AIDS day turns focus to black community - In the epidemic's 25th year, health officials cite a change in demographics of those who are infected

Twenty years ago, the people Greg Haun knew with AIDS were white, gay males. Today, the majority of people he encounters are black heterosexuals.

"The epidemic, as it grows, has changed," said Haun, community liaison for CENTAUR, an AIDS testing and counseling service in Orlando. "Sometimes a community has a hard time accepting that, particularly minority communities."

As World AIDS Day today marks the 25th year of the discovery of the disease, AIDS has evolved from the "gay plague" to the scourge of the black community. A report by the Florida Department of Health released Thursday found that while blacks comprise 14 percent of the state's population, they make up 51 percent of the HIV/AIDS cases.

The AIDS virus is now the leading cause of death for blacks ages 25 to 44.

"African-Americans are disproportionately affected and impacted by HIV/AIDS. And the response has been silence," said Ken Swann, assistant director of the Orange County Health Department.

It is an epidemic fueled by denial within the black community, said Kathy Walker, minority AIDS coordinator with the Health Department.

"The attitude in the African-American community is that HIV is not anything they have to worry about. That belief runs rampant, and so does the epidemic," Walker said.

In Orange County in 2005, one of every 90 black people was infected, compared with one in every 284 whites and one in 237 Hispanics. Blacks with the AIDS virus outnumber whites 2,283 to 1,997.

Health officials cite a number of reasons for the prevalence of AIDS and the silence surrounding its existence in the black community.

One is a culture that for generations refused to discuss the existence of cancer; that taboo has now been transferred to AIDS. There is also the widespread refusal by black men to wear condoms during intercourse. Compounding the problem is a long-standing distrust in government that fuels conspiracy theories of AIDS being introduced into the black community by the federal government.

But the biggest problem is the simple refusal to discuss the disease.

"The bottom line is, we don't talk," said Sean Webb, an urban-health specialist with Orange County. "In the African-American community, a lot of times we are taught that your business is your business - keep it to yourself. That thinking has gone along the lines of HIV also."

Webb spends much of his time in black barbershops, beauty parlors and laundries talking to people about the disease, handing out condoms and urging people to get tested.

An infected person can pass the disease to a dozen other people who can, in turn, unwittingly infect a dozen more, said Bill Toth, an Orange County epidemiologist. That is how a disease as high-profile and long-lasting as AIDS can become an easily ignored epidemic.

"There's the feeling that if I'm healthy, I'm not infected," Toth said.

The answer to the epidemic of disease and silence is making AIDS testing as common for men and women of all races as having cholesterol tested, said Dr. Kevin Sherin, director of the Orange County Health Department.

"We should create a culture of routine testing," Sherin said. "We want it to be a routine part of medical care in this country."