In Black America; Aids In The Black Community, Part 2

T In years to come, AIDS may be the most deadly killer in the black community. I'm John Hanson. Join me this week on in Black America. In mid-1987, we have over 40,000 cases of this 40,000, 25% of black, 14% are Hispanic and 62% are white. AIDS in the black community, part two, this week on in Black America. This is in Black America, reflections of the black experience in American society.

AIDS stands for acquired immune deficiency syndrome. Actually, it's an infectious disease that's caused by deadly virus called the human immune deficiency virus or HIV. What this virus does is it destroys the body's immune system, allowing diseases which are normally controlled to assault the body. These diseases are called opportunistic and can be very fatal. Dr. Paul Bristol, a physician in private practice in Austin, Texas. 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 40,000 AIDS cases have been diagnosed and more than 21,000 have died from the disease. According to widespread anxiety among their constituents, politicians across this nation have introduced a number of AIDS legislation, most of which the sensitive moral and medical questions. What concerns many black officials is how test results will be used and whether the privacy of the individual will be protected. I'm John Hanson. This week, AIDS and the Black Community Part 2 in Black America. In 1981, we had 265 cases of AIDS documented. In mid-1987, we have over 40,000 cases of this 40,000, 25 percent of black, 14 percent of Hispanic and 62 percent of white.

Blacks compromise approximately 12 percent of the United States population. We have a rate of 25 percent. If we compare our rates to the white community, we would, in fact, compromise 8 percent of the AIDS cases, but now we compromise 25 percent. Another issue is that three out of every five children who have AIDS are black and that one out of every two women who have AIDS are black. So it's very important, yes, it's a problem. In speculating that in 1990, 270,000 Americans will have AIDS, if 25 percent of the black population or 25 percent of all the AIDS cases are black, that means 67,500 blacks will have AIDS. Dr. Paul Bristol, a private physician in Austin, Texas. In the next half hour, we will continue our attempt to give you a better understanding

concerning AIDS. You will attempt to answer many of your 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 the disease? Dr. Paul Bristol. Actually, it was 1979 when they thought that the first patient with AIDS came and 1981 was actually when they started recording AIDS victims. Has there been any concrete proof that AIDS came from Africa or did it originate in Europe somewhere? There was a lot of speculation, but we really don't know. How devastating or severe the problem of AIDS in the black community. Are we taking this too lightly? I think we are. And I think the best way to answer this question is to look at some of the facts. In 1981, we had 265 cases of AIDS documented. In mid-1987, we have over 40,000 cases.

Of this 40,025 percent of black, 14 percent are Hispanic, and 62 percent are white. Blacks compromise approximately 12 percent of the United States population. We have a rate of 25 percent. If we compared our rates to the white community, we would, in fact, compromise 8 percent of the AIDS cases, but now we compromise 25 percent. Another issue is to bring out is that three out of every five children who have AIDS are black, and that one out of every two women who have AIDS are black. So, it's very important, yes, it's a problem. They're speculating that in 1990, 270,000 Americans will have AIDS. If 25 percent of the black population, or 25 percent of all the AIDS cases are black,

that means 67,500 blacks will have AIDS. I've been seeing a lot of reports and studies, particularly you stated a few minutes ago, about females being not that concerned about contracting AIDS. Should females take this as a life and death, and it is life and death, or more seriously than they are, the present time? I think so. And the statistics show that majority of females who have AIDS that are in the black community and is transmitted by ivory drug abuse, it's possible for a male to infect a female, and this is one of the transmissions, but mainly the drug abuse is the main issue that we have to deal with here, so it is a problem. AIDS is now said to already be in the heterosexual population of the black community, so it's around, and both males and females need to be concerned.

What are some of the symptoms of AIDS? Some of the symptoms that we have to worry about is when a person is infected with the AIDS virus, it may take months or years before the signs appear. The AIDS symptoms, like many other viruses, but the big differences that these symptoms take a long time to clear how they reoccur. Some of the early signs are unexplained or recurrent fatigue, unexplained or recurrent fever, nightswets or shaking chills that last for several weeks or months, sudden onset or weight loss, more than 10 pounds, diarrhea that continues for several weeks, a dry cough that will not go away, purple pink spots or bumps underneath the skin, and these spots are usually generally harder than the surrounding skin, white spots that appear around the mouth that last for weeks.

These are some of the symptoms that we see in early stages. Our physicians today, more aware of the AIDS symptoms, I'm quite sure in years past when it wasn't that much information, there were being diagnosed for other respiratory illnesses or whatever. Are you all better equipped in recognizing these early warning signs? I think so because we're seeing a lot more in the community. I think a lot of the physicians are starting to treat AIDS cases, so whenever we see some of these symptoms, red lights go off and we know that we have to test to see if the person has the virus in their bloodstream. Now we all know that black Americans, a lot of us live below the poverty line, so the only treatment or medical services they will receive is from health clinics, public health clinics. What are the tests that are being given to these patients and are those tests kept in confidentiality? There are two tests. There are two tests that we run for AIDS. One is called the ELISA test and the second one is the Western blood, which is a more

sensitive test. These are the tests that are being run. First, you'll get an ELISA test and if that's positive, then you'll get the Western blood test. The results are confidential and that's a good point because many people have the misconception that if they have a positive AIDS test, red HIV test, that their information will be let out and this is not so. I'm quite sure once you decide to take the test, the level of anxiety is very high, positive or negative. Are there any counseling, pre and post counseling to patients who are taking the test? There are some and I think there needs to be a lot more. One of the laboratories are providing a lot of counseling and there are some social services that are providing the counseling around. I think as a group of physicians, we need to get more involved and counsel our patients is very important.

What is the current treatment for AIDS? There isn't a cure but there's some drugs out on the market. There's one drug that we've been using it's called Azulthymidine or AZT. Actually this does not cure or kill the virus, what it does is it halts the replication of the virus and the drug is very toxic. There are other drugs that they're doing a lot of research on now and it's very hard to try to find something to attack this virus because the virus is very smart. It has a very complex structure and it changes the shape so that any drug that we try to get to kill this virus, the virus will change shape and the treatment is no longer effective. That's one reason why we can't get vaccines. AZT, they're using now and it's just still in the experimental stages but it can slow the symptoms down.

Is there a definite way you can contract AIDS? There are three ways in which you can contract AIDS. One is bisexual contact, two is perinatal and three is parentally. As far as sexual contact, this is by having sexual intercourse, whether vaginal or anal and with an infected person. I think it's important to bring out at this time that anal intercourse is very risky because when the penis inserts into the rectal mucosa it can cause tears and this can get the blood, get the AIDS virus right into the bloodstream, that's a very risky form of sex. Also it's very important that men can infect women and men can infect men but as far as the transmission from women to men, that's very rare and as far as the transmission from women to women, that's also very rare.

As far as parentally, which means the virus is directly inoculated into the drug, this is where blacks fall into because 40% of all AIDS cases that are black related are through my IV drug abuse and this is by the sharing of dirty needles. Also transfusions used to be implicated, especially from 1977 to April 1985, they're stating that anyone who has had a transfusion at that time that they should be tested for the AIDS virus. Now since 1985, April 1985, the blood banks have been testing for the AIDS virus. So it's possible to contract the virus through shared needles, tattoo needles, through shaving razors as well as through toothbrushes because whenever you get the AIDS virus is in the bloodstream and any way that the bloodstream that you lose blood and you have the AIDS virus in, you

can infect somebody else through those means. Is there still some one of eight, excuse me, a state of hysteria about AIDS, a lot of people want to totally dismiss, there isn't epidemic health problem in this country, we've just said, well, it cannot happen to me and actually it could happen to you or someone in your family. In fact, there's a lot of denial going around now, yes, there's some hysteria, but not enough. In a black community particularly, from what I'm hearing is that people are saying we don't have to worry about this, this only you only see it in Gaves, a homosexuals and it's not going to affect me and that's the wrong attitude, especially in a black community because it's already in a heterosexual population and it's very dangerous, AIDS virus kills and I think we need to let the word out that, yeah, the AIDS virus is there and we have to

do something today, we need to educate our folks about it. Our health officials equip with the manpower and resources to better inform the public in your opinion. I think there needs, there's a lot that needs to be done in that aspect, we need more information that's out there, we need to get the information out to the public, there can be a lot more done about that aspect. What can black organizations, fraternals, social, civic organizations do to better inform the black community about the problem of AIDS? First, I think the thing that we need to do is we need to understand the problem. We're dealing with a deadly virus, we're also dealing with ivy drug abuse and sexual promiscuity and we need to deal with all of these issues equally if we're to stop the transmission of AIDS, there is no cure for AIDS, so it's got to be by education.

As far as what we can do, the government has allowed, or allowed, $70,000 for the state of Texas to help get the information out to the minority communities. We need to get some of those funds and we need to start educating our folks by using radio stations like this, by television, by newspapers, in fact the village had just had an excellent series on AIDS and we need to do more of this. We need to stick together, we need to get these groups together and we need to try to get some of these funds and we need to educate our folks and that means the churches and the different organizations. Getting back to the treatment of AIDS, once the person finds out here she is contracted to disease, the steps one must go through, I'm quite sure the other family members are informed, or are they informed, or is it up to the patient to inform the other family

members? Actually, it's up to the patient to inform their family members, we can't go out and say such and such has been tested positive to have the informed family members. The majority are, yes, but in some instances where the families are far away, they don't know and they come to find out eventually, but there's not much we can do as far as that goes, we have to rely on our patients to tell and you have to realize that once you have the AIDS virus in you, you have it for the rest of your life, so it's very important that those patients that have the AIDS virus in them that they practice, say for sex and let their partners know so that they can, they themselves can help halt the transmission. Because of the controversy, mandatory testing, your particular feelings on mandatory testing

for the AIDS virus? I agree with the CDC, I think that all high risk individuals need to be tested. No, what is high risk in your opinion? High risk is those that have abused IV drugs, those that have been treated for hemophilia, those that had blood transfusions between 1977 and April 1985, those who have engaged in homosexual or bisexual behavior since 1977 with an infected person, and those that have been engaged in promiscuous sexual behavior, especially with prostitutes or high risk individuals, those are the ones I think are high risk and that need to be tested. Okay, do you foresee testing of anyone applying for a marriage license? There's a lot of controversy over testing inmates, testing people that work for the job

core when everyone knows a lot of the inmates in our penal institution of black, the job core members are black and immigrants. Is there a discrimination somewhere in their new opinion because most of these groups have a high level of low income or black Americans as part of it? That's a good question, that's a very tough question to answer. I think as far as, must we get past thinking, yes, we do hold a higher percentage of AIDS patients, but it shouldn't come into play that we're going to be discriminating against because the numbers are there to somewhat justify the means if there is a justification. Want to get back to your question, as far as testing for the AIDS virus as far as marital

because it's concerned, I think that that's upon each and every one. That's just your own personal decision and you've pretty much known what you've done over the past seven, five to seven years or so. So that's just a personal decision that you have to make yourself. We can't mandatory say you have to go and get tested. As far as institutions and as far as getting tested for jobs, that's a very touchy issue because there's one, it can be used to discriminate against you, especially with insurance companies and jobs if you test positive for the AIDS virus, they can say, well, I'm not going to hire this. What else in the hysteria was, I guess I was trying to allude that to the hysteria with the sickle cell. They said all black Americans must be tested for sickle cell. Black women couldn't become airline disorders and it was used as a tool to deny employment

to certain occupations. I guess it can be used as a tool. But I don't think it's being used as a tool at this point now, true in the black community that they're saying that, yes, it originated in Africa and Haitian and these are just a lot of misconceptions. I think what we need to do is we need to stick to the facts and I agree with the CDC that all high risk individuals should, not everyone. Action every individual has to examine for themselves whether they're high risk and only you know that, nobody else. Do you foresee a day coming when testing for AIDS will be a part of everyone's physical when you want to take blood to see if you have diabetes and other blood diseases? It might in the future. I don't think so now.

Do you routinely test for AIDS and the person coming? If a person is high risk and only if a person is high risk, we will test and we don't routinely test or if we have an individual that we believe that has some of the symptoms of AIDS then we'll go ahead and test but not everybody and in that essence, I agree with that. I think it's very important. There isn't a cure, how important once a person has the AIDS virus, the counseling continues. I'm quite sure that one gets to a point where I'm going to die anyway so the will to live is gone. I'm not sure of your question. The post counseling wants to test is giving. If there isn't a cure, you can somewhat slow down the progression of the disease but the person having lost the will to live, it makes your job cumbersome because the person

is not trying and I guess there has to be a mental effort on the part of the patient. There is a lot of counseling that's going on because once you're, you're becoming infected with the virus, there's a lot of psychological trips that you go through because one, although you may not be symptomatic at this time, you do have the potential of developing an AIDS. Twenty to fifty percent of all people that have been tested positive for the AIDS virus will get AIDS and eventually you have to realize the fact that you might possibly die and it's very difficult, very difficult on the person, very difficult on the family and very difficult on the physician. And there are some social services that are available for that but it takes a toll. Are young people talking about AIDS because I'm quite sure this is going to have a detrimental

effect on how they live their lives in the coming century? I think so. I think there needs to be a lot more talk about it but one thing in some studies that were done was brought out that the black community is more concerned about AIDS and the other counterpart to white communities and the Hispanic communities and I think that's encouraging. It's out there and folks know it's out there but there's a lot of misconceptions in the black community about how to get it. I think there needs to be more education out there so yeah. Is the research coming along in your opinion out there enough money is being pumped into the research of AIDS and in that research our black physician and scientists involved to your knowledge with that research? I think there needs to be much more funds to aid in the research because we have a long way to go.

We have a virus here that's deadly and we've come, we've identified the virus, we know how the virus replicates and we know what it does but we still don't know how to stop it. There are the 10 to 20 years before we can find something to stop it and so there needs to be much more funds allocated to this. As far as black physicians and scientists being involved in this there are and especially in a black universities at Howard and Morehouse and King Drew and there needs to be a lot more though and there needs to be more physicians need to get involved in this. A person listening to this program can they obtain more information about AIDS from their family, a physician or local health clinic? I would hope so. Now physicians are now becoming a little bit more educated about AIDS and what the symptoms are and what we need to do about it, we still have a long way to go and there's a lot

of symposiums and seminars on AIDS and hopefully the family's physician can counsel the AIDS patients. I think we have some way to go though. To your knowledge, how many cases in the black community here in Texas have been diagnosed? In fact, I'm not the right person to ask for that. The question Charles Wallace, my counterpart, is this the person for that in Dirty Gibson? Put it this way as far as the numbers go. The majority of AIDS cases are in New York and New Jersey, Florida and California. Texas has a low number compared to them but we're close behind. I can't give you the actual statistics on that just yet but it's there. In a few years, those numbers are going to increase. One final question, Dr. Bristol, do you see a light at the end of the tunnel?

You're involved, your other colleagues in your office involved, going out and speaking to black groups, civic or social. Do you feel good about yourself, or do you feel that you're making an impact towards better education and understanding of AIDS? I feel optimistic about it. I think there needs to be a lot more needs to be done and I'm learning about the AIDS virus and the AIDS epidemic every day and it's a continual learning process. I think we have a long way to go. There is still a big denial problem in the black community and we need to deal with that because we are dealing with issues that have been a problem with the black community for a long period of time and until we deal with these issues, I mean, I have a drug abuse and sexual promiscuity and until we deal with these problems, then we will see if we don't deal with these problems, we won't see an end and it'll just get worse but if we deal

with these problems, then we can at least stop it because the scary thing about AIDS is there are a lot of asymptomatic individuals that are out there that don't know they have it and these are the ones that are spreading it and we need to, true, we need to get to the information to these folks. Dr. Paul Bristol, a physician in private practice in Austin, Texas. If you have a comment or like to purchase a cassette copy of this program, write us. The address is in Black America, Longhorn, Radio Network, UT Austin, Austin, Texas, 7-8-7-12. For in Black America's technical producer Cliff Hargrove, I'm John L. Hanson, Jr. Please join us 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 this station. This is the Longhorn Radio Network.