Fighting AIDS in Texas


A version of this story ran in the April 2012 issue.

In 1983, Jamie Schield went on a camping trip with a friend to Great Smoky Mountains National Park. But his friend was out of sorts; he was tired, out of breath and worried about the rash developing on his chest. Later, he told Schield he’d tested positive for HIV. His friend’s diagnosis motivated Schield to volunteer and later work at the Dallas Gay Alliance, now the Resource Center of Dallas. Today he’s co-chair of the state’s HIV-STD Prevention Community Planning Group and planning coordinator for the North Central Texas HIV Planning Council, which assesses the needs of north-central Texans living with the disease.

“In the past, the face of AIDS [in Texas] has been mostly men, mostly gay and mostly white. In the ’90s we saw the first major shift as more women became infected. It’s still heavily majority male—78 percent of the HIV-positive population in Texas are men—we’ve just added more women. The increase in women is significant, but it still makes up less than 25 percent of the total HIV-positive population.

“In Texas, unlike other parts of the country, 85 percent of infections come from sexual contact. And many women are getting the disease from their male partners. We do have to focus on women, but it’s still a male disease.

“In 2000, we saw a swing into communities of color. The African-American infection rate is four times higher than it is for whites. The future [of HIV] is gay men, but it has really changed to gay men of color. That is where the epidemic has been and will be. Seventy-eight percent of the Texans who have the disease are men, and 54 percent of those men are gay.

“Another concern we have is that a large [number] of Hispanics, almost all men, are testing positive. They are testing positive and converting to AIDS within a year, which means these men have had the virus for at least five years. We aren’t seeing this rapid progression to AIDS in other communities. And we don’t know why. Are they contracting it at a greater rate? Or has there already been a high incidence of HIV in that population and it’s only becoming apparent now, when these men fall ill with something, go to the ER, get tested and find out they have HIV?

“As of December 2009, 66,125 Texans were living with HIV. But the CDC [Centers for Disease Control] estimates that another [20,000 people] are living with the disease and don’t know it. That’s a big concern. Who are those people? What do they look like? That’s what the planning group will be focusing on.”