I met this sister on the bus a few years ago. I was headed home from 125th Street, so it was a relatively short ride. I don't know how we started talking. Maybe it was something that I was reading, something we both saw and laughed at. I don't know. What I remember is her telling me that it had been 11 years since she'd been to a gynocologist or a doctor of any kind -- and at this point, she was sort of afraid that something was probably wrong with her and there was nothing that she could do about it. The look on my face compelled her to explain, with a wave of her hand, that she didn't have money to see a doctor, she barely had money to pay her rent and keep her lights on, that sure, she wanted insurance but she couldn't afford it unless she gave up buying groceries and she couldn't do that because she had kids and kids need stuff every five minutes. And on and on she went.
I have been going to see a doctor at least every 6 months ever since I left my parents' jurisdiction. As a college student at UT (Austin), there was the clinic on campus that served 60,000 students more or less. When I decided that I didn't like them anymore, there was another one off campus, a community center that was run by what seemed to be educated, well-intentioned, bilingual hippies. I remember in particular that they nailed a bin to their door and stuffed with condoms, free of charge. They would sit and talk to me -- as opposed to the campus doctors who treated me like I was on a conveyor belt. I was so sad to see that, upon my most recent visit to The Nation's Capital, they were gone. But I digress.
When I moved to New York City and whined to my daddy that I didn't have health insurance because I didn't have a corporate job and I couldn't afford to purchase it a la carte, he told me that in this town -- to sort of quote the Stones, man -- I couldn't always get what I wanted but if I tried hard enough, I would get exactly what I needed. And you know what? He was absolutely 100 percent correct. He would know. He came to this town during the Great Migration North just as the Depression hit the nation, and he left during the Great Migration South, when African-Americans began going home in droves.
When I decided to finish my BA at The New School and they decided I needed a booster shot that I was missing from my childhood records, I opened the Yellow Pages and found a clinic somewhere in Chelsea that gave me that shot for free. You should have seen me, standing in a long, seemingly endless line with all those other black 9 year olds. You should have seen the doctor's face, when I came in without a little kid in tow and turned around and hiked up my dress and put my panties down. You should have seen the nurses' face when I insisted that she give me a lollipop, too. You should have seen the way the parents looked at me as I left.
I told my black sister on the bus that there was a clinic in the Adam Clayton Powell building that's run by a huge conglomerate of a hospital on the upper east side, specializing in mammograms -- but you can see a gynocologist and get a pap smear and anything else you can think of, if you want. And it's completely and utterly free.
She looked at me like I just threw up in her lap.
Look. There are a lot of variables floating around out there that can tell you why African Americans are infected with HIV/AIDS at such a high rate. Ignorance. The stigma of homosexuality and bisexuality in the black community. Lack of healthcare. Poverty. Incarceration rates. Higher prevalence of sexually transmitted diseases. Ghetto miasma. But the bottom line, really, is that this is a lifestyle disease. What that means is, if you live a certain way -- that is, having unprotected risky sex with multiple partners -- you are more likely to get this disease than if you don't.
We have to educate ourselves, we have to protect ourselves and we have to stop lying to ourselves. Don't stay in the dark about AIDS because you're delusional enough to think it's a gay white man's disease -- because the stats say that at this point, it's definitely an African American disease, and it's getting worse. Figure out what it is and get tested -- for everything and anything, actually -- so you'll know if/how it affects you. Don't have unprotected/unsafe sex with anyone -- ever, ever, ever. But instead of pointing at black people and asking, why can't they get it together, there's something we should all realize.
Lifestyle diseases are a phenomena of this modern industrial age. Think about it. With cars and subways and such, we stopped the all-day physical labor that comes with working on farms for example, or having to ride a bike or walk everywhere. We started eating way more dairy and meat and stuff like margarine and way less fresh vegetables and fruit. And surprise! We got fat. And then fast food happened, and we got really fat. And then junk food came along, and we collectively hit the couch as a nation, and we've been getting progressively fatter ever since. Throw in smoking tobacco, recreational drugs and unprotected sex and you get a real picture that shows most Americans what they look like. And apparently, thanks to fast food franchises all over the Western world, Europeans aren't too far behind. My point is this: all of it is within the individual's control.
It's not complicated. Stop eating garbage. Lay off the pork. Quit smoking (crack). Excercise. Use a good astringent to clease your skin, and then moisturize. (Yes, that's right! Acne is a lifestyle disease!)
But then again, it is complicated.
I think about that sister on the bus, how hard she works. I think about how difficult it is to find fresh fruit and vegetables in the ghetto -- and when you do, how expensive they can be. I think about how there are not one but three 24 hour McDonald's restaurants within a 10 block radius of my apartment -- all of them doing a brisk business with that ominous glowingly friendly dollar menu. Before Fairway came to my neck of the woods, I had to go all the way behind God's back to get the food I needed. And then I had to drag it all the way back home. And I did it, week after week. But it would have been so much easier to just throw up my hands and get a double cheeseburger for a buck.
It's like my trainer at my gym says about weight loss: You have to want it. But really -- don't you have to know what it is before you can really want it in the first place? I've worked in enough kitchens to know how to steam and saute vegetables until they're piping hot and brightly colored and crunchy. When I go down south and cook that way for my friends and a lot of my family members, they swear that none of it is ready to eat.
I've had the same gynocologist since I did my first national tour and went legit but I still go to that free clinic for mammograms. I hope sister woman took my advice and went there. Maybe I'll see her in the lobby one day, and we'll find something else to laugh about.
Here's that list. Enjoy.
- According to the 2000 census, African Americans are 13% of the population (40.3 million, more or less) -- but as of 2006, we're 49% of all HIV/AIDS cases.
- Over 200,000 African Americans have died of AIDS, over half a million are living with HIV and African Americans are 10 times more likely than whites to have AIDS.
- Over half (52%) of African Americans living with AIDS and 58% of newly diagnosed cases amongst us are -- where? -- in the South. And we are only 19% of the population there.
- ...then again -- in DC, more than 80% of all HIV cases are amongst black folk. That's 1 in 20 people.
- Of all the black men living with HIV/AIDS, the primary transmission category was sexual contact with other men.
- In 2006, Black gay and bisexual men between the ages of 13 and 29 accounted for more new HIV infections among gay and bisexual men than any other race or age group. And more than half, or 52 percent, of all Black gay and bi men infected that year were under 30 years old.
- Of all the black women living with HIV/AIDS, the primary transmission category was high-risk (unprotected) heterosexual contact.
- HIV/AIDS is the number one cause of death amongst African American women aged 25 to 34.
- The HIV Cost and Services Utilization Study (HCSUS) -- the only nationally representative study of people with HIV/AIDS receiving regular or ongoing care for HIV infection -- found that Blacks fared more poorly on several important measures of access and quality than whites; these differences diminished over time but were not completely eliminated. Blacks were more likely to report postponing medical care because of a lack of transportation, were too sick to go to the doctor, or had other compelling reasons.
- If we were our own country, we would rank above Ethiopia (420,000 to 1,500,000) and below the Ivory Coast (750,00) in HIV population.