ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Sunday, March 30, 1997 TAG: 9704010004
SECTION: HORIZON PAGE: 5 EDITION: METRO
DATELINE: MIAMI
SOURCE: Stephen Smith THE MIAMI HERALD
In 1996, AIDS killed 21 percent fewer whites, but the death rate slowed by only 10 percent among Hispanics and only 2 percent among blacks.
For 16 years, all the news about AIDS had been death. And more death.
Then, a few weeks ago, came a shimmering ray of hope: For the first time since the start of the epidemic, the virus claimed fewer people in 1996 than the year before, largely thanks to promising new drugs.
But the good news was not spread evenly.
While AIDS killed 21 percent fewer white non-Hispanics in the country, the death rate slowed by only 10 percent among Hispanics. And it was lower still in black America: just a 2 percent decrease.
That chasm has exposed the differing faces of an epidemic well into its second decade, an epidemic that is a reflection, too, of a health care system that often does too little, too late for the people needing help the most.
Stigma and powerlessness, poverty and neglect fuel the AIDS divide, a breach that began in the earliest days of the epidemic and persists 16 years later.
``We cannot continue to have a large segment of our population on the outside looking in while we watch them die,'' said former Surgeon General Joycelyn Elders, who is leading a campaign to empower and educate blacks and Hispanics about AIDS. ``We cannot let them die because of lack of knowledge.''
The AIDS divide manifests in ways profound and symbolic. It can be found in a glittering hotel and in a low-steepled church.
One night earlier this year, a Miami Beach hotel ballroom dressed in twinkling lights brimmed with hundreds of people - mostly men, mostly white - gathered to hear the latest on AIDS research. It was a technical, almost clinical discourse.
A few weeks later, the pews of a Liberty City church filled with dozens of people - mainly blacks - struggling to stop the AIDS virus from stealing more lives in their community. In song and words, they were urged to go back to the streets and spread the basics on AIDS education and prevention, to urge people to get tested and get help.
``The first strategies for fighting this disease were not designed for us - they were designed for the people who were making the biggest cry, which happened to be the gay, white male population,'' said Patricia Kelly, who runs an AIDS service agency on the edge of Liberty City. ``Now that the strategies have worked for the people they were designed for, the whole strategy has begun to change - the strategies are beginning to be designed around the newest drugs.
``But we haven't even reached the first level yet.''
The epidemic Kelly confronts when she peers out the bar-clad windows of her office on Northwest Seventh Avenue is stunningly different from the reality of AIDS on South Beach. When a newly diagnosed patient walks through the door at the agency called MOVERS - the name stands for Minorities Overcoming the Virus through Education, Responsibility and Spirituality - it is never just about AIDS.
``If you don't have food in your refrigerator, when you come to me, you're not coming to hear Vanessa spill her guts about how you should take your medications,'' said Vanessa Mills, who manages the care of MOVERS' clients. ``You're coming to me for a food voucher, you're coming to me because you can't pay your light bill.''
And they're often coming to her at a point when the disease has progressed so far it's impossible to harness. That late arrival into the health care system has long contributed to the higher death rates in the black community.
But it's more critical today than ever.
The new drugs that came onto the market within the past 15 months - called protease inhibitors, and often used in combination with earlier generations of AIDS medicines - were once available mainly to the wealthy or well-insured. Now they are being prescribed more routinely to the neediest patients. State and federal dollars are helping cover the stiff price of the drugs - a full year's regimen can easily cost $15,000.
Even though there are pools of government money to pay for the drugs, that won't matter much if people don't know where to go to get the medicine, or if they wait too long to find out they have AIDS.
Some AIDS service groups are reaching out, putting down roots on the street corners where the disease is wreaking the most destruction. Agencies - especially those founded by gay men at the dawn of the epidemic - have been criticized for failing to follow the virus to all the neighborhoods it invaded
Tangela Sears' brother was among the black Floridians killed by AIDS last year. He was a gay, black man in Liberty City, who confronted the pain inflicted by the disease - as well as the stigma of AIDS in his community.
When her brother died last May, Sears vowed that there should be no more funerals. So she has taken to the streets, lecturing about the disease. She has staged talent shows, to entertain and educate, and marshaled gospel singers to inspire.
``I feel that if I would have known a lot of the things that I know now,'' Sears said, ``my brother would have received more appropriate treatment. And just maybe, my brother would still be living today.''
LENGTH: Medium: 95 linesby CNB