By Chuck Strouse
By Scott Fishman
By Terrence McCoy
By Ryan Yousefi
By Ciara LaVelle, Kat Bein, Carolina Del Busto, and Liz Tracy
By Pepe Billete
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The picture is complicated in racially polarized Miami-Dade, where white Hispanics predominate numerically, politically, and economically. Here an ethnic group that is disadvantaged and often disenfranchised in the rest of the nation is a well-organized ruling elite. As such Hispanics hold a political advantage when it comes to soliciting AIDS funding. For example, according to the 2002 Miami-Dade HIV/AIDS Partnership Needs Assessment by the consulting firm Williams, Stern & Associates, Hispanic clients last year received 37 percent of medical services paid for by a major federal program, Ryan White Title I. The needs assessment noted Hispanics made up 29 percent of the county's reported AIDS cases in 2001. At the same time both black and white nonHispanic AIDS patients received relatively smaller percentages of Ryan White Title I benefits: African Americans and Haitians, 55 percent of 2001 AIDS cases, received 49 percent of the services; whites, 16 percent of cases, got 13 percent of the services.
On the other hand, under a different funding category, Ryan White Title II, black organizations in Miami-Dade received almost twice as much money as white and Hispanic service providers. (Apart from Medicare and Medicaid, which pay for the majority of AIDS treatment and prescription medicines, $6.3 billion annually, the Ryan White CARE Act passed by Congress in 1990 provides the largest portion of public funding -- $1.9 billion -- under four different categories, or titles.)
By all accounts the distribution of AIDS assistance in Miami-Dade is far more equitable than just a few years ago. Changing attitudes and increased publicity highlighting the severity of the epidemic in black communities have improved the lot of black AIDS activists and organizations. Still blacks working for parity in the AIDS arena also have to build what they've historically lacked -- political clout.
"It's always the squeakiest wheel that gets the most grease," points out Philip A. Hilton, a senior vice president at the National Black Leadership Commission on AIDS in New York. "If you have a vocal population that votes cohesively, you have the greatest ability to come together to utilize the political process in a way most advantageous for your community, especially if you have people in positions of power who look like you, who know where the skeletons are buried, who can ask the right questions and get the proper responses [during competition for grants] -- that makes all the difference. Many [black] communities just aren't there yet."
But once they get there, a new difficulty may await -- backlash. Successful black organizations are often seen as threats to white and Hispanic agencies. The increased inflow of resources to the black community, allowing new organizations to start up and older ones to expand, sometimes is made possible by diverting resources from other groups, especially since new AIDS funding is scarce. This past March in Broward County, a rare public disagreement erupted after gay white activists accused African-American and Hispanic interests of unfairly taking money away from successful gay-run programs. Blacks and Hispanics, in turn, complained whites were blocking federal aid money from going where it was most needed. In the end, the money went where the numbers were -- to the minority communities. All the hard work done by gay men in the Eighties now has paid off in lower infection rates, but also in a declining base of support. At least three venerable gay organizations in Miami-Dade have shut their doors during the past five years, victims of the changing times: Body Positive, People With AIDS Coalition, and Health Crisis Network. About a year ago gay activist Luis Penelas, brother of county Mayor Alex Penelas, became executive director of a four-year-old AIDS nonprofit, Union Positiva. Penelas worked long hours securing hundreds of thousands of dollars in grants for new outreach programs into the Hispanic community, which, like the African-American community, struggles with deep cultural and religious stigmas attached to AIDS. Penelas went before the county commission last year to ask for funding for an educational campaign. "My reasoning was for the last three years the black community had been receiving a total of $300,000 to do AIDS prevention, and Hispanics had not received anything," he explains. "The incidence [of AIDS] for Hispanics is still rising. That's how I got a grant for $100,000."
But this year Union Positiva will not get that money, since the commission reduced funding for many newer nonprofits. Penelas says he understands the urgency of the crisis in Miami-Dade's black neighborhoods, but he laments post-9/11 cutbacks that he believes have disproportionately hurt efforts to reach Hispanics with AIDS.
In Miami-Dade, where racial tensions usually stay just barely concealed, there are white and Hispanic AIDS workers who believe growing black clout has helped undermine the older gay groups or won funding at the expense of nonblack organizations. "I've heard the stories," confirms Kevin Garrity, executive director of the South Beach AIDS Project, which serves a mostly white and Hispanic gay clientele. "I know some people feel that way. There's a problem of a feeling of entitlement in most of the AIDS community. But I don't buy it. I feel we're only entitled to what we earn, and if a program is based on sound science and gets results, it will get funded."