"Thank you for your donation," the letter said, "But we are unable to use your blood because it is contaminated with HIV."
In 1996, a 16-year-old learns that her life has changed forever in a letter from the health department. There was no counseling, no discussion with parents and no offer of support. Just words on a page read by a black teen-ager after a day at school.
This indifferent treatment of an 11th-grader goes to the heart of the tragedy explored in The Secret Epidemic by Jacob Levenson. Medical experts rarely acknowledge that AIDS in America disproportionately affects African-Americans. Levenson wrote this book to correct this oversight.
He tells the story through the lives of some of the people at its center. Sara and Rebecca are sisters who live in poverty and are HIV positive. David deShazo, their social worker, spends his days fighting for medical care to keep his dying clients alive in rural Alabama. Mindy and Bob Fullilove are black researchers who work in inner cities and try to unravel the complex social factors that led to the disintegration of black communities. Laura Hall, a middle-class mother, has to come to terms with the shame of her son's infection. Desi Rushing, addicted to crack and HIV positive, finds solace in her belief in God.
Avoiding simplistic, reductionist theories, Levenson explores the epidemic through the interweaving of personal stories and historical facts. In a recent radio interview, he commented that the AIDS epidemic "crystallized the stories of crack cocaine, public housing, heroin, the decline of inner-city America, the rural South and race." The different stories he presents help us appreciate these complexities.
Levenson approaches the topic from a seemingly distant position: He is white, lives in New York and holds a master's degree in journalism from Columbia University. He wrote The Secret Epidemic, his first book, to dispel the common assumptions surrounding AIDS and to emphasize that in the United States it is now one of the top three causes of death in black men and women. The facts he quotes are staggering: Fifty percent of new HIV cases and 42 percent of AIDS sufferers are black. In 2001, the AIDS rate among blacks was 10 times the rate reported in whites.
Surprisingly, AIDS was always a disproportionately black disease. The doctors who first saw AIDS cases in the 1980s did not emphasize the racial characteristics of the victims. In 1983, although African-Americans made up 12 percent of the total population, 23 percent of Americans infected with HIV were black.
One of the biggest challenges Levenson faced as a nonfiction author was to draw the readers in and keep them interested. He achieves this with ease. His narrative is fresh and alive, and the book reads like a novel. We desperately want to know what happens to Sara and Rebecca. Tears well up as tragedy befalls Laura's son. We relish the few glimpses of hope, but our anger boils over as Mindy battles ignorance, indifference and bigotry.
Levenson forces us to face our own indifference to suffering. He explores the roots of that indifference and reminds us that ignoring distasteful facts merely exacerbates the consequences.
Toward the end of the book, Desi Rushing rebukes the preacher after her sister's funeral for failing to mention that AIDS killed her. She quotes Hosea 4:6: "My people are destroyed because thou hath rejected knowledge." Levenson's book is an attempt to recover some of that lost knowledge. It is well written, easy to read and, tragic as it is, a fascinating story from which we have much to learn.
-- Wayne Young
The Secret Epidemic: The Story of AIDS and Black America
By Jacob Levenson
(Pantheon Books: New York) $25/hardcover