas and other states if you have that knowledge working with blacks in the black community about AIDS? Here at the state level, I'm the only one that's working in the AIDS program. When I first started in April of 84, there were two positions available in the AIDS program. Both Wallace was the other person that occupies the other position. He's black also, but he recently moved to the TB program. They do have, still have some interaction with the AIDS program because some AIDS victims do have certain forms of TB. But I am the only black that's working paid from CDC monies. Are there, I mean, bephrases, questions. In dealing with the AIDS, are you finding blacks, you mentioned before, somewhat of sceptible

or believe it won't happen to me, once you've gone over the information and disseminate the information, are they coming to grips with a better understanding about the disease or a lot of it is going over their head? And I guess if you talk in medical terms frequently. Basically, I see the problem as where the blacks want the information. I don't see the evidence that blacks really want the information. And to want the information, they first have to recognize that it does involve them, that they are involved. I participated in a forum, a town hall meeting at Carver Library here in Austin about a month ago. And it was widely publicized. And there were less than 25 people in the audience. So blacks still feel that it's not a disease that's going to affect them. Are there any laws on the books to help you do your job better?

Well, as far as AIDS surveillance, yes. And Texas was one of the first states to make AIDS reportable to the State Health Department. And there are laws that says that if a person has AIDS or is diagnosed with a disease, that it must be reported to the Texas Department of Health through the local health authority. Also effective September 1, HIV positive patients are also reportable. These are people that were in the past known as ARC patient's AIDS-related complex. HIV stands for human immunodeficiency virus. And that is the virus that is believed to cause AIDS. And all the things that if you have the HIV virus, you are infected with that virus, but you may not have AIDS. So anyone that has full-blown AIDS or anyone that is infected with a virus that causes AIDS are reportable to the Texas Department of Health by law.

State law. A lot of been said about the confidentiality of the tests. In all honesty, can you be confidential if a person tests positive for the AIDS, a lot of the babies been discussed about children going to school with other children that may have the AIDS virus, but not the AIDS disease itself? Okay. When you talk about confidentiality, is there a fine line? There's a difference in the testing. You have confidential testing and you have anonymous testing. Confidential testing is when a person gives their true name and you say that you're not going to divulge this information to anyone. All of their information is going to be confidential. When you talk about anonymous testing, a person can go into a testing site to a doctor and have a test and give a false name.

In Texas, there are 56 alternate test sites that are testing anyone that wants to come into assess their status. Now the testing in Texas is anonymous. I can go into a testing site and say my name is Jane Doe, but I have to remember that my name is Jane Doe. So when I get the test results and go back, I can have them pull the correct test. Do you have to show up to get the results or will they give out that information over the phone? You must show up to get the test. After you're given the results of the test verbally, you are also given the test, the paper copy of the test, so no records are kept. You also counseled on what the implications are of your test. If you're positive, you're told things about safer sex practices. If you're negative, you're encouraged not to participate in high risk behaviors that

would expose you to the virus. Is it the health department responsibility, if the person who is tested or she is tested to get in contact with their sex partners, or that responsibility left on the person who took the test? The responsibility ultimately is of the person who took the test. What you're talking about is contact tracing. That's something that's done in the STD of such a transmitted disease division, where a person who is diagnosed with syphilis or gonorrhea, they would have to give the names of the contact, so the health department personnel could go out and inform them. But as far as AIDS is concerned, we don't have contact tracing. Because for every person diagnosed with AIDS, they say that there are 50 to 100 people infected. We don't have the manpower, in other words, we don't have the resources to do that.

How reliable are the tests? 99%. So, this is the second generation of the test. It was the virus that first recognized in 1984, the first tests were developed in the same year, but they were made commercially available in 1985. That was the first test. After it had been in effect for a while, then they developed tests that were more effective in diagnosing antibodies to the HIV virus. So this is the second generation test, and it's about 99%. Ms. Dorsey Gibson, AIDS Surveillance, AIDS Division, Texas Department of Health. If you have a comment or would like to purchase a cassette copy of this program, write us. The address is in Black America, Longhorn Radio Network, UT Austin, Austin, Texas 78712. For in Black America's technical producer, Cliff Hargrove, I'm John L. Hansen Jr., please

join us again next week. You've been listening to In Black America, Reflections of the Black Experience in American Society. In Black America is produced and distributed by the Center for Telecommunication Services at UT Austin, and does not necessarily reflect the views of the University of Texas at Austin or the station. This is the Longhorn Radio Network.