Obstacles to Reducing AIDS among African Americans

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Abstract
The major obstacles to sustaining mobilization efforts are objective conditions, attitudes toward sexuality, perceptions of substance abuse and HIV/AIDS, and conflicting policy views. Organizational responses to the epidemic occur within circumstances ofperceived oppression, neglect, competing and conflicting agendas, and religious conservatism. Suspicion, often dismissed by public health officials and community-based outreach workers, neutralizes programmatic activities. Popular reactionsfocus on debates about conspiracy theories, fear of racist stigmatization, anda pervasive sense that only marginal groups are affected. Ambivalence hampers prevention and treatment. Public health education is still not sufficiently penetrating African American neighborhoods. Efforts have not been systematic or continous. Many are top-down actions organized by professional elites aimed at their constituencies rather than neighborhoods. Addicts and their sex partners have not been sufficiently empowered or persuaded in large numbers to change their vulnerable actions. Unfortunately the crisis has not waned.