Kellee Terrell: While too many African Americans are disconnected from the health care system, underinsured and uninsured, what little health care we do get seems to be geared toward women, due to this culture that doesn't promote health among men. They seem to have less of a connection to the health care system. Ingrid, in the work you do, do you find this to be true?
Ingrid Floyd: Definitely in family situations, we see that as the case, where black women are more inclined to make sure that the family is taken care of. So, what's the health of my family? What's the health of my children? What's the health of my husband?
What we have seen in some of our HIV testing programs is ironic because the majority of the people that we test are men of color. I think we're getting more awareness out about HIV testing, but Larry brought up a good point, which is that men's health is definitely not a priority across the board when we look at it from a public health perspective and when we look at it just in our communities. Men's health has traditionally not been a priority. Once our young men age out of pediatric care, it's hard for them to get back into care on a consistent basis. So they go without and it's not until something is wrong that they go and seek medical care.
Whereas, for young women, and for women in general, there are preventative services that you go to every year. You go see your OB/GYN. You're probably more inclined to go have a physical. For men that's not the same; they don't have those annual visits that we would want them to have where somebody talks to them about HIV or STDs. So, men's health normally takes a back burner unless there's an issue.
Kellee Terrell: This reminds me of that shocking, and somewhat depressing, report from last year that claimed that black men can live longer behind bars than they can in the general population, because of the health care they receive in prison. In prison, they are getting physicals, HIV testing, you name it.
Now, looking at the connection between HIV and prison, a lot of people believe that straight men go into prison HIV negative and leave HIV positive because they are sleeping with men while locked up. When in fact, there are many straight black men who were HIV positive before entering prison, but because of a lack of access and this belief that HIV is not their issue, the first time they are ever being tested for HIV is when they enter the criminal justice system.
Ingrid Floyd: Right. And to that point: The reason they have better health care in prison is because they are insured in prison. Most black men in our communities who are unemployed are uninsured.
Larry Bryant: And then, the other thing as well, is the lack of focus on sexual health among men. I grew up playing sports and we had these basic, stand-in-line, assembly line kind of physicals that didn't really focus on covering healthy sex, or education. And obviously, there are going to be some legal issues around HIV testing for use in that scenario. But it's an opportunity to at least have the discussion about safe sex on college campuses, where a lot of young men and women are beginning to explore, or are certainly having unprotected sex, and aren't fully educated on or aware of what the risk factors are and how to protect themselves as well as others. I know, having attended a historically black university, Norfolk State, that the old-school mentality of some of the administrators and college leadership really downplays the epidemic as it appears on college campuses today, and doesn't put a whole lot of emphasis on that.
For a young black man in school in that time and exploration age, it's an incredible opportunity to not just educate, but to equip that young man -- and that young woman -- with this kind of knowledge.
Kellee Terrell: We touched on it briefly, but I want to hone in on homophobia, specifically our obsession with the down low. How has it served as a barrier to getting black straight men engaged in this conversation?
Ingrid Floyd: Are there men who sleep with women and men? Yes. Just like there are women who sleep with both men and women. But I was never one who bought into the down low. The problem is that people feel the need to put labels on everything in order to have a way to describe and to categorize people.
Our homophobia and the down low have created another label. And this label creates another barrier to why people won't come in and get tested and why people won't learn more. This label also gives people another reason to say, "It's not me, and hence, I don't need to get tested. I don't need to know my status. Because I'm fine."