By JERMECIA EDWARDS
As HIV rates in a number of New York City neighborhoods continue to be as high as those in some developing countries, studies and advocacy organizations say there is an urgent need to prioritize HIV prevention efforts in disadvantaged communities.
Advocates for AIDS services in Brooklyn and the Bronx say the city has cut its spending while shifting money to Manhattan organizations and away from groups based in the boroughs where the problem is worst.
AIDS deaths in Manhattan continue to decline at twice the rate of deaths in Brooklyn and the Bronx. The Bronx has the highest HIV rate of any county in the U.S., 2 percent of the adult population. When more than 1 percent of an overall population is infected, roshe run the United Nations defines it as a generalized epidemic, which is found in hard-hit nations like South Africa.
“There is a link not only between poverty, but poverty of certain kinds of resources,” said Chris Norwood, founder and executive director of Health People, a community health organization based in the South Bronx.
Limited access to health care and high substance abuse rates are common factors associated with poverty in New York City neighborhoods and developing countries.
A U.S Centers for Disease Control and Prevention analysis released in 2010 indicates that poverty is the most important demographic factor linked with HIV infections among inner-city heterosexuals. The study found HIV prevalence in high-poverty neighborhoods to be more than double that of the nation overall.
Norwood said that according to her 2010 study, “Follow the Money: AIDS Funding and AIDS Deaths in the Bloomberg Years,” the Bloomberg administration removed federal funding from Brooklyn and the Bronx and gave it to Manhattan-based agencies.
“We not only lost staff but volunteers. They took it out of the two poorest boroughs with the highest HIV rates and collapsed the center where there was a cohesive sense that we that we were fighting AIDS together in a community,” said Norwood. She says that as a result, thousands of AIDS clients were left without services as de-funded programs closed before new ones were in place.
Gerald Oppenheimer, distinguished professor at Brooklyn College and a health policy analyst, said poverty is a central issue to confront in the effort to prevent AIDS. “But it has many facets and determinants, including exploitation, corruption, and depredation by interests within a country and other nations outside,” he said.
The pattern seen in New York City has similarities to the epidemic among injection-drug users and gay men in Europe and Latin America. In New York City, black gay men are currently the highest risk group and there is an even higher level of injected drug-use.
The federal government in the first years of the Obama administration got Congress to end a ban on federal funding for needle exchange programs, but ultimately it was reinstated.
“You can directly blame the United States’ extremely high HIV rate on Congress for refusing to let any federal money be used for needle exchange,” said Norwood. “See it’s not a poverty thing, it’s a political thing.”
In addition, Norwood said, the city Health Department had stopped funding community-based AIDS prevention. “Last month, it ended all community-based contracts dependent on city money and will use allocations from the CDC,” Norwood said. “… I find it very annoying, the way this is spoken about. Yes, poverty and HIV go together, but it’s made to sound inevitable, when clearly there are other factors.”
When asked about the funding cuts, city Health Department spokeswoman Veronica Lewin declined to comment.
Paul Lopatto, supervising analyst for social and community services in the city’s Independent Budget Office, said city funds for AIDS services were projected to decrease from $3.3 million to $2.1 million. roshe run femmes Lopatto said this is a result of reductions the mayor proposed in November.
Organizations like Health People say that in order to prevent an epidemic like this from becoming worse, the work has to be community-based. This includes funding, social support and medical services that are well distributed.
“Almost all diseases, endemic and epidemic, reflect the community and the society in which they occur. However this requires not just medical or public health considerations, but also political, cultural and economic considerations,” said Oppenheimer.