``Each one told me, 'Whatever you do, don't tell my pastor,''' Scott recalled. ``I said, 'Something is wrong. Do I have to be both doctor and minister too?'''
So Scott rounded up their pastors, who ministered at some of the East Bay's largest black Baptist churches. ``What have you said or not said that makes people fearful of talking to you?'' he asked them.
It's a question being asked more and more at black churches, as the latest statistics show blacks are not benefiting as much as other groups from a slowing of the AIDS death rate.
Thanks to new drug treatments, AIDS deaths nationwide dropped 65 percent between 1995 and 1998, but only 55 percent for blacks. While blacks represent just 13 percent of the U.S. population, they comprise 49 percent of AIDS deaths; 8,316 people last year, according to the Centers for Disease Control and Prevention.
Since most African Americans have at least some cultural connection to a church, it's vital that black churches take an active role in HIV prevention, said Pernessa Seele, founder of The Balm in Gilead, a New York nonprofit that teaches ministers how to do AIDS education.
``In our community, the church, the pulpit, is the loudest voice that we have,'' Seele said. ``Historically, if you want to organize around anything, you go to the church. With AIDS devastating our community we must use that vehicle which we know.''
It wasn't always this way. Homosexuality, sex outside of marriage and intravenous drug use are sins churchgoers learn to hate. In many cases, they learned to hate the sinners as well.
``It was always reinforced that being gay was a bad thing, it was a sin. If it was talked about, it was in a negative sense,'' said Derek Lassiter, 34, a gay black man who is HIV-positive.
He has been welcomed at Glide Memorial Methodist Church in San Francisco, where gays, drug abusers and the homeless are equally embraced, and where advocates hand out condoms and HIV testing is available. But he says this is an anomaly.
``In the black community, everyone has had a church experience; it never leaves you,'' he said. ``But then you start remembering how you were not accepted.''
``As a Christian physician it was clear to me...the church is a diverse reflection of our whole society,'' said Scott, who heads the AIDS ministry at Allen Temple and has 400 HIV-positive patients among his 2,000 clients in Oakland.
``Some people who got this disease are drug users. Some were prostitutes. Some got it because they are gay,'' he said. ``As a church we're having to confront a whole population of people who are marginalized. We certainly don't want to push aside and marginalize people of our own race.''
Money is starting to embrace the community, too.
Since the Congressional Black Caucus successfully lobbied President Clinton to authorize $156 million to fight AIDS among blacks and Hispanics in 1998, the AIDS National Interfaith Network, a clearinghouse for religious organizations conducting HIV education and support, has seen many more inquiries from church leaders.
The funds allowed the CDC to expand its church-based initiative, inflating an annual budget of $100,000 to $2 million. In October, the CDC also allotted $39 million to prevent AIDS in minority communities--up 50 percent over last year.
``Clearly as the epidemic continues to spread--and particularly in communities of color--I think religious leaders in faith communities realize the role they can play and they want to play that role increasingly,'' said Dr. Helene Gayle, who directs the CDC's center for prevention of HIV, sexually transmitted diseases and tuberculosis.
That would help clients of AIDS case manager Kenneth Hall, who set up the outreach group Ark of Refuge at Allen Temple four years ago. ``Seventy-five percent are real leery about committing themselves spiritually anywhere if they haven't outed themselves to the pastor or the congregation about their diagnosis,'' Hall said.
Support for AIDS programs is evolving.
``The church was part of the problem because no one was saying anything and it was moving through the church,'' said the Rev. Theo Frazier of Church of the Pentecost in San Francisco, who emphasizes abstinence when he discusses AIDS with congregants. But as people got sick and began dying, he said, ``we had to talk about it.''
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