Shaping AIDS Education and Prevention Programs for African Americans Amidst Community Decline

Abstract

Race, culture, geography, and gender all are critical factors in understanding the epidemic of AIDS-Acquired Immunodeficiency Syndrome. Among African Americans, however, there are two striking features of the AIDS epidemic that deserve special notice. First, AIDS is part of a general pattern of excessive risk and mortality observed among all African Americans (Secretary's Task Force, 1986). More recently, McCord and Freeman's (1990) examination of mortality rates in Harlem (NY) underscores how dramatically the health of the nation's best-known Black community has been affected: The rate of survival of African American men in Harlem beyond the age of 40 is lower than that of men in Bangladesh, one of the poorest nations on earth. AIDS has joined an extensive list of health problems (including cancer, heart disease, violent! accidental death, and liver disease) which together result in lower life expectancy and higher rates of illness among African Americans. The second noteworthy feature of the AIDS epidemic is that infection with the causative virus-Human Immunodeficiency Virus (HIV)-is preventable. In adults, with the exception of those infected via blood transfusions, infection with HIV results from choices people make about their sexual behavior and their use of illicit drugs. On one hand, we health practitioners and educators can be optimistic that we will eventually be able to assist adults in making informed choices about behaviors that affect their health. On the other hand, we must also recognize that simply educating individuals about the relationship between behavior