Race, Health Care and the Law 
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Introduction - AIDS Pandemic

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Vernellia R. Randall
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Maya Rockeymoore, Ph.D.





Since the beginning of the epidemic, the politics and policies that developed in reaction to the AIDS scourge have been rooted in the unique experiences of America ’s gay community.  Overwhelmingly white and male, the vocal gay community responded to the early threat of AIDS by mobilizing and using political muscle to marshal federal, state, and local resources.  Their remarkable achievements in battling the ravages of a mystifying disease should not be minimized—the more so because they simultaneously had to fight a widespread social stigma and blatant discrimination in order to bring the devastation of AIDS in their communities to national and international attention.  Their early dominance and success, however, have influenced the content and shape of the political processes surrounding the distribution of AIDS resources to such an extent that it has had a crowding-out effect on other groups who have also been severely affected by the epidemic. 

Unbeknownst to many, African Americans have been disproportionately affected by HIV/AIDS since the beginning of the epidemic.  Early surveillance data issued by the Centers for Disease Control and Prevention (CDC) revealed that black Americans were among the first cases of AIDS in America and that their rate of infection was disproportionate to their representation in the general population.  Unlike the white gay community, however, the black community failed to formulate a coordinated early response to the epidemic for a variety of reasons that were rooted in the campaign of misinformation about risk categories and transmission that surrounded AIDS in its early years, in socio-cultural biases that colored attitudes toward people affected by the disease, as well as in depressed socio-economic conditions that made it difficult to discern the gravity of a new threat amidst other pressing concerns.[1]  The salience of this last point cannot be ignored.  In the 1980s the crack-cocaine epidemic, a dramatic spike in drug-related crime activity, massive unemployment, and the hostile posture and punitive policies of the Reagan/Bush administration consumed African American communities.  The impact of these and other factors diminished their capacity to recognize the spread of AIDS and to formulate an appropriate response.

The second decade of AIDS would bring new concerns to the fore as epidemiologists and the mainstream news media brought heightened attention to the growing devastation created by HIV and AIDS in communities of color.  Since 1994, African Americans have outpaced other groups in new cases of HIV/AIDS.  Although only 12% of the population, African Americans represent 38 percent of all AIDS cases reported in the United States .  In 2000 more African Americans were reported with AIDS than any other racial and ethnic group.  Indeed, 63% of all women and 65% of all children reported with AIDS in 2000 were African American.  The rate of reported cases for African Americans was two times greater than the rate for Hispanics and more than eight times greater than the rate for whites.[2] 

Contrary to the malaise in the first decade of AIDS, the second decade of AIDS was very different in terms of impact, organization, and advocacy in the African American community.  By the second decade it became clear that the institutions created by the AIDS epidemic were a micro-version of the racialized institutions and processes of the larger U.S. health care system and society-at-large.  The fact that African Americans were contracting HIV and dying from AIDS in record numbers provided an indicator that AIDS service organizations, research entities, and treatment and prevention models—formed to meet the needs of white men of means—were inadequate to address the unique circumstances of African Americans and other racial and ethnic minorities.  These stark socio-political realities would serve as a catalyst for a new era of black political activism.

Introduction - AIDS Pandemic
The Changing Face of AIDS
AIDS and Community Mobilization

Related Pages:
Home ] Up ] [ Introduction - AIDS Pandemic ] The Changing Face of AIDS ] AIDS and Community Mobilization ] LEANING ON THE 'CONSCIENCE OF THE CONGRESS' ] CONTINUED CHALLENGES IN THE THIRD DECADE ] Conclusion ]
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Home ] AIDS and Minorities ] Minorities and HIV ] HIV/AIDS: The Law, Minorities ] Issues for Elderly Persons Living with HIV/AIDS ] Access and AIDS/HIV Infection ] Drug Laws and AIDS ] AFRICAN AMERICANS CONFRONT A PANDEMIC- AIDS ]
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Professor Vernellia R. Randall
Institute on Race, Health Care and the Law
The University of Dayton School of Law
300 College Park 
Dayton, OH 45469-2772
Email: randall@udayton.edu


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