On June 3 and 4, SLO County residents may notice an odd though not unknown scene on our roadways—3,000 cyclists and crew pedaling through the wind and fatigue. Hopefully, most will look long enough to realize that this is not just some mega-bike club or century ride. This year, the 545-mile AIDS/LifeCycle is expected raise $11 million for the San Francisco AIDS Foundation and the L.A. Gay & Lesbian Center, money that will be used for both HIV treatment and prevention. The spectacle of all those road-weary souls riding onward reminds us: This fight is not over.
According to the Centers for Disease Control and Prevention’s most recent numbers, in 2006 there were more than one million people living with AIDS in the U.S. (143,000 in California)—more than ever before. Estimating the number living with HIV is more difficult, but the rate of HIV infection appears to be increasing, particularly among African Americans and people under 25. And the virus itself continues to change and resist all the pharmaceuticals we throw at it.
Clearly, this is still a public health crisis. Yet even as we see a record number of volunteers turn out for the AIDS LifeCycle, the battle against AIDS faces its own cocktail of foes. If the California legislature passes the governor’s proposed budget, many people living with HIV/AIDS could lose coverage for drugs vital to their treatment, critical Medi-Cal benefits will be cut, and AIDS support programs already strapped will have to survive on even less. These cuts come as deepening health inequities and widespread complacency challenge prevention.
On June 5, 1981, the Centers for Disease Control published a report on five cases of a rare kind of pneumonia. The day would later be called the start of the AIDS epidemic. I was a year old. Like many others of my generation, I grew up with the fact of HIV, which seemed both as real as TV dinners and Nintendo and as distant and remote as anything else on the evening news. Yet as I watched through the haze of childhood as Magic Johnson went public with his HIV-positive status, a small group of AIDS warriors was fighting tirelessly behind the scenes to find appropriate preventions and treatments for the baffling disease, and correct the prejudices and misunderstandings that stood in their way.
Twenty-seven years into the struggle, we’ve seen major gains on all three fronts. If you have access to the developed world’s medicine and health care, AIDS is now a manageable disease, not the painful death sentence it once was. The gay rights movement has had its own successes, which have helped the conversation on AIDS to be more frank and the government funding more reasonable. HIV testing is easier and quicker than ever before, the dangers of intravenous drug use are more known, and public health campaigns have imprinted the words “safe sex” on our brains.
But has safer sex become part of our decision-making? Have high-risk behaviors become a thing of the past? Has HIV testing become a regular part of our health check-ups? Unfortunately, the answer to all of these questions is no. That may be why we’re still seeing 40,000 new HIV infections every year in the U.S., and why it is estimated that 25 percent of people infected with HIV do not know about their positive status.
Ironically, the advances in medicine, particularly antiretroviral therapy, that have improved HIV treatment enormously have also shielded many of my generation from the worst horrors of the disease. And as reporting on the AIDS crisis has understandably shifted to Africa, the threat of infection in this country seems less real to some and risky behavior becomes more acceptable.
As 22-year-old AIDS/LifeCycle participant Henry Bonifas put it, AIDS is something “you hear about on the other side of the world. I didn’t realize the extent and the presence it still has here in the U.S.” The Atascadero native watched his father make the S.F.-to-L.A. trek twice, but only learned about the prevalence of the disease in his home state after becoming involved with the ride himself.
“When I talk about it with my friends, they’re kind of in the same boat with me. They know AIDS is out there, and people die of AIDS, but when you come up with the numbers of [cases of] HIV/AIDS, particularly here in California, it’s just astounding.”
The disease continues to have a disproportionate effect on minorities, particularly African Americans. Black Americans make up only 12 percent of the general population, but accounted for 49 percent of new AIDS diagnoses in 2006. Black men who have sex with men are most at risk for infection, though black women and youth also suffer disproportionately from AIDS compared to their white and Latino peers.
The statistics cannot be divorced from the poverty and other health inequities affecting the black community. According to the HIV Cost and Services Utilization Study (the only major national survey on the care of HIV patients), 59 percent of African Americans relied on Medicaid (what is called Medi-Cal here in California) for insurance, compared to 32 percent of whites. But type of insurance is only one factor that can lessen access to services and quality of care. According to the same survey, African Americans were also more likely than other ethnic groups to postpone medical care because they lack transportation, were too ill to make it to the doctor, or had more pressing necessities.
Not everyone can take a week off from his or her life to bike from San Francisco to Los Angeles. We can however be inspired by the number of people who have. To become involved locally, contact the AIDS Support Network of San Luis Obispo County at 781-3660, or check out San Francisco Aids Foundation at www.sfaf.org to register for the next ride. And get tested: call the county Public Health Department at 781-5500.
Kirsten Flagg is the former editor of the Santa Maria Sun, the New Times’ sister paper. She now works in public health. Send comments via [email protected].