Cook County Rep. Constance Howard led the Illinois legislature in drafting the African American HIV/AIDS Response Act.
By Keith Green
Illinois Governor Rod Blagojevich signed on to a first-of-its-kind bill last Friday, August 19th, that launches his state into a massive, government-wide initiative to address the AIDS epidemic among African Americans. AIDS activists say no previous federal or state law has marshaled a similarly wide swath of public resources for work specifically targeting the Black epidemic.
Dubbed the African American HIV/AIDS Response Act, the new law follows a June U.S. Centers for Disease Control and Prevention report that estimated African Americans account for nearly half of all HIV infections in the country. In Illinois, where African Americans make up only about 15 percent of the population, they account for 51 percent of diagnosed AIDS cases.
The new legislation, which takes effect January 1, 2006, calls on the state to establish point people for the initiative in the Governor’s office, the Department of Human Services, the Department of Health and the Department of Corrections. A panel consisting of representatives from each of these agencies and from three HIV/AIDS service organizations, along with two former prisoners, will develop an annual report for Governor Blagojevich on the state of AIDS among Illinois’ African-American residents.
The bill also mandates that “high-traffic” state agencies, such as the Department of Motor Vehicles and the secretary of state’s office, create space for community-based HIV/AIDS organizations to conduct rapid HIV testing.
But the aspects of the bill that have been called both its most ambitious and its most controversial seek to get a handle on the still-shadowy epidemic behind bars.
According to the U.S. Department of Justice, the AIDS case rate in the nation’s jails and prisons is three and half times that of the general population. Illinois’ prison epidemic is more intense than any in the Midwest, with 1.3 percent of inmates known to be positive.
Under order of the new law, the Illinois Department of Corrections and county jails will be required to offer free voluntary testing and counseling to all inmates upon and during incarceration, as well as immediately prior to their release. Case managers will be assigned to help positive inmates transitioning out of incarceration and refer them to support services on the outside.
In addition, researchers at the University of Chicago will conduct a study to examine the correlation between incarceration and HIV infection. Prison health advocates nationally have long complained that correctional facilities rarely allow such research.
Initially, the legislation also authorized condom distribution to inmates. But that provision was later removed due to heavy opposition from the Department of Corrections. Only two state prison systems, Vermont and Mississippi, make condoms available to prisoners, though a handful of city jails do so.
The law was originally developed by Illinois State Representative Constance A. Howard and Lloyd Kelly, who directs Howard’s “Let’s Talk, Let’s Test Foundation,” which helps raise money for Black AIDS groups throughout Chicago. Howard’s bill first called for mandatory testing of inmates, a population that some believe are largely responsible for the growing disparity in HIV infection rates among Black and white women. But many community advocates, including members of the Black Health Alert and the AIDS Foundation of Chicago, strongly opposed forced testing.
“When I first looked at this bill, I encouraged my colleagues to strongly reconsider that piece,” says the Reverend Doris Green of the AIDS Foundation of Chicago. “Who are we to force anybody to do anything?” she continued.
“And, more importantly than that, have we considered the effects of enforcing something of this magnitude on the lives of prisoners? Have we really considered that?” she asked.
After several intense discussions and debates, lawmakers agreed to make testing an option, rather than a requirement.
“The only way that we are going to beat HIV and AIDS is for everybody to know their status,” Kelly says. “I am really excited about this bill, because it increases exposure to HIV testing and expands the potential for us to let African Americans, in particular, know that this disease is a serious issue within our community.”
But given the political landscape for HIV/AIDS funding nationally, some here fear that this will be just another wonderful piece of legislation without the money needed to support it.
Illinois AIDS activists largely credit state government with doing its share to support local AIDS work. But Washington has all but flat-funded its HIV/AIDS-services budget since 2001. And the Bush administration recently proposed a suite of changes to the Ryan White CARE act that would shift resources from urban to rural communities, rather than pumping new money into both.
“Sure, we extend our testing capabilities…that’s great and necessary,” says Montre’ Westbrook of Test Positive Aware Network in Chicago (which publishes a magazine that employs this writer). “But are we prepared to deal with an even greater number of HIV-positive people on an already way overtaxed budget?”
Kelly agreed that supporting this legislation with adequate funding should be a priority. “We have always realized that you can’t eat an elephant at one time,” says Kelly, “you have to do it one bite at a time. So getting this piece of legislation into law is only the first step in our plan of action. Getting money for it is the next.”
Rev. Green stated that the AIDS Foundation of Chicago is also committed to helping secure the funding necessary in order for this act to be completely effective. She warned, however, that bureaucratic hurdles must not slow down implementation. “We already have a lot of the people in place we need to carry out the plan,” she noted. “People who are well qualified to do the work. We don’t need to do a whole lot of hiring, the only thing we really need to do now is just do the work.”