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CHAPTER 4 BLACK MEN DIE A THOUSAND DIFFERENT WAYS AIDS in African American Communities Sometime in the late 1980s, Garry Lipscomb of the Lesbian and Gay Health Project (LGHP) attended a meeting at Mt. Olive Baptist Church in northern Durham County. “They wanted to talk about the AIDS epidemic,” Lipscomb remembered, “and they had people, mostly drug users, who were talking about getting infected and turning around and how this was really a good thing for them that they had gotten this and they were living better lives.” Lipscomb found this emphasis somewhat troubling, particularly in light of the dramatic rise of HIV in black communities. So, when it was his turn to speak, Lipscomb posed a direct challenge to the gathered congregants. “I got up and spoke about needing volunteers to get out there and work with someone who had HIV,” Lipscomb recalled. “They didn’t want to hear that there was a need for them to actually go and work with people that they didn’t know who had AIDS.”1 It was in this context that Lipscomb encountered Howard Fitts. “When he got involved, there were much more middle-class folks who starting seeing that there was a need to do things differently,” Lipscomb noted. “A couple of the churches started doing things. . . . He put respectability on it, it was okay for other people to talk about it.” Unfortunately, Lipscomb pointed out, there were not enough people like Fitts: “It would have made a difference, but there just weren’t.”2 While it was profoundly valuable for black organizations to join the fight against HIV/AIDS, it was not clear how effective these groups were at addressing HIV/AIDS in African American communities. Challenges on several different levels—structural, institutional, cultural, and organizational—all conspired to hamper outreach efforts while contributing to the spread of the virus in vulnerable minority communities. This chapter explores the nature of these challenges and the role they had in the limited effectiveness of AIDS programs among African Americans in North Carolina. AIDS IN AFRICAN AMERICAN COMMUNITIES59 HOWARD FITTS’S AIDS CLEARINGHOUSE symbolized the larger commitment that North Carolina had made to funding AIDS Service Organizations in African American communities. Community-based AIDS organizations had been a passion of David Jolly’s even before he became head of the state’s AIDS program, and soon after Jolly arrived at the state health department, he and Rebecca Meriwether determined to obtain as much money as they could from the Centers for Disease Control and Prevention (CDC) for community groups. “We knew we couldn’t do what needed to be done at the grassroots level from the state,” David Jolly later explained. “So we set up a grant process and funded a lot of projects.”3 Standard programs like the Metrolina AIDS Project (MAP) and the LGHP received funding, but Jolly also worked hard to get support for programs targeting minority communities like Teens Against AIDS (a Raleigh program coordinated by Strengthening the Black Family), Project First Step (a Winston-Salem substance abuse program), and the Minority AIDS Project in Rocky Mount (run by the local Opportunities Industrialization Center). Other programs, like Cumberland County’s Minority AIDS Speakers Bureau (launched in 1991) received state support to bring AIDS awareness to black congregations on their annual “AIDS Sunday.”4 This state support notwithstanding, providing adequate AIDS education for minorities in a multicounty region proved a daunting task for groups like the AIDS Clearinghouse. Few of the county health departments offered AIDS education and prevention programs at all, much less for high-risk minority groups.5 With few black men as health educators and few culturally competent AIDS materials and prevention strategies, Fitts and his team worried that most AIDS warnings held little relevance for black men who had sex with men.6 After about six months, Fitts and his team had made little headway “identify[ing] groups of black homosexual males” with which to partner in their efforts against AIDS.7 Worried that their efforts to reach high-risk individuals would continue to prove ineffective and hoping to maximize their limited resources, Fitts and his team expanded their efforts to black communities by taking their message to black churches, colleges, NAACP chapters , and medical professionals.8 Fitts and his team hoped this scattershot approach would raise general community awareness about AIDS while also taking advantage of “the presence of homosexuals in any groups where presentations [were] being made.”9 They also trusted that black...

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