Exactly who's sleeping in your bed? The answer to that question may present critical consequences because nowadays ignorance of your partner's sexual history can be deadly. For, just when you thought that most sexually transmitted diseases were at least under control, the Centers for Disease Control and Prevention warns that there is a multiple epidemic of sexually transmitted diseases, and it's hitting the Black community like a hurricane.
Fifteen million Americans are newly infected annually with sexually transmitted diseases (STDs) that respect no boundaries and strike across all gender, racial and socioeconomic lines. But during the last decades, sexually transmitted diseases have pounded the Black population at a rate of up to six times the sexually transmitted disease rate of other nationalities.
Case in point: If you're Black, you are 30 times more likely to be infected with gonorrhea than your White counterparts, and 10 times more likely to get the disease than Hispanics.
If that's not enough to make you commit to a life of celibacy, Blacks are leading the pack in herpes infections as well. The CDC reports that of the 1 million new herpes cases each year, Blacks are three times more likely to be infected with the disease than Whites. Since herpes is an incurable disease that may not bear symptoms, most sufferers are unaware of their infection, and the disease has steadily increased among men and women in all racial groups.
So why are Blacks especially at risk of contracting these potentially deadly diseases? The answers may surprise you, for experts say the problem is much more serious than just a lack of practicing safe sex. Some experts say the problem is not enough has been done to educate minorities on the dangers of unprotected sex; others believe the sex disease epidemic boils down to economics, since Blacks traditionally have been poorer and have little or no access to quality health care.
The most startling view of all, however, is that some minorities don't believe there is a problem, mainly because they don't trust the sexually transmitted disease statistics. It has been often said that there are three types of lies -- lies, damned lies, and statistics, and there is a belief among some minorities that the higher incidence of sexually transmitted disease cases among minorities may be related to faulty or slanted statistics. Adding to that belief is the manner in which sexually transmitted diseases are reported. Both public health facilities and private health-care providers are required by law to report sexually transmitted diseases accurately and completely, but private health-care providers are not as likely to do so. Since Blacks are more likely to seek care in public-health facilities, the reasoning is that Black sexually transmitted disease cases are overreported, whereas White cases are underreported.
Dr. Helene Gayle, director of the CDC's National Center for HIV, STD and TB Prevention, says that although there may be some overreporting of sexually transmitted diseases in the Black community, this does not completely explain the higher levels of sexually transmitted disease infections.
"I think there is clearly some degree of greater reporting through public clinics, and yes, there will be some relative degree of sexually transmitted disease overreporting," Dr. Gayle says. "However, we get data from a variety of sources -- laboratories and private doctors included, and these results are not biased. Even if there were some overreporting, in some cases Blacks are 30 times more likely to be infected with a sexually transmitted disease -- the trend remains that sexually transmitted diseases are still affecting African-Americans at a greater rate."
Dr. Gayle also believes that social variables, including the disruption of the family, have ignited the spread of sexually transmitted diseases. "There are a variety of reasons as to why Blacks are more inflicted with sexually transmitted diseases," she states. "We have less access to treatment centers, less information about sexually transmitted diseases, and sometimes we [involve ourselves] with a network of people who may continue to infect one another and not know it. Another social reason is that the disruption of family often leads to multiple sex partners."
Rochelle N. Shain, professor of obstetrics and gynecology at the University of Texas, says the problem is poverty, not race. "It's important for everyone to understand that sexually transmitted disease infection has nothing to do with skin color," she says. "It has to do with poverty. The value system is skewed for poorer people; they are more concerned with where their next meal is coming from and do not put sexual protection high on their list. They do not have access to quality health care and generally don't visit the doctor unless it really hurts, and poor people often share medication. The end result is that disease stays in the community longer."
Sexually transmitted diseases are not contained solely in one sector of the Black population. Middle-aged people are at risk, so are teens and the elderly, who are especially at risk for contracting the AIDS virus. The National Institute of Allergy and Infectious Diseases (an arm of the National Institutes of Health) claims that a sexual revolution of sorts is to blame for the current trends of sexually transmitted diseases nationwide.
According to the CDC, teens are engaging in sexual activity at a much earlier age, and their parents are more likely to divorce. The result is that today people are more likely to have multiple sex partners during their lifetime and are potentially at a greater risk for developing sexually transmitted diseases.
As many daytime television talking heads may tell you, "out-of-control" teens are at an extreme risk of contracting sexually transmitted diseases because hormone changes may lead to a destructive sexual lifestyle. The CDC confirms that teens and young adults are more likely than other age groups to have multiple sex partners, to engage in unprotected sex, and to choose sexual partners older than themselves. One out of every four teenagers becomes infected with a sexually transmitted disease each year, with gonorrhea and chlamydia as the most common sexually transmitted diseases for teens.
According to Planned Parenthood spokesperson Chaunda Roseborough, the forecast in general for teens looks good. "Generally we are seeing teens acting more responsibly when they choose to have sex," she says. "Teens are seeking information and are trying to find ways to protect themselves. We also see a decline in pregnancy rates across all ethnic lines, and a significant number of teens are choosing abstinence."
But there are disturbing trends in some areas. ShaVonda Fields, a Planned Parenthood counselor who services primarily Black clients in Chicago, says that "among Black teens who visit my center, sexually transmitted infections have increased." "There is a self-esteem depression within the community. The lack of jobs, a lack of information, and the drain of resources have caused young people to become more sexually active, and now we have more incidences of sexually transmitted infections. I tell my clients all the time that it's not about birth control, it's about self-control," Fields states.
On the opposite end of the spectrum is the sexual behavior of the elderly population, which has often been stigmatized in the media as an asexual group, although in reality, most enjoy satisfying sex lives.
According to the National Council on the Aging, nearly half of all Americans age 60 or older engage in sexual activity at least once a month; and 4 in 10 say they want sex more frequently. "Our study debunks the prevailing myths about sexuality in older years, for many older Americans, sex remains an important and vital part of their lives," says Dr. James Firman, President and CEO of National Council on the Aging.
Although many people take comfort in the fact that most sexually transmitted diseases can be effectively treated with proper and timely medical attention, the jolting truth is that they greatly increase a person's risk of both acquiring and spreading HIV, the virus that causes AIDS (acquired immune deficiency syndrome).
AIDS was first reported in the U.S. in 1981 and immediately labeled a "White gay man's disease," after the much-publicized death of Hollywood actor Rock Hudson.
Today, the face of AIDS has evolved from White gay men to a "Black thing," and major leaders like Coretta Scott King have launched a National Campaign to warn of the dangers.
AIDS, in fact, is the No. 1 killer of Blacks under age 55, surpassing heart disease, cancer and murder. Black women comprise a whopping 60 percent of all new AIDS cases among females, and AIDS kills twice as many African-American men as homicide.
AIDS has consumed the elderly population as well. Between 1992 and 1994 adults aged 60 and overrepresented the fastest-growing segment for AIDS infection with an astounding 71 percent increase, according to the American Association of Retired Persons (AARP). "The impact of HIV and AIDS on older Americans is dramatic," says C. Anne Harvey, director of AARP's Programs Division. "Clearly there is a critical need for AIDS prevention and health-care information to be targeted to older adults, and health-care providers also must be better educated to discuss the risks of AIDS with older patients, and to identify and counsel those dealing infected with AIDS."
With Viagra, the wonder sex drug, renewing sexual prowess, elderly men are nearly twice as likely to be sexually active than elderly women, which may explain the male/female disparity in the number of elderly AIDS cases. Last year, African-American men aged 60 and over accounted for nearly four times the reported AIDS cases compared to Black women, according to the U.S. Department of Health and Human Services.
One of the main reasons the AIDS epidemic has had such a sharp impact in the elderly population is that older adults are less likely to take precautions, be tested or be properly diagnosed by doctors who often mistake AIDS symptoms for Alzheimer's dementia, the AARP concludes. Today, persons over 50 account for 10 percent of all reported AIDS cases nationally.
As if the present condition of AIDS among Blacks isn't depressing enough, the future for the war against AIDS in the Black community looks bleak as well, according to a report released last year by the Henry J. Kaiser Family Foundation. The foundation predicts that within two years Blacks will make up more than half of all AIDS cases in this nation. "Right now, the number of new reported AIDS cases for African-Americans made up almost half [45 percent] of the total number of AIDS cases, and in a couple of years it is likely that the number will increase," says Jennifer Kates, senior program officer for HIV/AIDS at the Kaiser Family Foundation.
Kates contends that AIDS is ravishing the Black community because Blacks were virtually ignored in the war against AIDS in the very beginning. "Historically, preventive measures weren't focused in the African-American community because AIDS was labeled a White disease, and a lot of communities didn't feel AIDS would affect them," she explains. "But now we realize that even back then Blacks were disproportionately affected with the disease." The CDC reports nearly 100 new cases of AIDS among Blacks every day.
Where you reside may also play a vital role in the spread of sexually transmitted diseases in your community, according to the CDC. For example, although syphilis and gonorrhea rates have reached all-time lows in the United States, residents in 15 major cities are especially at risk of contracting the two sexually transmitted diseases. These cities, listed alphabetically, have been earmarked by the CDC for leading the nation with the highest rates of both gonorrhea and syphilis -- Atlanta, Baltimore, Birmingham, Chicago, Detroit, Memphis, Tenn., Milwaukee, Nashville, Newark, New Orleans, Norfolk, Va., Oklahoma City, Richmond, Va., St. Louis and Washington, D.C.
Additionally, the 10 "hot spots" for chlamydia as listed by the CDC are Arkansas, South Carolina, Mississippi, North Carolina, Alabama, Louisiana, Texas, Georgia, Illinois and Florida. Chlamydia remains the most widespread of all the sexually transmitted diseases and the largest burden of the disease remains in the Southern states. The South also faces the highest rates of both gonorrhea and syphilis, and researchers say, the higher rates may be a result of poverty and the lack of access to quality health care.
Ultimately, no matter your gender, sexual preference or age group, information is vital, and Blacks especially must be armed to the teeth to win the war on these diseases.
"We
need to get information, and we must realize that sexually transmitted
diseases are serious and have lifelong consequences, including death,"
Dr. Gayle explains. "Community leaders need to view sexually transmitted
diseases as an important challenge and a major health threat."