There are two particular ways in which the racist structure of U.S. society fosters the spread of HIV: The public health system fails to stem the spread of s**ually transmitted diseases (STDs); and the legal system seeks only to punish drug abusers rather than treat them or ameliorate the underlying social and economic causes.
A major risk factor for HIV transmission is untreated STDs. These infections can concentrate HIV-laden blood cells in the genital tract and can also cause genital sores, which are easier points of entry for HlV. 42 Although some STDs can be readily contained by responsible public health programs, rates began to soar for Blacks in the mid-1980s, with, for example, a doubling of the syphilis rate for Blacks from 1985 to 1990. At the same time, the rate remained stable for whites. This grave racial difference probably results from the lack of adequate STD clinics and the failings of public health education, along with the more general breakdown in social cohesion and values that can affect communities under intense stress.
Drugs, along with the violence and police repression that accompany them, constitute a plague in their own right for the ghettos and barrios. However, the public perception that illicit drug use is more prevalent among non-whites is wrong. Household surveys conducted by the National Institute of Drug Abuse show that New Afrikans, 12 percent of the U.S. population, comprise 13 percent of illicit drug users. Where there is a tremendous difference, though, is in incarceration. 74 percent of the people in prison for drug possession are New Afrikans 43
There is also a major disparity in terms of drug-related infection by HIV. Some studies indicate an HIV rate (seroprevalence) among Black IDUs five time higher than among white IDUs. 44 While partially a result of which d** are used and how they are used, there is certainly a big and deadly difference in who has access to new (sterile) needles and syringes through either pharmacies or personal networks. Also, on the street, police are much more likely to stop and search Blacks and Latinos. This practice deters injection drug users of color from carrying personal sets of works (in states where they are illegal) and pushes them instead to share needles at shooting galleries.