By Rod McCullom Special to the NNPA from the Black AIDS Institute
Originally posted 9/22/2011
Part 1
The first of a two-part series examining what can be done to reverse
the high rates of new HIV infection among Black gay and bisexual men.
The number of new HIV cases in the United States has remained fairly
stable at about 50,000 per year between 2006 and 2009, according to
data from the Centers for Disease Control and Prevention (CDC) that
was published in early Au-gust in the online scientific journal PLoS
ONE.
Predictably, the epidemic continues to affect Black America
disproportionately: Forty-four percent of all new infections occurred
among African Americans, who make up only about 13 percent of the
population. And gay and bisexual men, who make up only an estimated
two percent of the population, accounted for 61 percent of all new HIV
infections in 2009. Young Black gay and bi men—"men who have sex with
men" (MSM), in public health jargon—ages 13 to 29 experienced the
greatest increases, with infection rates sky-rocketing by more than 48
percent.
But government researchers described the soaring serocon-versions
among young Black MSM as "alarming." "The data is not surprising
because we've been talking about young Black gay and bisexual men for
some time," says A. Cornelius Baker, a member of the Presidential
Advisory Council HIV/AIDS (PACHA), the senior communications
consultant at AED Center on AIDS & Community Health and board chair of
the Black AIDS Institute. "Now we have an opportunity to make some
progress with bold and comprehensive strategies." Viral Loads "Off the
Chart"? It's unclear why serocon-versions are increasing.
"It's not just individual risk behavior. It's probably behavior plus
late testing practices," says David J. Male-branche, M.D., M.P.H.,
assistant professor of medicine at Emory University in Atlanta and an
expert on qualitative HIV behavioral prevention. "We see late testing
across the Black community, such as in cancer, diabetes, high blood
pressure. Plus, the heightened stigma of HIV certainly delays
testing."
Experts estimate that African Americans make up 56 percent of all
"late testers"—people who learn of their positive HIV serostatus so
far along in their illness that the disease progresses to AIDS within
one year of diagnosis. "That means their viral loads are off the
charts," Dr. Malebranche adds. The presence of high amounts of HIV in
the body makes a person significantly more infectious.
Once people become aware of their HIV-positive status, not only are
they more likely to take steps such as using condoms to avoid
infecting their sexual partners, but research now shows that beginning
treatment soon after diagnosis makes people with HIV/AIDS
significantly less infectious.
But Black HIV-positive gay and bi men are least likely of all MSM to
be aware of their serostatus. Among HIV-positive Black MSM under age
30, 71 percent were previously unaware of their infection. So not only
does their own disease progress unimpeded, but they may unknowingly
pass HIV to others. "We also have higher rates of STDs that can lead
to higher risk for HIV," says Dr. Malebranche.
"We have to look at sexual networks among Black gay men, especially in
Black gay enclaves in large urban centers and rural areas. We tend to
sexually partner with each other more so than other races." A
significant body of research has shown that sexual networks can play a
critical role in facilitating the spread of STDs, including HIV. The
apparent rise in new HIV infections could also reflect the success of
recent efforts to aggressively test Black gay men, rather than an
increase in new infections themselves, Dr. Malebranche adds. New CDC-
Sponsored Social-Marketing Campaign Targets Black MSM
For years HIV/AIDS activists have criticized the CDC for responding
inadequately to persistently high increases in new infections among
Black MSM. Today, however, the CDC is receiving high marks for a new
social-marketing and public-awareness campaign to encourage HIV
testing among Black MSM. The campaign, titled Testing Makes Us
Stronger, debuted in August at the 2011 National HIV Prevention
Conference in Atlanta and will officially launch on Sept. 27 in
Atlanta, Houston, New York, Baltimore and Oakland, Calif. The new data
"underscores the urgency of reaching young Black men who have sex with
men," Kevin Fenton, M.D., Ph.D., director of the CDC's National Center
for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, told reporters
during a telebriefing. "We cannot allow the health of a new generation
of young Black gay and bisexual men to be lost to essentially
preventable diseases."
The testing message is a critical component of the new campaign.
"Knowing one's status is important in order to get medical care and
treatment for their infection," says Richard Wolitski, a deputy
director in the CDC's HIV/AIDS Prevention Division. "The CDC has shown
that people who know their status engage in behaviors that
significantly reduce risk for others of contracting HIV." "Testing
Makes Us Stronger builds on the strengths of young Black gay and
bisexual men," adds Wolitski. "We wanted to show Black gay couples who
are loving and supportive and, at the same time, document a diverse
range of strong men in [the] community."
The program will include transit, magazine and online advertising—and
outreach across Facebook, Twitter, blogs and "hookup" websites popular
with Black MSM.
"The young men we are targeting are on these sites," says Daniel
Driffin, a 25-year-old prevention specialist at the Atlanta-based
National AIDS & Education Services for Minorities. "It makes perfect
sense for [the] CDC to be there—especially because the first place
many men [my age] get information is [the] Internet."
Kali Lindsey, the 30-year-old senior director of federal policy at
Harlem United, was part of a CDC advisory group on the messaging. "The
process was refreshing. They brought in about 19 or 20 of us who had
expertise in delivering messages to Black gay men," he says. Venton
Jones, senior program associate for communications at the National
Black Gay Men's Advocacy Coalition, also participated in the work
group. "It's great that [the] CDC took our responses and made sure
that the campaign portrayed the diversity of images of Black gay men,"
says the 27-year-old about the photography of the critically acclaimed
Duane Cramer, a San Francisco-based Black gay photographer who snapped
a variety of Black men for the campaign. "One or two images cannot
fully represent who we are," Jones adds. "The campaign is a step in
the right direction to raise awareness in the community," says Harlem
United's Lindsey, and "to encourage dialogue to where people are
regularly engaging in conversations about HIV."
____
Reversing the Alarming HIV Increase Among Black Gay Men, Part 2
Monday, 26 September 2011 06:45
By Rod McCullom, Special to the NNPA from the Black AIDS Institute –
The second of a two-part series examining the high rates of new HIV
infection among Black gay and bisexual men. Part 1 described the new
data detailing the dramatic increases in new infections, examined some
of the reasons driving the numbers and described the CDC's new social-
marketing initiative, designed to encourage testing among Black MSM.
In light of the persistent increase in new infections among MSM (men
who have sex with men)--and despite the Centers for Disease Control
and Prevention's new testing initiative--a consensus has emerged among
prominent Black gay men who have leadership positions in HIV/AIDS
policy, prevention and public health: A larger investment is needed
from public and private sources, as well as a more "holistic" approach
to Black gay men's sexual health.
"It's a question of dollars," says A. Cornelius Baker, senior policy
adviser of the Washington, D.C.-based National Black Gay Men's
Advocacy Coalition (NBGMAC), which delivered a forceful set of
recommendations in response to the CDC's incidence report. Across the
federal bureaucracy, "there is not a sufficient investment in line
with the scope of the epidemic in Black and Latino gay populations,"
he says.
"The CDC must increase funding to organizations providing services to
young MSM and transgender [people] of color from $9 million to $14
million," says Baker, who is also board chair of the Black AIDS
Institute. "Five years after its initial commitment, the numbers are
worse, and their investment remains at $9 million. That makes no
sense."
Among NBGMAC's additional recommendations: increased funding, capacity
building in Black gay organizations, continuing HIV education for
medical professionals, high-level consultations with Black gay men and
research on how to lower the viral load in MSM communities of color.
Extending Advantages, Reducing Stigma
Other prominent MSM agree with NBGMAC's call for a more comprehensive
approach to the multiple health, economic and social disparities that
Black MSM experience, particularly those in the under-30 demographic,
which is experiencing the greatest increase in new infections.
"I'm 25 years old and part of that 13-to-29 demographic, but many of
my contemporaries [do not] have some of my advantages," says Daniel
Driffin, a prevention specialist at the Atlanta-based National AIDS &
Education Services for Minorities. "I have full-time employment, a
college degree and health insurance. Many younger brothas are jobless,
homeless, uninsured or have low literacy rates. Some of them [engage
in] 'survival sex' to provide for some basic needs. If we begin to
tackle those issues, we can influence health-disparity rates."
Kali Lindsey, senior director of federal policy at Harlem United,
believes that the outreach to Black MSM should address "not only
sexual health but physical and emotional decisions as well that drive
our sexual behavior."
He continues: "We also have to stop letting our community off the
hook. More than half of our gay men do not disclose same-sex behavior
to their primary care physicians. That means that we are missing many
opportunities to have key conversations about sexual health. We can't
accept that anymore."
"We have to get comfortable discussing sexuality," says Venton Jones,
senior program associate for communications for NBGMAC, "in our
Facebook discussions, faith settings, with medical providers and in
our communities. That is critical for the Black community."
NBGMAC's statement of recommendations also called attention to a study
by the National Medical Association that found many of its members--
almost exclusively Black doctors--were "not willing to recommend HIV
testing because of social stigmas."
"That's shameful," says Baker. "Whatever the discomfort some Black
doctors may have in talking about sex, they have to get over it. Our
people have been through a helluva lot, from slavery to segregation.
And they're uncomfortable talking about sex?"
Baker offers an anecdote from his experience with a pediatrician when
he was a teenager. "He said, 'I get the sense that you might like
boys; is that okay for me to say?' Then we had a conversation, and he
took care of my sexual health. The conversation was loving and
respectful. He took his responsibility as an adult and a caretaker
[seriously], and guided me on a path to being 50 years old and still
alive. Our institutions have to do the same thing. We haven't shown
youth that there's a better way to live."
Rod McCullom has written and produced for ABC News and NBC, and his
reporting and analysis have appeared in Ebony, The Advocate,
ColorLines and other media. Rod blogs on politics, pop culture and
Black gay news at rod20.com.
--
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