The Secret Epidemic: The Story of AIDS and Black America (review)

In his recent book, The Secret Epidemic: The Story of AIDS and Black America, Jacob Levenson adopts an unusual style (with some debt to new journalism) to explore the history and ethnography of HIV/AIDS in Black America. With a foundation of scholarly research underlying his work (the book includes references), Levenson uses narrative to trace history and explore race relations as they bear on the HIV/AIDS epidemic. The approach ranges from anthropological to journalistic as Levenson uses the stories of everyday people with HIV/AIDS (names changed to protect privacy) and prominent researchers, activists and politicians to recount in a forceful and memorable way how this epidemic has reached such grave proportions, with facts growing grimmer everyday. Beginning with its powerfully oxymoronic title, The Secret Epidemic: The Story of AIDS and Black America is not only useful and meaningful for scholarly individuals, it is a must-read for all, especially those under the misconception that we have tamed the beast of HIV/AIDS in our country.

Spanning six decades, from 1942–2002, Levenson's book tells the story of the evolution of AIDS into an epidemic that is ravaging Black America, both infecting and affecting individuals, families, communities across the country, and, ultimately, the nation as a whole. The third person narrator explores the personal experiences of several real people whose lives have been changed by HIV/AIDS. Through personal histories, it situates individual stories in a rich, if unresolved, exploration of race relations in America.

The book begins in 1996, over ten years after the beginning of the AIDS epidemic, with the initial shock of Sarah Jackson. She's Black, she's sixteen, she's HIV-positive. She is one of many such cases in rural Alabama. She copes with her illness and her shame through denial, withholding her status from her family and mostly everyone else for fear of rejection and ridicule. David, a social worker assigned to blanket the poorest Black rural counties in Alabama, reflects on the hopelessness endemic to poverty, to which his work as one of five caseworkers assigned to over 800 clients is a testament. Recognizing the potential devastation that HIV/AIDS could cause in rural Alabama, with its small towns and stable social networks, David immerses himself in the lives of his clients in an effort to prevent its spread.

These are two of many diverse, fleshed-out portraits that Levenson draws. Counted among them are single Black mothers, researchers, drug users, politicians, and homosexuals, categories that are not always mutually exclusive from selected hotbeds of the Black epidemic (California, New York, and the South). Their experiences provide an intimate illustration of modes of transmission of HIV/AIDS, of the reactions of those affected as well as of the larger society, academia, and the government. The author does a wonderful job of making the people he describes engaging and familiar, interesting the reader in their development and the outcomes of their individual situations. In some cases, the characters eventually experience a revelation of faith, a sense of renewed purpose, or political mobilization. Some individuals try to effect change while others just try to deal with the virus invading their lives.

Various societal factors emerge as themes as the author takes a quasi-anthropological approach to elucidating the underlying causes that allow the spread of HIV/AIDS in the Black community to go largely unnoticed, a veritable elephant in America's living room. By 1995, the epidemiology of HIV/AIDS in America tipped: from that point on, HIV/AIDS has disproportionately affected Black people in America. An epidemic that had long been viewed and treated as limited to gay, White men or injection drug users (IDUs) changed its face and the author describes how the public health community and general public scrambled to adjust. Though prevention efforts (referred to as the neglected arm of public health) among gay, White men and IDUs calling for...