Unquestionably, AIDS has hit the black community hard. We are los­ing our sons and daughters at an alarming rate. Twenty-five percent of all persons with AIDS in the United States are African-American.2 Among the newly diagnosed, the figure exceeds 36 percent.3 In many Eastern cities, blacks and Latinos constitute a majority of the AIDS cases.4 In New York City, where AIDS is the number one killer of women between the ages of twenty-five and thirty-four,5 black women, with their Latina sisters, account for 84 percent of the adult female AIDS cases.6 Nine out of ten children with AIDS in New York City are black or Latino.7 In the Bronx one baby in forty-three is born infected.8 Across the board, black people are disproportionately rep­resented. Thus, even among gay and bisexual men and intravenous drug users, blacks are more likely to be infected than are their white counterparts.9 On average, black persons with AIDS (PWAs) are sicker at time of diagnosis than white PWAs and die nearly five times as rapidly.10

Notwithstanding this bleak picture, public health officials and AIDS organizations around the country have been frustrated in their efforts to organize the black community to deal with AIDS.11 While the vast majority of such people and organizations are predominantly white, even black and Latino officials and activists have run into more than their fair share of walls.12 Resistance within the community ranges from the simple refusal to acknowledge that AIDS is a prob­lem for black people (an increasingly difficult position to maintain in the face of the overwhelming numbers) to the rejection of programs designed to stem the transmission of HIV. In between these extremes, our leaders, however defined, seem to run away from the issue of AIDS. They talk about it as little as possible and even more rarely in­volve themselves in efforts to develop constructive solutions.13

Perhaps the most dramatic example of the black community’s re­sistance to AIDS intervention involves New York City’s pilot needle – exchange program. The goal of the program is to test whether addicts will, if given a chance, exchange used needles for clean ones and, if so, whether that step will appreciably lower the incidence of HIV in­fection in the addict population. Originally designed to operate in neighborhoods where drug abuse is prevalent, the program was lo­cated instead, thanks to pressure from black and Latino community leaders, in a downtown government office building, far away (geo­graphically and otherwise) from its target population. This conces­sion of city officials (a move that, in the view of most observers, se­verely compromised the program’s prospects for success) did not, however, dampen community opposition. On the contrary, word of the program’s grand opening "ignited," in the words of one re­porter.14

Typical of the reaction was Harlem city council member Hilton B. Clark, who characterized the program as a "genocidal campaign."15 A key opponent was New York’s police commissioner, Benjamin

Ward, who explained that, as a black person, he had "a particular sensitivity to doctors conducting experiments, and they too fre­quently seem to be conducted against blacks." One month after the needle-exchange program began, the New York Council, led by its black and Hispanic caucus, urged the health commissioner to cancel the program. In commenting on the nonbinding resolution, which passed on a vote of 31-0, caucus chair Enoch Williams explained that "the city is sending the wrong message when it distributes free nee­dles to drug addicts while we are trying to convince our children to say no to drugs."16

City officials were not the only ones to join the chorus. For exam­ple, the Reverend Reginald Williams of the Addicts Rehabilitation Center in East Harlem promised that "there will never be a needle-ex­change program here. I think the communities and neighborhoods would rise up in opposition. They tell me this is what we must try. . . . Why must we again be the guinea pigs in this genocidal mentality?"17 To the surprise of many, the needle-exchange program was even op­posed by the likes of Dr. Beny J. Primm, a highly respected leader in the field of substance abuse and a belated addition to former Presi­dent Reagan’s AIDS Commission. Primm took issue with the claim that the needle-exchange program would lower the incidence of HIV transmission and, as an alternative, pushed for a more traditional sys­tem of assigning addicts to available treatment program openings.18 There were, of course, some blacks and Latinos who lined up in favor of the program, most notably the Brooklyn-based Association for Drug Abuse Prevention and Treatment (ADAPT), led by Yolanda Ser­rano.19 For the most part, however, the community response was ex­ceedingly negative. And this negative response relates to the Black community’s reluctance to "own" the AIDS epidemic.