Sonja Mackenzie, Jeff Moore, Debra Allen, Cynthia Gómez 2006 CAPS Conference April 21, 2006 Narratives of HIV origin, historical trauma and political economy among African American men and women in the Bay Area Funded by: University-wide AIDS Research Program Dissertation Award # ; CAPS Innovative Research Program; Predoctoral Training Fellowship, Alcohol Research Group, University of California, Berkeley.

Background Research has found that 15% - 35% of African Americans believe that AIDS is a form of genocide Research has found that 15% - 35% of African Americans believe that AIDS is a form of genocide (Bogart & Bird, 2003; Bogart & Thorburn, 2005; Gamble, 1997; Guinan, 1993; Herek & Capitanio, 1994; (Bogart & Bird, 2003; Bogart & Thorburn, 2005; Gamble, 1997; Guinan, 1993; Herek & Capitanio, 1994; Klonoff & Landrine, 1999; Parsons, Simmons, Shinhoster et al., 1999; Thomas & Quinn, 1993; Waters, 1997) Klonoff & Landrine, 1999; Parsons, Simmons, Shinhoster et al., 1999; Thomas & Quinn, 1993; Waters, 1997) Experiences of racism, having a college education, and male gender associated with stronger conspiracy beliefs Experiences of racism, having a college education, and male gender associated with stronger conspiracy beliefs (Bogart & Thorburn, 2005) Stronger HIV/AIDS conspiracy beliefs associated with more negative attitudes toward condoms and less consistent condom use among men (Bogart & Thorburn, 2005)

The medicines used to treat HIV are saving lives in the Black community, 38%** A lot of information about AIDS is being held back from the public, 59% HIV is a manmade virus, 48% There is a cure for AIDS, but it is being withheld from the poor, 54% The government is telling the truth about AIDS, 37%** The medicine used to treat HIV causes people to get AIDS, 6% HIV was created and spread by the CIA, 12% AIDS is a form of genocide against Blacks, 15% The medicine that doctors prescribe to treat HIV is poison, 7% AIDS was created by the government to control the Black population, 16% Doctors put HIV into condoms, 13% People who take the new medicines for HIV are human guinea pigs for the government, 44% Medical and public health institutions are trying to stop the spread of HIV in Black communities, 76%** AIDS was produced in a government laboratory, 27% * Don’t know/Not sure and refused responses were included in calculations of percent somewhat or strongly agree. **These items were reverse scored prior to inclusion in scale. Agreement with Statements about HIV/AIDS (Bogart and Bird, Relationship of HIV Conspiracy Beliefs to HIV Risk Behaviors and Intentions Among African Americans, Annual Meeting of the American Public Health Association)

Study Goal To elicit through in-depth qualitative interviews understandings of the types, meanings and implications of HIV/AIDS conspiracy beliefs.

Qualitative Study In-depth qualitative interviews, 1-2 hrs: In-depth qualitative interviews, 1-2 hrs: –22 HIV-negative men and women (SF, Oakland) –8 HIV-positive men and women (Oakland) Data collection ongoing: Data collection ongoing: –HIV-positives in SF –HIV prevention providers Street recruitment, venue-based recruitment Street recruitment, venue-based recruitment Theme areas: life context, awareness, knowledge, community, personal risk, beliefs, program development Theme areas: life context, awareness, knowledge, community, personal risk, beliefs, program development Preliminary team analysis and coding with ATLAS.ti Preliminary team analysis and coding with ATLAS.ti

Preliminary findings Theories of HIV origin speak to political economy frameworks for understanding HIV/AIDS inequalities Theories of HIV origin speak to political economy frameworks for understanding HIV/AIDS inequalities Science/government as profit industries Science/government as profit industries Histories of trauma and racism embedded in collective understanding of the epidemic Histories of trauma and racism embedded in collective understanding of the epidemic Conspiracy beliefs and knowledge of transmission co-exist Conspiracy beliefs and knowledge of transmission co-exist The cure exists -- but for the rich The cure exists -- but for the rich

Spectrum of beliefs about HIV origins No government involvement Natural virus evolved over time Government involvement, no target Wouldn’t put it past government Man-made virus; experiment gone wrong Government involvement, with target (specify) U.S. scientists developed to annihilate the poor Global germ warfare to bring U.S. (superpower) and Africa (resources) down Virus from baboon in Africa introduced into African American communities Man-made, dumped into African American communities Crack laid groundwork, then HIV introduced into African American communities

Participants held strong political and economic understandings of HIV’s origins, spread and treatment.

Crack and HIV are both forms of targeted genocide.

The legacy of slavery affects community vulnerability to HIV.

The cure exists, and can be bought by the rich, but it is not in the pharmaceutical industry’s interests to release it.

HIV prevention implications might include low vaccine receptivity.

Beliefs about origins hold implications for HIV testing.

Prevention Implications Acknowledge the importance of beliefs about HIV’s origins to prevention efforts Acknowledge the importance of beliefs about HIV’s origins to prevention efforts Belief and knowledge are separate - importance of open dialogue and education Belief and knowledge are separate - importance of open dialogue and education Political economy analyses of epidemic may be resonant messages for prevention programs Political economy analyses of epidemic may be resonant messages for prevention programs

Contact Information Sonja Mackenzie CAPS, UCSF (415) Addressing Historical Trauma Among African Americans as an HIV Intervention: