This weekend at a party I met a public health researcher who focuses on HIV/AIDS, and her compelling story soon riveted all of us. Perhaps you knew this, but I did not: while blacks are about 16% of the US population, they suffer from 46% of the AIDS cases, with the growing population of infected people being black women and teenagers. According to the Kaiser Family Foundation (http://www.kff.org/hivaids/upload/6089-09.pdf) black women now are are 34%, just over a one third, of AIDS diagnoses among blacks — in other words, if you associated AIDS with drug use, men in prison, male homosexuality — none of those factors apply. And then teenagers — black teenagers are 17% of the total US teenage population, but accounted for 68% of new AIDS diagnoses in 2009.
Sixty eight percent! So here we are — trained adults who write for teenagers, educate teenagers, review books for teenagers, stock libraries used by teenagers and plan programming for those spaces. What can we do? Is there anything? When I asked why AIDS was spreading in these populations the expert mentioned poverty, poverty, poverty, and poverty as a key — because with poverty also comes poor health care, other untreated diseases, lives that are so marginal that a silent disease whose ravages you may not feel for years is hardly worth thinking about. We cannot do much directly or easily about endemic poverty — although the last time I sounded a warning here it was about the 50% black high school drop out rate — want to make any bets on the relationship between that number, extreme poverty, and AIDS rates? But there are other forces at work where we may be of use. Libraries are sources of information — information about health options, testing options, privacy needs to be made available to teenagers. And if you are thinking I am talking just about a few large urban ghettos, you are wrong. More than half of the new AIDS diagnoses among blacks are in the South. Now it is true AIDS cases in the black community cluster — in DC and New York — but now also in Georgia and Florida. But I bet many/most of your libraries have some display about health options for teenagers — display, not just some books in their Dewey spot — right?
The other problem, and where we may be of help, is silence, shame, and fear. The heritage of the Tuskeegee Experiment, the mythologies about AIDS as a deliberate white plot, the deeply unfortunate position taken by some South African leaders that AIDS was a myth, or a colonial plot, or could be defeated with “traditional” means, all serve to make some African Americans reluctant to go to government doctors, to be tested, to take medicine that in fact has strong side effects, especially at first. There is the ongoing stigma of AIDS as being associated with homosexuality, which has made the black churches — which had been so much at the forefront of the Civil Rights struggle — slow to take leadership on AIDS. In other words the combination of shame, myth, and community resistance serve to make it harder for a teenager who might have gotten tested, been better about protecting her or himself, or been given medicine, to take those steps. And there — in breaking silence and making the circuit of information flow better — is where we all can and should come in. If the churches for whatever reason, and fighting the full range of battles they need to fight, are not being a great source of information, surely the library can be. What about a display on real medical abuse of blacks (Tuskeegee, for example) and myths (AIDS) — to take on the challenge, and separate one from the other.
Have any of you tried programming or displays around the issue of AIDS and black teenagers? How can you bring information without creating further stigma? What have you done? What works? What doesn’t? What should we all know? What can we all do?