AIDS: A Small World After All

The African HIV crisis--15 million dead, 25 million infected--hits home in Minnesota

Even when African-born clients do seek medical help, providing effective treatment can be tricky. In the past, the vast majority of HIV infections in the United States have been of the class known as subtype B. But there are numerous other subtypes of the HIV virus present throughout the world, each with distinct characteristics. African patients can be infected with any of several subtypes of the disease. This has raised some concerns among doctors that the virus will not respond favorably to medications that have been effective in treating subtype B patients.

Dr. Keith Henry, who has been treating HIV-positive clients in the Twin Cities for two decades, says that so far African patients seem to be reacting positively to existing therapies. But he warns that little research has been done on strains of the virus other than subtype B. "The knowledge base is incredibly minimal," he says.

African immigrant patients can also prove bewilderingly complex to treat for reasons that have nothing to do with medicine. Dr. Henry notes that he recently saw a first-time AIDS patient at HCMC who had just arrived from a central African country. The woman's family had not known of her status prior to her arrival and now wanted to send her back to Africa. Compounding this difficult situation, the woman was deaf, didn't understand English, and was unfamiliar with Western medicine.

"She'd never taken a pill," notes Henry. "We're dealing with almost impossible situations that are popping up all the time. There's no cookbook for this stuff."

Henry eventually persuaded the woman's family members that they weren't at risk of being infected just by having an HIV-positive person living in their house. He's now beginning to treat the woman, starting her off on fairly simple medications such as vitamin pills and antibiotics. "Rome wasn't built in a day," he says. "We have a lot of work to do."

 

On a Saturday afternoon in mid-December, roughly 200 people are gathered in a gymnasium at the Brian Coyle Community Center in the Cedar-Riverside neighborhood of Minneapolis to commemorate African World AIDS Day. The first-time event is intended to highlight the HIV crisis facing Africans around the globe.

An impressive array of politicians and health experts are on hand. U.S. Senator Mark Dayton stops by to address the crowd, as does State Health Commissioner Dianne Mandernach. Congresswoman Betty McCollum receives a standing ovation for an impassioned speech detailing the devastation AIDS has brought to African countries from Senegal to South Africa.

But the most significant speeches of the day are delivered near the end of the event by two people with little political clout. A jovial 48-year-old HIV-infected grandfather originally from Tanzania tells the audience that the disease he initially thought would kill him is now largely under control. "Thanks to the services that are available here in Minnesota, I've been given a new lease on life," he says. "We should not be fighting people with AIDS. We should be fighting the AIDS pandemic."

He's followed at the microphone by Siona Nchotu, a Cameroon native and mother of six. She urges the crowd to get tested for HIV. "I waited until the last moment because I did not know," she says. "We are not back in Africa where we don't have the facilities. We are in America."

Back in 2001, when the scope of the AIDS epidemic among African-born Minnesotans first became evident, such public witnessing about the impact of HIV was unheard of. In fact, a gathering such as the African World AIDS Day event would have been impossible. Nobody would have shown up.

"Two years ago it was hard to speak about HIV/AIDS in public," says Ephraim Olani, of the Sub-Saharan Africa Youth and Family Services, which helped put the conference together. "Even though the stigma is still there, there is a big change."

Over the last three years, prevention and treatment efforts have begun to reach African residents. Large, established AIDS-service organizations, such as the Minnesota AIDS Project, have hired African-born staff members to more effectively reach out to the community. HCMC, in partnership with the African American AIDS Task Force, now has African-born social workers on duty five days a week in order to educate people who have been diagnosed with the disease about the services available to them. And the state health department has dispensed $100,000 over the last two years to 18 nonprofit organizations serving the African community for outreach programs.

The Minnesota African Women's Association, for instance, received $6,000 from the state to work on HIV prevention. The nonprofit organization used the money to conduct a survey of African residents assessing their perceptions of safe sex and HIV transmission. The group then created an educational brochure to distribute to various churches, social service agencies, and businesses that serve the African community. Along with basic information about how HIV is spread, it incorporates various proverbs from different African cultures. "When a lion comes into your village, you must raise the alarm loudly," the front of the pamphlet warns.

According to Nambangi, the group's executive director, some 2,500 copies of the brochure, printed in English, French, and Oromo, have now been distributed. "All the AIDS providers in town have it," she notes. "Some churches requested it, some pharmacies."

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