It seems that there aren't as many differences between the presentation of HIV/AIDS in the US and in Africa as one might have thought.
You just have to know where to look.
Fiddling with a cigarette, Louise, a straight-talking 23-year-old who has been living with H.I.V. for four years, grimaced as she discussed life in the black neighborhood of her small town, a sleepy outpost east of the state capital.
The only jobs, she said, were generally at fast-food places, farms or factories. Entertainment consisted of hanging out on the street corner or at the strip mall. And as for men, she said, with an air of resignation, "They've either been in prison, they're married or they're gay."
It never seemed unusual, said Louise, who asked that her last name be withheld because some people close to her are unaware of her H.I.V. status, that nearly all the men she had been involved with - including the one who passed the virus on to her - had been in prison. "In a grocery store you have a big selection of meat laid out in front of you, and you can chose which grade you want," she said. But in her town, she added, "you don't have that choice. There is no way to really decide the good from the bad. It's all what you decide you can deal with."
As health specialists continue to grapple with global challenges to combating AIDS, Louise, a black woman living in the South, infected through heterosexual sex, represents the continuing struggle with the epidemic in the United States. Her story also illuminates a complex domestic issue: the link between high rates of imprisonment among African-Americans and high rates of H.I.V. and AIDS...
Women in Lesotho Prove Easy Prey for H.I.V. (Lakeland, Polk County, Ledger)
By MICHAEL WINES
New York Times (reprinted)
Published: July 20, 2004
MASERU, Lesotho - Boxes of laundry detergent sometimes adorn apartment windows in Ha Thetsane, a rough-and-tumble neighborhood near this city's booming garment district. It has nothing to do with clean clothes - and everything to do with the AIDS pandemic among young women here.
Ha Thetsane is home to thousands of women who have fled Lesotho's impoverished countryside to seek jobs as garment workers. But the average wage for such jobs, about 70 cents an hour, is seldom enough to both sustain a worker and allow her to send money to the family she left behind.
Thus the detergent boxes in the windows. They signal that the women's husbands or boyfriends are visiting - and that the men who have been supporting them in exchange for sex should lie low.
"One woman will go out with four or five men," said Bolelwa Falten, a 26-year-old former seamstress. "One will help with the rent. One, maybe, will drive a taxi and take her to and from work. One will help with food. One will help her pay her installments."
Experts refer to such desperate arrangements by the dry term "transactional sex." This is one reason, though hardly the only one, that in Lesotho H.I.V. infects one in four men aged 15 to 24 - and one in two women.
The situation in Lesotho (pronounced le-SOO-too), a tiny, mountainous kingdom with the world's fourth highest H.I.V. infection rate, mirrors the catastrophe barreling through sub-Saharan Africa. A confluence of factors - including culture and the destitution that turns sex into currency - has transformed AIDS here from an indiscriminate killer into a plague against women.
At the recent international AIDS conference in Bangkok, United Nations officials said young African women are three times as likely as young men to become infected with H.I.V, the virus that causes AIDS. Worldwide, 48 percent of those with H.I.V. are women, up nearly a third in 20 years. But in sub-Saharan Africa, including Lesotho, women are 57 percent of the infected. [...] In an interview in Bangkok, Stephen Lewis, the United Nations envoy on AIDS in Africa, said he envisioned a southern Africa 20 years from now in which "you are going to sense and see the loss of women."
"There will be portions of Africa," he added, that "will be depopulated of women."
Patients With H.I.V. Seen as Separated by a Racial Divide (New York Times)
By LINDA VILLAROSA
Published: August 7, 2004
Last January in Manhattan, at the memorial service of a colleague who died of an AIDS-related illness, Joseph Bostic lost feeling in his legs and had trouble standing. A friend, Keith Cylar, hailed a cab, crumpled some bills into the driver's palm and sent Mr. Bostic home to Brooklyn. Two months later, Mr. Bostic died of heart and kidney failure related to H.I.V., the virus that causes AIDS. Within three weeks, Mr. Cylar, too, was dead of heart disease related to the virus.
The loss of these two men - both of them AIDS activists who had lived with H.I.V. for years - shocked many who had nearly forgotten the days when attending funerals and memorial services was a constant, unsettling ritual. In the United States, death rates from H.I.V./AIDS have sharply dropped in the past eight years as new medications have made the disease manageable for many patients.
But among African-Americans like Mr. Bostic and Mr. Cylar, AIDS is still a killer.
In 2002, almost twice as many blacks with AIDS died compared with whites, a gap that has been increasing since 1998. Researchers say the reasons include late diagnoses and inferior care, along with complications because blacks are more likely than whites to suffer from other illnesses. As a result, health experts say, many blacks in the United States have far more in common with their counterparts in Africa than they do with white patients....
newsobserver.com | Lifestyles | Down-low buzz may drown message
Public health educators see pitfall in author's exposure of some black men's secret sex lives
By SHEARON ROBERTS, Staff Writer (Raleigh News and Observer)
Published: Aug 11, 2004
Modified: Aug 11, 2004 6:36 AM
Author J.L. King has a mantra: Always practice safer sex. With his book, "On the Down Low, A Journey into the Lives of 'Straight' Black Men Who Sleep With Men," he has given a face to the down low phenomenon.
It's a phenomenon with a lot of buzz. Essence magazine did a two-part series on it. An episode of "Law and Order: SVU" featured the issue and sparked online conversations among heterosexual African-American women, whose ranks make up the fastest-growing new cases of HIV in the country. King's book is a New York Times best seller, landing him a spot on Oprah's couch. But while King has used his fame to talk about safe sex, some local researchers who examine HIV cases among college students say all this focus on the down low -- known as the DL -- actually may be hurting their HIV education efforts.
Typically, men on the down low secretly have sex with men while maintaining relations with women. But they may not define themselves as gay or even bisexual. It's the emphasis on that secret nature that's the problem. "If we develop messages on sexual orientation, rather than prevention, for students who don't want the world to know that they have this proclivity, then we've missed the mark," says Phyllis Gray, the project manager for the HIV/STD prevention and care branch for the North Carolina Division of Public Health....
Durban Journal: South Africa 'Recycles' Graves for AIDS Victims (NY Times, registration required)
By MICHAEL WINES
Published: July 29, 2004
DURBAN, South Africa, July 23 - At S Cemetery in Umlazi Township, Innocent Gasa's handiwork is everywhere: endless mounds of fresh red earth topped with headstones, unpainted wooden crosses, or, for the most miserable, bricks bearing a painted identifying number. Mr. Gasa has dug graves on this lumpy, unkempt, Halloween-spooky hilltop for two years now, five holes a week, 52 weeks a year, well over 500 holes in all.
Which may seem peculiar, seeing as S Cemetery exhausted its last space for new graves five years ago. City records sum up its status succinctly, even dismissively: "Full."
But in Durban, "full'' is a term of art. This city is being battered by an AIDS pandemic so sweeping that people are dying faster than the city can find space to bury them. And so gravediggers like Mr. Gasa are reopening existing graves - the city calls it "recycling'' - and interring fresh bones atop the old ones....