Helene Gayle: Leading the anti-AIDS war

Helene Gayle: Leading the anti-AIDS war
By Dahleen Glanton
Copyright © 2009, Chicago Tribune
November 8, 2009
http://www.chicagotribune.com/news/opinion/chi-perspec1108hivnov08,0,3933535.story


It is not as though Dr. Helene Gayle didn't have enough on her hands fighting poverty across the globe as president and CEO of CARE. But she has never been known to turn down a chance to do battle against HIV/AIDS.

This time the invitation came from President Barack Obama, who recently tapped Gayle -- a more than 20-year veteran of directing HIV/AIDS programs at the U.S. Centers for Disease Control and Prevention and the Bill & Melinda Gates Foundation -- to chair the Presidential Advisory Council on HIV/AIDS.

Gayle will help shape a national HIV/AIDS strategy, which for the first time will provide a blueprint for using resources and developing programs across the country. However, she is quick to point out that that her additional duties will not interfere with her mission at CARE.

She says the two missions are not all that different. In her view, fighting poverty and combating HIV/ AIDS should work hand in hand.

In the three years she has been at CARE, she has set out to merge those two issues, primarily by empowering women to become self-sufficient while taking control of their sexual health.

"Few things demonstrate how interconnected the world is today more than the AIDS epidemic and the U.S. government's response to it," she said.

There are obvious parallels.

Women and girls make up 50 percent of the new HIV infections around the world, and in Africa, women and girls make up 60 percent of new infections, she said.

In the U.S., HIV/AIDS has soared among women of color, particularly African-Americans, who now account for the majority of new HIV/AIDS cases among women and the most women living with the disease.

More than three-fifths of the global HIV infections are in Africa, the worst-affected region of the world, according to the World Health Organization.

In the U.S., African-Americans have surpassed other racial and ethnic groups, charting the most new HIV infections, the most cumulative AIDS cases, the greatest number of people living with HIV and the highest HIV-related deaths, according to the Henry J. Kaiser Family Foundation.

Gayle, who is based in Atlanta, recently was the keynote speaker at the Chicago Council on Global Affairs' Women and Global Development forum. Below are excerpts from an interview with the Tribune.

Q Why are HIV trends in African-American communities increasingly mirroring those in Africa?

A If we look at health in general in this country, we know that communities of color are disproportionately impacted by a whole range of things, whether it's HIV, diabetes, heart disease, drug use or teenage pregnancy. Health disparities, in some ways, bring to light existing social and economic inequities overall. In many ways, diseases are a harbinger of social inequities.

Q How does the economy affect HIV rates?

A It is not the lack of money but the things that go along with poverty that impact HIV rates, such as not having the economic resources necessary to access information, good facilities, testing services, treatment of other sexually transmitted diseases or drug treatment.

Q Why is HIV spreading so quickly among women globally?

A Young women between the ages of 15 and 19 are, in some countries, five times more likely to be infected with HIV than young men in that same age group. That is because older men who are more likely to be infected often have young girls as sexual partners and these young girls are unable to demand that the man use condoms, or are unable to say no to sex, sometimes from teachers or other adult men in their communities.

Q Do you see parallels in the U.S.?

A Oftentimes young girls are in situations where they don't feel that they are in control of their sexuality and they aren't in the position to make sure that if their partner is not faithful to them, that they get their partner to use condoms. We've got to make sure that women and girls have the tools and the ability to keep themselves safe.

Q What changes can be expected under the Obama administration?

A Part of what the administration has made a pledge to do is a national HIV strategy. We've never had a national strategy that looks at the needs in prevention, treatment and in care and services and support.

Q Where should immediate attention be focused?

A The rural South and some urban communities continue to have pockets of very high rates of HIV, increasingly infecting women, but it continues to be a huge problem among young men of color, particularly men who have sex with men.

Q With numbers surging in African-American communities, does federal funding disproportionately target the white gay male population?

A People often say the (white) gay community or the black community, and the reality is they overlap. The group that is most impacted by this epidemic is young men of color who have sex with men and that is where our resources need to go.

Q What funding disparities need to be addressed?

A We have not invested in prevention as much as we probably should. We haven't really put the resources into making sure that people have access to their HIV status. Over half the people who are HIV-infected don't know it and continue to spread the disease.

Q How can you effectively fight HIV in minority communities where even talking about sex is taboo?

A It's figuring out who are the best people to speak to these issues. We find ministers are better at speaking to other ministers and young women are better at talking to young women. Peer-to-peer education is oftentimes much more effective.

Dahleen Glanton is a Tribune reporter. dglanton@tribune.com