One of the Children "nsd0e3704"

8— "This Epidemic Thing": Gay Black Men and AIDS in Harlem

1. See Goldsmith (1989) and S. Altman (1986).

2. See chap. 9 for suggestions for further research.

3. See Coimbra and Torabi (1987), Davies (1986), Martin and Dean (1990), Schreiner (1986), Siegel et al. (1988), and Turner, Miller, and Moses (1989).

4. See Bakeman, Lumb, and Smith (1986), Friedman et al. (1987), Quimby and Friedman (1989), Rogers and Williams (1987), and Sehk, Castro, and Pappaioanou (1988).

5. There is, of course, much literature within anthropology and other disciplines on the social creation of the "other." This construction is especially common when those who are suffering with AIDS are blamed for their own illness. Patron's (1985) groundbreaking work on the sociological impact of AIDS not only explains why we create an "other" category, when threatened but also carefully exposes the social construction of AIDS by the gay community. Gilman (1988) shows how AIDS was constructed by media images as a disease of the ''other." Sontag (1989) applied her model of illness as metaphor to AIDS in much the same manner as she had for cancer in Illness as Metaphor (1979). Clatts, an anthropologist who works with adolescents and AIDS, and Mutchler (1989) unravel nonmedical representations of AIDS. And Murray, a medical sociologist, and Payne, a sociologist who recently died from AIDS, explain how the creation of risk groups helps deflect attention, by blaming the victim as "other," from the inability of science and medicine to cope with AIDS (Murray and Payne 1989).

6. None of my informants had been tested for antibodies to HIV by the conclusion of this study. Since that time (1989), approximately 20 to 30 percent have, but all have tested negative.

7. GRID (gay-related immunodeficiency) is believed by Murray and Payne (1989) to be a 1981 gay press term for the illness. AIDS (Acquired Immune Deficiency Syndrome, the same acronym for Autoimmune Deficiency Syndrome) made its first appearance in print in Science (13 August 1982).

8. That AIDS may have its origins in the African continent was either ignored by my informants or, if acknowledged as a possible theory, always discussed within the context of racism: another attempt by the white power structure to blame blacks for something wrong in society, and to further stigmatize African-Americans (Dalton 1989). For discussion of the theory, of African origins of AIDS, see Barnes (1987), Dickson (1987), Doolittle (1989), Feldman (1986), Greaves (1987), Newmark (1986), Palca (1988), Penny (1988), Piot and Plummer et al. (1988), Sharp (1988), and Schmidt (1984).

9. Compare Rogers and Williams (1987), who state that AIDS is regarded in the "public consciousness" as a disease of white, middle-class, gay men See also Senak (1987). For black perspectives, see Greaves (1987) and Porter (1989).

10. During the course of the fieldwork for the study, five informants continue

passed away: key informant Cletuh died during an epileptic seizure in April 1988; Ralph and Bailey suffered fatal heart attacks in December 1987 and October 1988, respectively; Franklin passed from pneumonia after surgery in April 1989; and Todd, a hustler, died from a brain aneurism in March 1988. After completion of the data collection, Francis, a diabetic and another key informant, passed away after surgery in July 1990. None of these men had been diagnosed with HIV.

11. Centers for Disease Control statistics reported in the gay press ( Outlines, February, 1990, 43; Brinkley [1989]) and elsewhere (Quimby and Friedman 1989:405) show that black gay men comprise 10 percent of the total AIDS diagnoses and 16 percent of the "male gay/bisexual contacts" category. Blacks total 27 percent of reported AIDS cases to date. This percentage is the same as reported a year earlier ( BLK , March 1989, 17). For New York City, the percentages are higher; for example, at least 19 percent of gay diagnoses are black men, and a further 37 percent are men who engage in homosexual practices and use IV drugs (Quimby and Friedman 1989:406).

12. Some of the significant New York City and national press examples are L. Altman (1981, 1986, 1987), Brand (1988), Collins (1985), Johnson (1988), Lambert (1988), Shilts (1988), Stone (1987), and Sullivan (1986).

13. Quimby and Friedman list organizations and individuals in the black community who have assisted in their respective communities' mobilization against AIDS. All of the churches noted are in Brooklyn (Quimby and Friedman 1989:408). Since that time at least three churches in Harlem have offered some type of assistance to people living with AIDS.

14. The availability of drugs and a lack of sex education allow for the transmission of HIV in Harlem. See Friedman et al. (1987), Greaves (1987), and BLK (1990).

15. These reasons for and against condom use compare favorably with the responses of male clients of female street prostitutes in Camden, New Jersey (Leonard 1990), and with the responses of patrons of singles bars in San Francisco (Stall, Huertin-Roberts et al. 1990). See Martin et al. (1989) on changes in sexual behavior.

16. Increased risk-taking associated with drug and alcohol consumption has been the focus of other research (Hasin and Martin 1988). It has been found that sexual risk-taking among drinkers, especially regular bar patrons, gay and non-gay, is substantially enhanced by substance abuse (Stall, Huertin-Roberts et al. 1990).

17. See De Stefano (1990), Hardy (1990), and Au Courant (1990).

18. This is not to denigrate the Minority Task Force on AIDS. It is composed of a group of hardworking gay men (and others) who are devoted to this cause.

19. During 1989, condoms and nonoxynol-9 lubricant were once again made available to whoever wanted them in the bathhouse.

20. See Greer (1986), Voelcker (1990), and Zuckerman (1988).

21. Altogether, the 57 respondents in this study identified 86 different people who had died from AIDS (57 men, 23 women, and 6 children). Of the 57 men who had died, 27 were presumed to be gay, 7 of whom were continue

also reputed to have been IV drug users. Currently, these respondents know a total of 62 different people who are living with AIDS (31 men, 26 women, and 5 children). Of the 31 men with AIDS, at least 20 are believed to be gay. Most of the gay men who died from AIDS passed away early in the epidemic: 1979 to 1984. The 6 who died later were not members of this community.

22. Compare the findings of Singer et al. (1990:81-83), who found the opposite in the "Latino community."

23. This is an example of homophobia. It's happening in Brooklyn, not Harlem, and is being perpetrated by staunch church members.

24. Several reports of funerals have emerged in the gay literature on AIDS. A similar example from Harlem is Harris (1986).

25. As an aside, one of the most startling impressions made on me in Harlem was the ubiquity of the funeral parlors. Every block seemed to have a funeral home tucked away in a basement. On main thoroughfares like Lenox Avenue, some blocks sported two or three. I wondered if the surrounding neighborhoods had the population to support such a need. For reports on morbidity in Harlem, see Kristal (1986) and Terry (1990).

26. The press reports otherwise (Lazare 1990). It is suspected that the trade in (and the addiction to) crack have enhanced a sex-for-crack exchange, which may in fact lead to an increase in the spread of the HIV virus to other addicts and dealers (Des Jarlais et al. 1986, Harold 1990).

27. See D. Altman (1986), Clatts and Mutchler (1989), Fabian (1983), Ingstad (1990), and Sabatier (1988).

28. See Herdt (1988/89) and Schinke, Holden, and Moncher (1989).

29. See Gagnon (1989), Kus (1988), Martin et al. (1989), Sandoval (1977), Zehner and Lewis (1983/84), and Ziebold and Mongeon (1982).

30. Lack of safer sex practices and forays outside of this community will endanger the entire community. Recommendations have been made to outreach workers at the Gay Men's Health Crisis and the Minority Task Force on AIDS to educate these men.