Last month, a new study conducted by the Kaiser Permanente Medical Center in San Francisco found that 100% of study participants taking the HIV prevention pill Truvada as a pre-exposure prohylaxis (PrEP) remained infection-free when engaging in sex with high-risk partners.
While the new study is a tremendous step in the right direction in the fight against HIV and AIDS, Black men who have sex with men (MSM) are still significantly over represented in new HIV infections. According to the Centers for Disease Control (CDC), African Americans are the group that's most affected by HIV, and the rate of new HIV infection is eight times higher for African Americans than Whites.
Advocate, an LGBT media outlet, reports that although gay men are 40 times more likely to contract HIV than the general population, that number launches to a whooping 72 times more likely among Black, gay men. If not treated properly, HIV can lead to AIDS. In 2013, of the estimated 14,611 gay and bisexual men diagnosed with AIDS, 40% were Blacks/African Americans; 32% were Whites, and 23% were Hispanic/Latinos according to the CDC.
Simply put, long-term PrEP needs to reach the community’s most at-risk people. Howard Brown Health Center in Chicago, one of the nation's largest LGBTQ health services organizations, recognizes the gap for Black MSM.
“Howard Brown Health Center (HBHC) is committed to providing PrEP access, navigation and counseling services to help HIV negative people stay negative," said Kristin Keglovitz, Howard Brown’s Chief Operations Officer. "This is particularly true for Black men who have sex with men, a population that experiences disproportionate rates of HIV infection and barriers to access quality healthcare services."
There’s no ONE reason why cases of HIV infection are skyrocketing among Black men who sleep with men. It’s a holistic mix of stigma, access, and lack of awareness that form the perfect storm.
Stigma doesn’t always have to be attributed to family and friends. Healthcare-related stigmas often lead to mistrust and medical visit gaps. The American Journal of Public Health published an article in its February 2015 issue titled: "The role of stigma and medical mistrust in the routine healthcare engagement of Black men who have sex with men." The piece focused on a study that sampled 544 Black MSM attending a community event. Of the 544 participants, 29% reported experiencing racial or sexual orientation discrimination from their healthcare providers, and 48% reported an overall mistrust of medical establishments.
Because of this mistrust, the study found that HIV-negative Black MSM had longer gaps in the time since their last medical exam. The results of medical-related stigmas doesn’t operate in a vacuum. It has a domino effect for Black MSM.
Gaps in medical exams and HIV screenings often lead to Black MSM not knowing their status. The CDC’s 2013 HIV Surveillance Supplemental Report revealed that overall, 1 in 6 Blacks or (17%) living with HIV do not know they’re infected. There’s a much greater chance of passing HIV to a sexual partner if one simply doesn’t’ know their status. Also, Black MSM is a small social network, making it an ideal incubator for HIV.
New HIV infections are like a bull in a boutique china shop when it comes to Black MSM. The CDC found that among Black MSM, 45% of sexual encounters were with other Black men, while Latino MSM had their largest percentage of sexual encounters with White men. Researchers aren’t able to scientifically narrow down the reasons why a great percentage of Black men engage in sexual encounters exclusively with other Black men, but it’s possibly because Black MSM have built and share a sense of community with one another, which is no surprise when you take into account racism within the LGBT community.
A staggering 80% of Black, gay men have reported experiencing racism in the gay community, according to GMFA, a London-based gay men’s health charity. Racism is what drives Black MSM to create their own communities of safe spaces with one another, even if these same safe spaces are costing them their physical health. But safe spaces can still function as a way to protect and uplift Black MSM.
Jamie Frazier, head of The Lighthouse Church of Chicago in Uptown of Chicago, describes Lighthouse as a “multi-ethnic and LGBT-inclusive church that focuses both on religious and social justice topics and issues."
Frazier believes that one of the reasons why HIV disproportionately affects Black MSM goes back to their sense of self worth.
“We have to raise self-worth and self-value. We have a community (Black MSM) that deal with spiritual terrorism because certain churches have told them Sunday after Sunday they’re going to hell," said Frazier. "When people know that they are worthy, that they are loved by God, that they’re not a mistake, that they are not an accident, they will make healthy choices regarding the expression of their sexual desires. Direct services have to be provided."
Black MSM often is a gray area for HIV programs and services, which presents another dilemma.
In a recent review, the Obama administration found that DHHS-run HIV prevention programs geared towards Black populations focused on heterosexuals who only had an HIV rate of 2%. The initiatives failed to target Black, gay men where one in three are HIV-positive. Overall, the audit revealed that HIV funding and research isn't geared towards educating and helping Black, gay men or gay men in general.
To address this finding, the CDC has awarded $55 million to 34 community-based organizations with deep connections to Black MSM. The funding will provide HIV testing to more than 90,000 young, gay, bisexual, and transgender youth of color, and link HIV-positive people with proper healthcare.
In order to put an end to this epidemic, community-based and government organizations will need to execute multifaceted HIV prevention and healthcare tactics that directly target Black MSM. The problem is more complex than offering a bowl of condoms and a bottle of PReP. In fact, according to the Black AIDS Institute, Black MSM are less likely to engage in high-risk sex, use drugs while having sex, and overall have fewer sexual partners than White MSM. The epidemic is layered in discrimination, stigma, lack of access and resources that can all lead to an HIV-positive status or worse, full-blown AIDS.
If nothing changes, studies, organizations, and publications all predict that 6 out of 10 Black MSM will be HIV-positive by their 40th birthday.
That’s 60% of our fathers, of our brothers of our boyfriends, and of our friends living with HIV, something that’s preventable. Above all, there’s the human element as well. Every single STAT represents a person. And what happens in that person’s life has a ripple effect across other people’s lives. This isn’t a black issue. This is a human issue.
Terrence Chappell surfaced on Chicago's media scene as "UR Chicago Magazine Online's" fashion editor. Since then, he has worked and contributed to various media outlets such as "Michigan Ave. Magazine," "CS Magazine," and "The Men's Book." Currently, Terrence serves as editor-at-large for ChicagoPride.com, the city's largest LGBT entertainment and news website where he writes "Chappell Confidential," a nightlife and society column. Terrence also heads "Chappell on Community," the site's newest editorial monthly series that profiles the LGBT community's most innovative leaders.