SEX ISSUE: HIV afflicts minorities in St. Louis
The Centers for Disease Control’s last report, conducted in 2004, ranked St. Louis the 24th worst area in the nation for HIV rates. That amounts to 217 newly reported cases that year, and nearly 7,000 people living with HIV/AIDS today.
Rates of HIV are not spread uniformly in the St. Louis area; certain segments of the population bear an overwhelming share of the burden. African Americans and homosexuals, for example, have the highest rates of any group in the city. African Americans, who comprise 20 percent of the population, make up 50 percent of the HIV cases in St. Louis. Among women, the numbers are even worse, as 65 percent of women with HIV are black. Gay men account for over 70 percent of all cases of HIV/AIDS in the St. Louis area, split almost evenly between whites and blacks.
“Why are HIV rates so high among minorities? I’d have to say the reasons are more social. The social influences, the family, poverty level-all of that plays a role. Community norms and values are a big piece of it too,” said Sandy Hentges of the Missouri Department of Health.
The Centers for Disease Control (CDC), Missouri Department of Health and local groups such as the St. Louis Effort for AIDS struggle with this uphill battle everyday. The disease doesn’t just have a biological cause; there are social factors at work as well.
“You’re dealing with an age group with huge libidos and a sex addiction,” said Mark, a St. Louis native who requested that his last name be withheld. “Educated or not, if people go out and have a few drinks, and if they have a few tokes on top, they lose all sense of good behavior, then they’re liable to do anything,”
Mark, a homosexual male, has lived with HIV since 1983 and watched the AIDS epidemic unfold. He remembers what it was like to be college-aged, and knows the importance of being careful with drugs or alcohol consumption. Mark added that new medications have made the effects of diseases like HIV much less severe, which makes students let down their guard.
“It makes people a bit less cautious,” he said. “They think now, that these so-called ‘miracle drugs’ exist [and that] they can take risks. But people are still dying left and right. Maybe the vast numbers aren’t dying like they used to, but you also don’t hear about it like you used to.”
The statistics on HIV rates in St. Louis may not tell the entire story. Many cases of HIV go unreported and, among more affluent communities, that is even more likely.
“I don’t think there’s a big difference among infection rates-it’s a reporting factor,” said Thomas Blisset of the St. Louis Effort for AIDS Foundation. While free clinics are required to report their HIV cases, private doctors are not.
“There are a lot more minorities becoming infected, but we know because they’re going to free clinics,” he says. “Private doctors can hold on to this information and not report it. If you have a single mom with three kids and a family out in Chesterfield, she’ll get medical insurance and can go to her primary care physician.”
Despite his misgivings about statistics, Blisset still acknowledges that there is a problem with sex education and encourages everyone to know the risks and get tested.
While medication helps increase the survivability of people with HIV, the primary method of control is prevention.
“We need more safe sex education at a younger age. My personal belief is that once you reach the age of 13, you reach that transitional stage, and you should have that information about STDs and be aware of how to put on a condom correctly,” said Blisset.
The best approach, according to Hentges, is group intervention tailored for a particular group. One such intervention program, run by the Department of Health, is called “Many Men, Many Voices.”
“They’ll meet MSM [Men who have Sex with Men] engaging in risky behavior, and learn to reduce their risk through behavior modification, role-playing, demonstrating other skills, and through intensive counseling with a prevention specialist and the group,” said Hentges. “We also have Active Outreach, where we go to where we know groups at risk hang out, and we give them information. It’s a group setting, but it’s more general. It’s not intervention as much as giving information and tools needed to see how they’re at risk and how to reduce that risk.”
Reducing HIV risks means more than putting on a condom, according to Paola Rijos from Student Health Promotion Services. She recommends getting yourself and your partner tested before getting physical, or getting tested as part of a yearly check-up. She also encourages wearing condoms for oral sex.
“Some STDs can be transmitted from the mouth to the genitals and from the genitals to the mouth. Gonorrhea, chlamydia, genital herpes, oral HPV, syphilis and HIV are among the STDs that can be transmitted through oral sex,” said Rijos.
While HIV and other STDs may be frightening, it is important to understand how they work and how to remain safe. Changing negative social attitudes also play a major factor in the fight against HIV and AIDS. Mark has seen the effect of society’s perceptions of HIV on attitudes towards sex.
“People need to know, because so many people are terrified and won’t get into relationships with people who are [HIV] positive. That needs to change, too. It’s very much possible to have satisfying and safe sex with an HIV positive person,” said Mark. “There are forms of sex other than intercourse that can be satisfying. Depends what you’re into. We need to be aware and safe, not afraid.”
Other STDs cause worry
HIV is not the only disease hurting minorities. Nearly 70 percent of cases of gonorrhea and 60 percent of chlamydia in St. Louis are among African Americans. The most threatened and vulnerable group is black women under the age of 18, acquiring 650 cases of gonorrhea and 1,700 cases of chlamydia in 2004. 148 of the girls were aged 14 or younger.
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