Versus the Virus, v2.0, Part 4

As the HIV/AIDS epidemic has shifted from Manhattan to the outer boroughs of New York City, young Black gay men have banded together against a resurgent killer. The third of a four-part series. Part 1 covered the founding of the Sexy With a Goal (SWAG) peer-to-peer forum for young HIV-positive MSM in the city. Part 2 discussed efforts to provide support to young men through discussion groups and outreach geared toward HIV prevention and treatment. Social-messaging efforts in the City were covered in Part 3.

Some young gay men go through the public school system -- or drop out of it -- while living with HIV. Elery George did both, testing positive in 2007 at 19, a year before earning his GED. Soon confronted with homelessness, he lived in the Safe Spaces shelter for young, HIV-positive gay men in Queens for six months. "It was hard. I didn't know anybody. They had their Christmas party on my birthday," said George, who was soon able to leave the shelter for a small apartment in Brooklyn.

Shelters like Safe Spaces are now facing serious obstacles, as lawmakers prepare to cut their funding out of the state budget and charitable donations wane. While New York state has partially funded housing for homeless youth since 1978, the budget for 2011 proposed by Governor Andrew Cuomo would reduce the number of beds for LGBT youth citywide by roughly one third, city officials have said.

Private organizations like Health & Education Alternatives for Teens (HEAT), a Brooklyn-based HIV-prevention organization founded by Jeffrey Birnbaum, M.D., M.P.H., and Center for HIV Educational Studies & Training (CHEST), a research center affiliated with Hunter College that performs behavioral studies to identify epidemiological trends, are facing similar cuts, threatening the scope of their outreach and research programs. Dr. Birnbaum says that his organization would reduce the number of ballroom vogueing events that they sponsor. At CHEST, where research is largely funded by the National Institute of Health, psychologist Jeffrey Parsons, Ph.D, has a new reason for concern. The NIH announced earlier this year that due to a $260 million cut in its own funding, the size of nearly all research grants this year would decrease. "There's certainly a money issue," said Dr. Parsons. "There's a combination of factors: the general economy and the reduced philanthropic giving in general, but then certainly this perception that HIV is not as big of a deal that it used to be."

Anti-retroviral medicine today can keep those living with the virus alive for a normal lifespan, but only if the patients adhere to their regimens. A combination of anti-retroviral pills helps block the destruction the body's immune system, but inflicts a number of grueling side effects. Factors like homelessness and substance abuse make adherence to anti-retroviral schedules that much harder to keep. AIDS-related deaths have fallen consistently since the mid 1990s, but sometime between this year and next, AIDS will kill its 100,000th New York City resident since the Department of Health began keeping records in 1981.

If trends continue, specialists like Dr. Birnbaum and Dr. Parsons will have to treat with fewer resources a growing number of young gay men. "The rates will continue to rise until we develop more programs that are going to particularly resonate with young people, particularly for the young men of color," said Dr. Parsons. The future of youth outreach in Brooklyn is equally tenuous, said Brooklyn AIDS Task Force outreach specialist Tree Alexander. "In the next couple of years, there will be a continuous HIV rise in the MSM community," Alexander said. "In terms of outreach and educating and funding cuts, we're going to continue to have problems."

At Sexy With a Goal (SWAG) and Brooklyn Men's (K)onnect, the line between socializing and learning about HIV has been intentionally dissolved, and the methods are working. For Elery George, the SWAG group has become a second home. His own apartment is bare save for a mattress, a pile of textbooks, and his pocket-sized dog named Amber. "Growing up, I wanted to go to school and I didn't finish. Now I'm able to be a kid," said Elery, thumbing through his African studies notes before an upcoming exam. "With my HIV diagnosis, I took lemons and made lemonade," he said, now teaching others to do the same, very much the adult saving his own generation from itself.

Adrian Fussell is a freelance journalist based in Brooklyn, N.Y., and a graduate of the NYU School of Journalism.