A fourth impediment to our efforts to grapple with AIDS is the association of the disease with drug abuse. We as a community have a complex relationship with illicit drugs, a relationship that often paralyzes us. On the one hand, blacks are scared to even admit the dimensions of the problem for fear that we will all be treated as junkies and our culture viewed as pathological. On the other, we desperately want to find solutions. For us, drug abuse is a curse far worse than you can imagine. Addicts prey on our neighborhoods, sell drugs to our children, steal our possessions, and rob us of hope. We despise them. We despise them because they hurt us and because they are us. They are a constant reminder of how close we all are to the edge. And "they" are "us" literally as well as figuratively; they are our sons and daughters, our sisters and brothers. Can we possibly cast out the demons without casting out our own kin?
And so we find ourselves paralyzed, caught up in our own conflicting emotions—guilt, anger, shame, horror, fear, sympathy, aversion, affinity. We know that to deal with AIDS we must deal with drugs. If only we knew how.
My overriding goal in writing this essay has been to spur conversation about how a country as racially polarized as ours can hope to deal with a virulent disease that, as fate would have it, manifests itself differentially. We must recognize that the face of AIDS is rapidly changing, from mostly white to predominantly black and brown.
The implications of this shift for public health policy and practice are profound; we have just begun to explore them. But this much is clear already. As the drama unfolds, we cannot simply ask white actors to put on blackface and favor us with their best rendition of "life in de ghetto." We must increasingly turn to black actors, and to black directors and producers as well, if we are to truly capture the social meaning of the darkening epidemic. Nor can we treat as bothersome background noise black America’s complex attitudes toward white America, and vice versa. Only by acknowledging such disconcerting realities do we have a prayer of a chance of escaping their constraining