H. Alexander Robinson

Why Ending AIDS is the Black Gay Priority

Filed By H. Alexander Robinson | August 04, 2008 6:00 PM | comments

Filed in: Living
Tags: African-American, Barack Obama, black gay men, call to action, CDC, gay men, HIV infection rate, HIV/AIDS, John McCain, National Black Justice Coalition

The wires have been buzzing with the news from the Centers for Disease Control and Prevention (CDC), which recently revealed that over 55,500 new HIV cases occurred each year from 2003-2006, with 56,300 cases in 2006 alone.

The new estimate of all annual new infections replaces CDC's old one of 40,000 that was based on reports of new HIV diagnoses annually. The old estimate was criticized as inaccurate starting three years ago. The CDC conceded that the old method for calculating annual infections resulted in an undercount.

Within the entire 2006 sample, the infection rate among African-Americans was seven times higher than the rate among whites while the rate among Latinos was three times higher than the rate among whites. Fifty-three percent of the new infections were among gay and bisexual men who have sex with men.

Black gay men are in the crossfire of the twin epidemics bombarding the African-American community and the gay community. This trend in the epidemic shows the lack of investment in prevention research and programs for gay men, especially black gay men. The last time I posted a call to action on the Project some took me to task for suggesting that our movement should keep HIV as a top priority. Clearly, this new data suggests that our survival depends on us doing just that.

Our partners with the National Black Gay Men's Advocacy Coalition and others have been calling on the Administration and Congress to adopt a national AIDS strategy. Indeed, in their testimony before the Democratic Party Platform Committee, the Human Rights Campaign prioritized an AIDS response:

"HIV and AIDS remains a critical issue for GLBT people, as the epidemic continues to affect our community disproportionately, particularly young people and gay and bisexual men of color. We ask that the platform continue to call for robust funding of prevention, care and research efforts. Prevention programs must be comprehensive, science-based and focused on the communities they are meant to serve. We ask that the platform include a call for the development and implementation of a comprehensive national strategy on HIV/AIDS."

Noting the lack of evidence-based interventions for gay men demonstrate and the lack of investment to save the lives of Black gay men, NBGMAC, of which the National Black Justice Coalition is a member, has called for the National Institutes of Health and CDC to commit to speeding up the roll-out of new interventions with urgency. States must make responding to the HIV epidemic in gay men a funding and program priority and the public health community must do more in addressing issues of human sexuality, including the sexual health of gay men.

According to a new study from the CDC new HIV infections among gay and bisexual men of all races have been increasing for nearly two decades. Yet a colleague recently wrote:

"I came out as HIV positive in April (as part of national day of silence). I have known for just over a year now. And I am a well known figure in my state and particularly in the capitol. But when I approached the ASO here to start connecting with them to do speaking engagements, they had no funds for prevention to reach into schools -- it had been cut early on in the Bush administration."

Senators Barack Obama and John McCain both responded to this weekend's news with statements vowing to take action against the epidemic. Sen. Obama repeated his pledge to draft and implement America's first national HIV/AIDS strategy, while Sen. McCain did not make any specific commitments or proposals for how he will deal with the epidemic. The Black AIDS Institute summed it up in this way:

"...these statements again make clear that Sen. McCain has a long way to go to earn the votes of those who care about HIV/AIDS in America.

Sadly, this seeming disinterest in the epidemic is not new for Sen. McCain. His record on AIDS vacillates between total disengagement and reactionary can't.

Voters considering supporting Sen. McCain must demand that he take this epidemic more seriously and articulate meaningful proposals and specific commitments for dealing with it."

Infections have, in fact, been rising among men who have sex with men as the data show a steady increase since the early 1990s," Dr. Kevin Fenton, director of CDC's National Center for HIV/AIDS, was quoted as saying on an August 2 conference call with reporters, "These data among men who have sex with men point to an urgent unmet need."

Unmet need, indeed. Three decades into this epidemic and too little has been done to target educational, healthcare and prevention resources to communities suffering under a disproportionate share of the pain - gay men and African Americans. Indeed, the distribution of HIV in communities of color has remained relatively the same, despite the new numbers from the CDC. Nearly half - 45% - of all new HIV cases occur among African Americans. African American women and men who have sex with men of color also are testing positive for HIV in shockingly high numbers.

The resolve to end this epidemic must come from all sectors. As a community and a movement LGBT Americans must look at our own priorities to ensure that we are making the investment in advocacy, innovation and public awareness called for by the data. HIV prevention efforts need to be expanded, re-tooled and re-imagined if we are to reach the many gay men who missed the devastation that was evident during the early days of the epidemic but has now faded. As individuals and communities of men we must take personal responsibility for our own lives and that of our brothers and sisters.

AIDS knows no race, gender or sexual orientation. However, AIDS in America has not affected us all with equal force. Until our advocacy and the resources follow the epidemic, AIDS will continue to be fueled by bigotry, poverty, low literacy, stigma, failed drug policies, unemployment, disproportionate incarceration, and the lack of access to quality health care rooted in anti-gay, racial and ethnic bias.

Black gay men and indeed the entire Black LGBT movement will not be able to move on to new issues until we address HIV and AIDS. We too want full equality and we are working hard to achieve it but the reality is that AIDS remains the number one threat to our survival.

And we cannot do it alone. We need the love and support of our families, the voice of our LGBT brothers and sisters, the innovation of Black institutions and the forces of our government -- until it is over.

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Thank you, Alexander, for posting about this critical matter.

The transgender community, particularly black MTFs, also seems to be hit hard by HIV - at least if a study which was released earlier this year can be trusted.

A meta-analysis of studies of MTF (FTM data was too limited for statistics) transgendered persons showed

[t]he average prevalence was 27.7% (range 16-68%) from the four studies that reported rates of laboratory-confirmed HIV infections among MTFs ( Table 2 ). Further, African American MTFs (weighted mean, 56.3%) had higher rates of HIV infection than white MTFs (weighted mean, 16.7%) or Hispanic MTFs (weighted mean, 16.1%).

It is alarming to note that the overall rate of HIV infection among MTFs in these four studies exceeded the 25% prevalence of HIV infection among MSM in five US cities (Sifakis et al. 2005).

(free registration is required to view the article)

Self-reported positive status (in 18 studies) was markedly lower than laboratory confirmed infections, perhaps because the individuals were unaware of being infected. This would fit with the high number of non-transgender persons who are unaware they are infected.

I couldn't agree more.

The community of black gay men in America sometimes seems on the verge of implosion. Yes, we have tons of issues and pressures of deal with -- but that's no excuse for complacency in the face of this growing crisis. Some of our organizations of late have proven to be lacking in leadership and focus. The matter is complex, but the first step I guess is recognizing the need to wake up.

I think you have your title (and target) set too narrow, Alexander. I'd give your post the title: "Why ending AIDS has to be the gay priority."

It's not just the black community putting its head in the sand, all of America is. Unfortunately, a lot of us are left dying in the streets while others have a new-found and insurance-paid lease on life.

Michael Crawford Michael Crawford | August 6, 2008 5:59 AM


I agree with you that this should be a top priority for the LGBT community and not just for the Black gay community,but I think that the last sentence of your comment can be read as pitting those us fortunate enough to have insurance against those of us without insurance. I know that that is not what you mean.

There are a number of critical issues here including the lack of effective prevention campaigns sponsored by the federal government, the continued hatred of gay men that is expressed in the media and by politicians, the embarrassingly poor for-profit healthcare system that we have in the richest nation on the planet and the anti-gay abstinence until marriage bull that is funded in part by LGBT tax dollars.

Hearing this news again, I am filled with a sense of anger and can't help but wonder is this the best that we have to offer future generations of gay men?