ENDGAME: AIDS in Black America.

FRONTLINE explores one of the country’s most urgent, preventable health crises — uncovering why HIV is so much worse in black America.

Every 10 minutes, someone in the U.S. contracts HIV; Half are black. Thirty years after the discovery of the AIDS virus among gay white men, nearly half of the 1 million people in the United States infected with HIV are black men, women and children. “If black America was a country unto itself, it would have the 16th worst epidemic in the world,” says Phill Wilson, head of the Black AIDS Institute.

Featured here is Chapter 1 of 9: Silence, “We grow up in families that tell you don’t tell people about your business.” The film is directed, produced and written by Renata Simone, the producer of the 2006 award-winning FRONTLINE series The Age of AIDS.

Watch ENDGAME: AIDS in Black America  in its entirety at PBS.org

A FRONTLINE special presentation, ENDGAME: AIDS in Black America, is a groundbreaking two-hour exploration of one of the country’s most urgent, preventable health crises. The film traces the history of the epidemic through the experiences of extraordinary individuals who tell their stories: people like Nel, a 63-year-old grandmother who married a deacon in her church and later found an HIV diagnosis tucked into his Bible; Tom and Keith, survivors who were children born with the virus in the early 1990s; and Jovanté, a high school football player who didn’t realize what HIV meant until it was too late. From Magic Johnson to civil rights pioneer Julian Bond, from pastors to health workers, people on the front lines tell moving stories of the battle to contain the spread of the virus, and the opportunity to finally turn the tide of the epidemic.

The following are interview highlights of AIDS in Black America: A Public Health Crisis.  Dr. Robert Fullilove EdD, featured program commentator, is a Clinical Professor of Sociomedical Sciences at Columbia University Mailman School of Public Health.

On how AIDS, once called Gay-Related Immune Deficiency (GRID), was presented in the media during the early days of the epidemic

“The name itself gave rise to the notion that this was something that was affecting Americans from a particular community, identified by their sexual preference, separate and apart from folk in black communities like Harlem or Watts were experiencing themselves. The presentation in the press was of a white epidemic.”

On secrets in the African-American community

“We were so much afraid of what it meant to have what was happening in the slave quarters revealed to those who were empowered to direct every aspect of our lives. So we became secretive, because if there was dissension, if there was anger, the last thing you wanted to do was to make it public. To make it public was to be punished. So it created the notion that silence was indeed golden. And to the degree that carried over well after slavery had ended, that did us a fundamental disservice when the epidemic began.”

On the decision to treat drugs and addiction as a criminal justice problem and not as a health problem

“Sharing needles for intravenous drugs was a primary means by which many people became infected. It is especially important, in the African-American community, to understand that in the late ’80s and early ’90s, roughly 40 percent of the cases of AIDS were basically identified among people whose major risk behavior was intravenous drug use. Between 1970 and 2010, we made a practice of making the war on drugs, which meant we were locking up the folks who were at greatest risk for being exposed to this virus.”

On prisons

Recognizing that the problem exists but not making moves to prevent terrible things from happening, like the transmission of HIV, means that more than anything else, we had a situation where prevention could have worked. We didn’t seize the opportunity, and in failing to seize the opportunity, we’re now living with the consequences.

“The simple fact that we’re not taking appropriate public health measures to prevent the transmission of this virus means that in the very beginning of the epidemic, prisons became places where the virus had to have become transmitted freely. The danger, of course, in this kind of discourse is to demonize and stigmatize prisoners. I think it’s probably more important to think about putting the onus for taking public health measures to prevent this kind of tragedy from happening on the folk who are responsible for running the prisons. Recognizing that the problem exists but not making moves to prevent terrible things from happening, like the transmission of HIV, means that more than anything else, we had a situation where prevention could have worked. We didn’t seize the opportunity, and in failing to seize the opportunity, we’re now living with the consequences.”

On the attitude in some black churches

“In 1964, I was part of something called Mississippi Freedom Summer. I was a field secretary for the Student Nonviolent Coordinating Committee. I worked in a number of counties in Northern Mississippi, and really got a sense of the importance of the church and its capacity to galvanize community support around, for example, getting people to register to vote. When I started doing research and community work in HIV in the 1980s, I, like many folk working in the black community, went first to the church and said, ‘Hey, we have another problem that really requires the galvanization of all elements of the community. You’re the only institution left standing that really has the capacity to bring us all together. Let’s get all this work done.’ And what we were met with was an enormous amount of resistance. There were many, many folk who were clear about the importance of what we were doing, but they were in the minority. The vast majority were either unaware or uninterested or worse, were extremely homophobic — saw this as a gay problem that had nothing to do with them and were much more likely to engage in the kind of preaching [that was harmful] than just about anything else.”

On the Affordable Care Act

“It’s thought that maybe 20 percent of all African-Americans who are living with HIV/AIDS don’t know that they’re infected. And they don’t know that they’re infected because they haven’t been tested. If the act is successful in increasing the rate at which people get regular checkups, become aware of their status and enter treatment, then I think we’re going to see an important change in the direction of the epidemic. It’s sad to say that prevention, right now in the U.S., is neatly characterized by the phrase: ‘Treatment is prevention.’ If you’re in treatment and your viral load has been lowered, you’re very unlikely to pass the virus onto someone else. It means we’ve taken a step back — we’ve acknowledged that there are some folk that are already infected, and the best we can do is make sure they don’t infect someone else. That’s a real tragedy compared to where we were in the 1980s, when we thought keeping folk from being infected in the first place was going to be our primary goal and objective.”

SOURCE: PBS.org

Columbia University Mailman School of Public Health  started as the Institute of Public Health in 1922, by the University, with a mandate to study and teach the cause of human disease. In 1945, the Institute became known as Columbia University’s School of Public Health. More recently, the Mailman Foundation made an extraordinary $33 million gift to the School in honor of Joseph L. Mailman, a prominent businessman deeply committed to the welfare of others. Shortly thereafter the School was renamed as the Mailman School of Public Health.

Since its inception, the Mailman School has demonstrated core values that shape the institution. Deep commitments to community engagement, application of research findings to real-world settings, and cutting-edge curricular design have characterized the School’s focus for almost ninety years. It is consistently ranked as one of the top public health research programs in the United States.