Color Blinded

A federal grant earmarked for "African-Americans" with AIDS has care providers in Broward debating linguistics rather than logistics.

Look it up in the dictionary," sighed the anonymous woman in the back row, her voice flavored with a trace of contempt.

Her timing was perfect. For two tedious, temper-fraying hours last week, the nine-member multicultural committee of the Broward County HIV Health Services Planning Council had been arguing, of all things, the definition of the term "African-American." Now, with a chorus of voices rising once more in frustration, came this formerly silent woman with her commonsense suggestion.

Unfortunately her voice failed to carry over the din, and the argument raged on. Does "African-American" mean black people in general? Americans of African descent? Does it include Haitian-Americans? Blacks of Cuban descent? Other black-skinned Hispanics? What about black immigrants who aren't American citizens?

And so it went, around the table and back again, for two hours, until finally the committee decided, six to two (with one abstention), that African-American means "all people of African descent." Staffers say that definition includes Haitians but not black-skinned Cubans. Go figure.

Judging by postdebate comments, nearly everyone in the room seemed to agree on one thing, at least: The exercise had been an utter waste of time. "We've got to quit talking about who's black, who's green, who's purple and focus on the serious problem we're facing in our community," said Georgia Foster, chair of the planning council, in the one comment of the day that drew wholehearted applause from every corner of the room.

Don't bet on the talk dying down anytime soon, though the problem Foster speaks of is serious: the epidemic of HIV and AIDS sweeping through the poor black communities of Broward County.

Even as overall numbers of new AIDS cases have fallen over the last five years, the disease has been on the rise among poor blacks, both locally and nationally. Of 2042 new Broward County AIDS cases reported to the Centers For Disease Control and Prevention (CDC) in the two years ending March 31, 1998, 53 percent (or 1075) were "black" and 37 percent (759) were "white."

Compare that to the numbers from just half a decade ago. In 1994 the racial breakdown of Broward residents with HIV or AIDS was 55 percent "white" versus 37.9 percent "black," according to the Health Council of South Florida Inc.

Experts say the turnabout in AIDS demographics has less to do with race than with socioeconomic factors. With "safe sex" education permeating society, the most significant risk factors for AIDS are fast becoming substance abuse, poverty, and homelessness. "It's much less a gay disease these days than it is a poor person's disease," says Gary Morey, a planning council member and chair of the South Florida AIDS Network.

Yet as the demographics of the disease have changed, the strategies for its treatment and prevention have lagged, some advocates say, with most of the funding still going to organizations run by -- and for -- gay white men. The federal government has responded by directing more AIDS funds to black communities and requiring bodies such as the Broward HIV planning council to increase diversity.

One result of these changes was last week's heated debate over semantics -- a debate that had its roots in a one-time grant of $118,000 the county is set to receive from the federal Health Resources Service Administration. The grant, sponsored by the Congressional Black Caucus (CBC), came with the stipulation that the money be used in "an effort to improve the quality of care and health outcomes for African-Americans living with HIV/AIDS."

To committee member Francois LeConte, a black man of Haitian descent, nothing in that sentence could be construed as denying funds to Haitian-Americans living with HIV or AIDS. LeConte favors as inclusive a definition of "African-American" as possible.

Fellow committee member Tyrance Kingdom disagreed -- vehemently. Kingdom is executive director of the perhaps ironically named Voice of All People With HIV and AIDS, an agency that focuses on HIV-positive members of the black community. To Kingdom, any attempt to expand the distribution of the CBC funds beyond native black Americans is tantamount to attempted theft.

"What you're seeing here is true greed," he declared, shortly after the committee voted to spend the CBC funds on home visitation and peer counseling programs. "What you're seeing here -- again -- is money being railroaded from the black community."

Kingdom felt the meaning of the provision was clear: The money should go to the African-American community -- a community that does not include Haitians, Cubans, Dominicans, or non-U.S. citizens. "I'm from Mississippi," he said, "and 'African-American' means 'black American.' My argument is not for myself but for all the [people with AIDS] -- the black ones -- who have been overlooked for years. It's a changing face of this disease, and it's a face that they refuse to take a look at."

Could all the squabbling be a sign of things to come? "Oh, yes," says Morey. "I believe this is only the tip of the iceberg. You're going to see more and more and more of this kind of thing."

The reason? Money. Every year the federal government disburses "Ryan White funding" (named for the HIV-positive Indiana teenager who died in 1990 after a nationally publicized fight to attend public school) to local governments across the country for the treatment and prevention of HIV and AIDS. The funding covers a number of programs, called "titles," the largest of which, Title 1, is awarded to local jurisdictions. In 1997 Broward County received $10.1 million in Ryan White Title 1 funding; this year the grant was raised to $10.8 million. In a county where the entire budget for the health department is approximately $36 million, that's quite a check.

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