The Tuskegee Effect

For Blacks, a 28-Year-Old Study Is One of Many Barriers to HIV Prevention

Some black heterosexual couples are also locked into a disturbing catch-22. Health Watch's project showed that most black women (one of the fastest-growing groups among new AIDS cases) want their partners to use condoms. But they may not speak up for fear of physical or verbal abuse, or losing their partners when so many young black men are caught up in the criminal justice system or otherwise ineligible.

"We have to recognize that in a society with few eligible men, she may sacrifice her self-esteem to keep that man," says Dr. Norma Goodwin, president and founder of Health Watch.

Meanwhile, men in the study reported that they would use condoms if women said they had to. This request is even more important when men who cheated said that they rarely practiced safer sex—it ruined the moment and they weren't about to discuss sexual history with a stranger.

This project underscored the fact that programs which, for example, help women assert themselves or leave abusive relationships will be more successful than ones that merely tell them to use condoms. Similarly, a trickle of HIV prevention programs look to stabilize people's lives as a way to keep them HIV-free, realizing that often HIV is the last thing on the mind of someone who's worrying about eviction, unemployment, domestic violence, or substance abuse.

"Simply zooming in on HIV/AIDS is not effective," says Tokes Osubu, network coordinator at the East New York/Brownsville HIV Care Network, which coordinates services and programs for AIDS organizations in the area. "There are family issues here, like 'I don't have a job.' "

To deal with these issues, AIDS prevention programs will have to form partnerships with other service groups in the black community or expand their own offerings. It's a huge, expensive mandate, especially in an era of disappearing AIDS funding.

But the good news: These shifts have already begun, although tentatively. For instance, the Caribbean Women's Health Association in Brooklyn tackles immigration issues in addition to AIDS, since many immigrants are afraid to use public services, including health programs. And Harlem United works with agencies that distribute clean needles to gain access to drug users, and refers clients for legal, domestic-violence, and psychological counseling services.

"It's really about that person as a whole, not just about HIV," Osubu says. "They are a mother, a sister, a churchgoer; it's about bringing all these things to the table."


Part I: Emergency Call by Kai Wright
How AIDS Is Hurting Black Communities

Part II: Black, Gay, At-Risk by Kai Wright
Homophobia, Racism, and Rejection Fuel Rising Infections

Part III: The Tuskegee Effect by Kemba Johnson
For Blacks, a 28-Year-Old Study Is One of Many Barriers to HIV Prevention

Part IV: Double Jeopardy by Kai Wright
In NY State Blacks Rank Highest Among HIV-Positive Inmates

Part V: Black Women and HIV by Sharon Lerner
Rising Infection Rate Reflects an Age-Old Gender Imbalance

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