"I will be heard," shouted the black gay writer and activist Craig Harris at the 1986 American Public Health Association meeting. He was 28, and a few months prior coordinated the first ever National Conference on AIDS in the black community. Attending the American Public Health Association's first ever session on AIDS, and noticing that no one of color was invited to participate, he stormed the stage and took the microphone from Dr. Merv Silverman, then the San Francisco health commissioner. After commanding the attention of the room, he began to explain the challenges of AIDS in communities of color. Though this happened over 25 years ago, young black gay men are still fighting to have their voices heard, as they continue to be the most vulnerable of the vulnerable.
The impact of HIV on black gay men,and young black gay men in particular, is sobering. According to the CDC, in 2010, more new HIV infections occurred among young black gay/MSM than any other age or racial group of MSM. Despite these challenges, there is a way forward. A path is gradually clearing. We now see steps to take that can decrease the number of new infections among young black gay men. Perhaps a decade ago this might have been seen as somewhat utopian, but now it's more in the realm of possibility than ever.
A blueprint has been forth both by scientific leaders, community stakeholders and policy advocates. These are action steps that have proven efficacy and point the way to reducing HIV rates. Strategies include: Ensuring that HIV testing is available and accessible, robust male and female condom distribution, ensuring that HIV positive people are connected to their HIV status and placed on treatment, expanding Medicaid to those who are economically distressed and need access to quality health care, and making PrEP available to HIV negative people who may not be able to or choose not to use condoms regularly. These are critical steps to take and would bring us closer to ending the epidemic. I would also like to offer the following additional strategies we should consider:
It is not enough to target HIV and anti-gay stigma as structural issues alone. We need to hone in and target with absolute precision the specific institutions and organizations that reproduce stigma. Campaigns should be more focused on specific institutions, organizations, and associations, and channel those messages into the culture of those entities. For example, we might target barbershops in a local community to challenge anti-gay stigma, and partner together to create a more affirming experience for black gay men in barbershops.
We also need to better understand from a research perspective, institutions that have shown ability to inspire protective factors in black gay men, and how to replicate, scale, and program those protective factors.
We should find ways to develop campaigns and promotions that encourage young black gay men to offer ideas and innovations. Though it's imperative to continually develop and cultivate black gay men that can enter the HIV/AIDS and healthcare workforce, we should also identify ways to support them in leading them too. Social media has democratized information in a way that makes it possible to more efficiently and cheaply disseminate information, and also provides a vehicle for increasing the culture of social entrepreneurship among black gay men, and expanding the ranks of thought leaders in the field.
We must be deliberate and intentional about training the next generation of senior and executive leaders in HIV/AIDS, and particularly work to ensure continued diversity in HIV/AIDS leadership. Though I recognize that HIV/AIDS leadership might look different in the post-Affordable Care Act reality, we will still need to have leadership in HIV/AIDS and LGBT movements from diverse communities. We should be intentional about mentoring programs, executive training, and coaching to prepare young black gay men to take on some of those roles.
There must be intergenerational dialogues between younger and older black gay men. We must create spaces where stories are shared and wisdom can be passed on. This does not assume that young black gay men are lacking in insight and perspective. But we must pass on the experience of the generation of black gay men that survived the 80s, and their beautiful and heartbreaking stories -- stories of courage and resilience. Those stories of Craig Harris, Reggie Williams, Marlon Riggs, Essex Hemphill, Joseph Beam, Charles Angel, and others. It's not enough to talk about resilience in the present, without looking at the stunning brilliance and strength of those who came before us and that left the blueprint -- our own kind of "profiles in courage for black gay men." There were black gay men, often young black gay men, in the 1980s on the frontlines of HIV activism. We need these stories because a culture is most resilient when it's able to pass it stories down across generations. And though many of the greatest answers in how to grapple with HIV/AIDS will come from Public Health, not all of them will, and thus, we must look to our stories, our cultural traditions, our collective memory, to offer if not the answers, at least the language to begin to pose better questions.
The impact of HIV among young black gay men has caused suffering. Being vulnerable doesn't mean being powerless, and have your choices structured based on your social location does not suggest you have no human agency. As we think about the way forward on National HIV/AIDS Youth Awareness Day it's important to keep importance to imagine the challenge from as many angles as possible. It's also important to continue to dare to be as innovative as possible and to remember, that we are most resilient through the preservation of our culture.
Charles Stephens is the Southern Regional Organizer for AIDS United.