THE CENTERS for Disease Control reported that after a 2.2 percent increase in the annual numbers, the "estimated number of American deaths from AIDS through 2002 is 501,669, including 496,354 adults and adolescents, and 5,315 children under age 15."Paradoxically and sadly, according to the same health officials there is an increasing aura of complacency among Americans when it comes to HIV and AIDS.This precarious problem is even more troublesome given that most Americans, whether liberal or conservative, approach AIDS as an individual, not a societal problem.
In general, there have been two mainstream approaches to the problem of unwanted pregnancies and STDs such as AIDS, all of which result from sexual intercourse. The traditionally conservative approach has been to preach abstinence, while the liberal perspective has involved preaching "safe sex" (which, for the purpose of STDs, is intercourse with a condom).Both of these approaches have their benefits, yet both of them display a fundamental misunderstanding of the AIDS threat by neglecting to give serious attention to the lurking societal variables.
To demonstrate that the problem is in fact social in nature, one must simply examine the breakdown of AIDS in different communities. A report released by the Centers for Disease Control indicated that the rate of new AIDS cases was twenty times greater for black women than it was for white woman, and five times greater for black women than it was for Latina women.Last year, according to the District of Columbia's Health Department, "black women represent 90 percent of women living with AIDS while making up only 62 percent of all women in the city." Many similar statistics have been promulgated by various groups, including the National Black Leadership Commission on AIDS.
The mainstream approaches to date have been, if implicitly, overly critical of the individual rather than the circumstances in which that individual is acting.Whether one advocates abstinence or protection, there is an implied assumption that the cause of these numbers is promiscuity, an assumption not empirically supported, according to Adaora A. Adimora, an associate professor of medicine and an adjunct professor of epidemiology at the University of North Carolina at Chapel Hill.
A better solution can be found by observing and understanding the social structures in which the AIDS phenomena occurs. For example, Adimora provides the real-life example that a 22-year old promiscuous law school student has a lower chance of contracting HIV than a "a 22-year-old woman who had sex with only one man in a poor D.C. neighborhood with a very high HIV prevalence."
Furthermore, there has been an astonishing and sad lack of attention given to socioeconomic and community factors. For example, availability of marriage partners, cohesion with a community, social networks, income levels (particularly those of women) and living conditions are just a few of the many variables that must be addressed. Scientists such as Adimora believe that behind such factors lies not only an adequate explanation of today's preposterous racially-divided statistics on AIDS, but also a solution to this social quagmire.
Regardless of the fact that many social scientists have been advocating a macro-level approach to the issue, media coverage of AIDS has been largely confined to the abstinence versus protection debate. A recent study done by Rand Corp. and Oregon State University indicated that half of African Americans of all ages and incomes believe that AIDS is a scientist-created disease. Even more disturbing, 12 percent attribute its widespread existence to the CIA, while 15 percent believe AIDS is genocide directed towards blacks, and 44 percent think that those who have been using recent HIV medications are government guinea pigs. This eye-opening study implicitly indicates that our social institutions should be accused of practical indifference to the issue -- otherwise, those institutions would have taken decisive steps in order to convince Americans that such claims are spurious.
The media should disseminate more information about the AIDS threat Americans face everyday, and public policy should lean not only towards education about abstinence and protection, but also installment of health centers where they are needed most, as well as a serious, well-directed effort to alleviate the socioeconomic conditions behind AIDS (and other STDs). This mobilization against AIDS will intrinsically address the problems that plague black communities, which happen to be a lack of information, health centers, and the widespread existence of poor economic conditions. Only with the presence of such effort will America stand witness to appreciable results and overall social betterment.
Sina Kian's column appears Thursdays in The Cavalier Daily. He can be reached at skian@cavalierdaily.com.
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