September 27, 2011
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.
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.