AIDS EPIDEMIC HITTING AFRICAN-AMERICANS THE HARDEST

Conference lures activists, health care providers eager to reverse trend

WASHINGTON -- Black Americans are becoming infected with AIDS at record
rates, receiving poorer care than whites and dying faster.

Now, almost two decades into the AIDS epidemic, about 1,000 health care
providers and activists gathered for the first medical conference on AIDS
among black Americans -- a frantic hunt for ways to fight the exploding
racial divide.

AIDS in the United States is evolving from a disease that once mostly
affected white homosexuals into one largely of poor blacks, often infected
from dirty drug needles or heterosexual encounters.

Blacks make up about 14 percent of the U.S. population but a devastating 45
percent of new AIDS cases. AIDS has been the leading killer of blacks
between 25 to 44 for most of the decade. One in 50 black men and one in 160
black women are estimated to be infected.

`A daunting challenge'

"This is no less a daunting challenge than we faced in the civil rights
movement," said Emory University's Dr. Stephen Thomas.

The doctors, social workers and activists sought practical, day- to-day
advice on fighting HIV, the AIDS virus, in communities often racked by
poverty and drugs, where a legacy of racism has left distrust of the medical
system.

How do you get a drug user or a homeless person tested for HIV? How do you
treat the hotel maid who can't afford the time off to go to a clinic only
open weekdays?

"We're talking about reaching people who might not have had a meal since
noon yesterday, and they're still sitting in the clinic" for four hours
because the doctor overbooked, complained Debra Hickman of Baltimore's
Sisters Together and Reaching.

HIV in prisons

Then came the thorny issue of preventing and treating HIV in prisons. "Our
men are in the jails. They do come home to their wives and girlfriends,"
warned a California AIDS worker, describing one reason HIV infection is
growing fast among black women.

Nor do many black doctors specialize in AIDS, complained a Colorado nurse
who described herself as the only black AIDS health worker in her town.
White doctors "do care, but they don't understand when I say, `Patients
don't trust you.' "

President Clinton has declared AIDS among minorities a crisis. The
administration is spending $156 million this year and seeking $171 million
next year to fight back.

Needle exchange funding

But Clinton refused last year to use federal money to buy clean needles for
drug addicts, one way to prevent HIV's spread. Frustrated at the ban,
administration doctors urged local communities Thursday to raise the money
themselves for needle exchanges.

And critics questioned whether the government's work is fair: One new
program calls for 35 percent of AIDS research sites to be in minority
communities, but two-thirds of new infections now occur in those
communities.