Development & Aid, Headlines, Health, Human Rights, North America, Population

Poverty and Racism Fuel HIV/AIDS Epidemic in U.S.

Kanya D'Almeida

WASHINGTON, Dec 1 2011 (IPS) - On World AIDS Day, all eyes are fixed on the global south, where a preventable HIV/AIDS epidemic across Asia, Africa and Latin America has infected almost 33 million people.

However, with the spotlight focused on the developing world, ominous trends and patterns in so-called democracies like the U.S. often go unnoticed.

During a speech in Washington Thursday morning, U.S. President Barack Obama promised to funnel 50 million dollars into domestic efforts to tackle HIV/AIDS.

“The rate of new infections may be going down elsewhere,” the president said, “but it’s not going down here in America. There are communities in this country being devastated still by this disease. When new infections among young, black, gay men increase by nearly 50 percent in three years, we need to do more to show them that their lives matter.”

Communities of colour and low-income or immigrant communities in the U.S. have always been disproportionately impacted by HIV/AIDS, a cumulative consequence of poverty, poor education, lack of public health infrastructure and services, and heavy rates of incarceration.

In fact, the Duke Center for Health Policy and Inequalities Research released a recent report saying that the HIV/AIDS epidemic in the south has reached “crisis proportions in the last decade”.


Drawing on the most current data from the Centers for Disease Control (CDC), the report found that a southern “belt” of states, including Alabama, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Texas, had the highest rates of new infections; accounted for 37 percent of the country’s newly infected people each year, despite housing just 22 percent of the country’s total population; and comprised eight of the 10 states with the highest AIDS death rates.

Given that the majority of African Americans live in the South, the study’s findings cemented what many advocates and experts in HIV treatment and prevention have known and lamented for years – that AIDS is still, as it was in 1970s and 80s, a plague of poverty.

The report itself noted, “The South and particularly the targeted states have some of the highest levels of poverty in the US. Nine of the 10 states with the lowest median incomes are located in the South and six of the 10 states with the highest poverty levels are located in the South. Mississippi has the highest poverty level, 28 percent, in the US.”

The Southern AIDS Strategy Initiative (SASI) added that between 2005 and 2008, “50 percent of men and 71 percent of women diagnosed with HIV in the South were African American. African Americans with HIV have also been identified as having higher levels of morbidity and mortality” than any other population.

Prisons: A breeding ground for HIV

A series of archaic laws, illegal practices and a lack of political will to embrace harm reduction policies have turned prisons and other centres associated with the “justice system” into a veritable breeding ground for HIV/AIDS.

“Sentenced to Stigma”, a new report by the national prison project of the American Civil Liberties Union (ACLU), estimated that 22,000 inmates are currently infected, four times higher than the prevalence in the U.S.’s general population. The report also found that “14 percent of those with HIV infection pass through a U.S. correctional facility each year”.

The ACLU is currently engaged in a legal battle with the state of Alabama, which houses its HIV-positive prisoners in segregated housing, forces them to wear white arms bands proclaiming their HIV status to other prisoners, visitors and other community members, denies HIV-infected patients the right to work-release programmes and faith-based housing, and strips them of access to essential rehabilitative and re-entry programmes, including residential drug treatment programmes.

These practices force HIV-positive prisoners to endure unnaturally long sentences or circle back through the prison system because they are unable to access various support services.

HIV-positive prisoners are routinely subjected to violence from other prisoners and even from guards, who, in Mississippi jails, have been heard to scream, “Get your sick asses out of my way,” as they passed segregated prisoners in the corridors, the ACLU says.

“The disproportionate number of HIV-positive inmates reflects other terrible demographics in the U.S. including a strong link between incarceration and people of colour, particular African Americans who are both grossly over-represented in the prison system for reasons of class and race and also suffer disproportionately higher rates of HIV due to poverty,” Margeret Winter, associate director of ACLU’s national prison project, told IPS.

“It is no coincidence whatsoever that the last three states to categorically segregate prisoners with HIV were Mississippi, Alabama and South Carolina, all of which also boast wildly disproportionate numbers of African Americans in state prisons,” Winter added.

“I think it’s very much been the sentiment that HIV is a disease for dark-skinned people, which basically enables a continuation of racist practices and unofficial policies that discriminate and brutalise people of colour,” she added.

Perhaps the most unjust aspect of these practices and policies is their cyclical nature. Aside from people who enter the prison already testing positive for HIV, scores of inmates contract the disease while behind bars, through intravenous drug use with shared needles, tattooing, consensual or forced sex, and a lack of medication.

According to a study in AIDS Education and Prevention, “From an original sample of 5,265 inmates from the state prison system of an unnamed Southern state, 271 tested positive for HIV/AIDS, 33 of whom contracted HIV inside prison and 238 were diagnosed after leaving prison.”

In this study, blacks accounted for 79 percent of those who contracted HIV in prison and 88 percent of those who contracted HIV after release.

Obama’s promises notwithstanding, legal advocates like Winter believe that there is little difference at the federal level between the current administration and its predecessors.

“It is almost impossible to get a serious hearing on issues of harm reduction, which advocates have long identified as the only viable option for preventing the spread and proliferation of HIV,” she told IPS.

“It is unbelievable that in the year 2011 we still cannot sit down with decision makers at the highest level of government and talk seriously with them about making condoms available to prisoners and introducing clean needle exchange programmes which would make an enormous difference not only on the transmission rates of HIV in prison also in the communities to which prisoners return.”

“Currently not a single state or federal programme provides condoms and clean needles to prisoners,” she added.

 
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