Read any report on HIV in black America, attend any HIV conference or look up at an HIV prevention billboard and it's clear who is most impacted by this epidemic in the U.S.: black men who have sex with men (MSM) and black heterosexual women. Perhaps that heavy focus, along with homophobia in the black community, is what led to the belief in the down-low phenomenon, according to which duplicitous and sinister bisexual men are sleeping with men and also having unprotected sex with women.
Kellee Terrell, News Editor for TheBody.com
And while so many in the African-American community buy into this myth, science demonstrates that that just isn't so. The down low is not fueling the HIV epidemic among black women. So, if it's not about men on the down low and the main source of HIV transmission among black women is heterosexual contact, at what point are we going to address the elephant in the room?
Heterosexual men do have HIV, and they are falling through the cracks.
In order to fully address this epidemic head on, we have to include heterosexual African-American men. But how do we go about doing this given the stigma and homophobia in the black community? What work is being done now that is making an impact among this demographic? And where are the heterosexual men living with HIV who will speak out?
Participating in this discussion on the subject are Ingrid Floyd, the executive director of Iris House in New York City, and Larry Bryant, the national field organizer for Housing Works in Washington, D.C. Bryant has been living with HIV since 1986.
This is part two of the discussion; you can read part one here.
Ingrid Floyd, Executive Director for Iris House
Larry Bryant, National Field Organizer for Housing Works
Kellee Terrell: The more I see how prevention gets framed, the more I see that the bulk of the responsibility for condom use is placed on women. I hear so much of this "Women, save yourselves, love yourselves," and while it's empowering, because we do need to love ourselves, this approach suffers from tunnel vision. Because it's really counterproductive to leave heterosexual men out of these types of conversations, especially given who is really controlling when condoms get used.
Ingrid Floyd: What we've seen in our work with women -- and this is how we've come to start to do programs for heterosexual men -- is that women aren't the ones who make the final decision about whether a condom is going to be worn or not.
Most of our programs focus on: How do we teach women how to negotiate? How do we teach women how to use a condom? And I agree that women need to have these skills and to know what to do in those situations, but in a lot of cases what we find is that at home and in the bedroom, a lot is being led by the male in the relationship. And that's due to the gender norms that we have in our society.
So men have to be as willing to use a condom. Men have to be as willing to know their status, and as willing to seek care and treatment if they know that they're positive. And it can't be the pressure of the woman to make that decision for him.
Larry Bryant: It works both ways, too. There are some women who see the idea of using a condom with their man as a challenge of trust. And there are women who may not be educated on prevention or protection, but for whatever reason believe that condomless sex is what is truly sexual, in the purest sense.
I have received those kinds of pressures from women even among the ones who knew my status from the beginning. So I think that in more "equal" and ideal situations -- definitely not counting in situations that involve sexual violence, rape or control -- we all need to have some accountability.
Ingrid Floyd: Larry brings up a good point. People feel that there's a lack of intimacy when condoms are used. So how do we make sure that, in those cases, people are educated enough to know each other's status? We often tell people that it's great to know your status, but if you don't know your partner's status, and you don't want to use a condom, then it doesn't benefit you. So, in those cases where people feel that condom use prevents intimacy, how do we make sure that both parties are educated and are aware of their status and have shared that information? How do they get to a place where they can at least have that kind of dialogue or communication?