The Changing Face of AIDS

Late morning. Harlem Hospital. Doris White (not her real name), 32, pulls her thin robe across her narrow, bony chest and lights a cigarette. Her dark arms are riddled with small, round scars, the hieroglyphs of chronic heroin abuse. She is here for the seventh time in two years. In 1982 she brought her four- year-old son Rashan to this same hospital. The boy was listless, losing weight; he had white spots on his lips and tongue. The boy's father, a drug addict, had recently come out of prison and was not at all well himself.

For the next few years, Rashan fought a battle he did not understand. "Mostly, my mother took care of him," says Doris, crossing her skinny legs. "It was hard. I'd have to get high before I could go see him." Rashan died a year and a half ago of AIDS, about the same time Doris was diagnosed as having the disease and two months after the boy's father succumbed to the illness, known in the ghetto as "the AIDS." She squeezes her brimming eyes shut. "I will feel the guilt the rest of my life," she says. A month ago Doris' five-year-old daughter Jamille received the deadly diagnosis. So far, only her 15-year-old daughter has been spared. Doris says the disease has changed her; she no longer shares needles. "It seems like every day someone else I got high with is sick," she says. But she still shoots up. "If I can get high," she explains, "I can push things to the back of my mind."

The face of AIDS in America is changing; it is getting younger, darker, more feminine. Stories like Doris White's are becoming common in inner-city ghettos: every day someone else who got high is getting sick. So are their - lovers, and so are their children. Although nearly two-thirds of AIDS victims so far have been homosexual men, the rate of new infection among gays has declined. At the same time, the rate among blacks and Hispanics, particularly those who are intravenous drug users, is rising alarmingly. Medical experts warn that unless urgent actions are taken, AIDS may become a predominantly minority disease. That prospect is frightening not only to health officials but also to civil rights advocates, who fear a backlash of racism.

This past weekend the Centers for Disease Control in Atlanta held its first national conference on AIDS and minorities. According to CDC statistics, although blacks and Hispanics constitute only 12% and 6% of the U.S. population, respectively, they currently account for a disproportionate 24% and 14% of the more than 39,200 reported AIDS cases in the U.S. For women with AIDS, the numbers are even more striking: some 52% of them are black and 20% Hispanic. Nearly 80% of all children with AIDS are either black or Hispanic.

In absolute numbers the problem of AIDS among minorities hardly compares with other enduring inner-city health-care problems such as hypertension, drug abuse and teenage pregnancy. But the future may tell a different tale. Testing of military-service applicants for exposure to the AIDS virus has revealed an incidence that is four times greater for blacks than for whites. If present trends continue, blacks and Hispanics might constitute as much as 40% of the predicted 54,000 AIDS deaths in 1991. Warns Dr. Wayne Greaves, chief of infectious diseases at Howard University Hospital: "Unless we can interrupt this pattern of transmission, this disease could potentially affect the size of the black population."