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As HIV Prevention Money Shrinks, Who Will Save Young Gay Men of Color?

By Mathew Rodriguez

August 15, 2013

From the Margin to the Center

From the Margin to the Center: A Spotlight Series

Table of Contents

Introduction

Save Our Sons

Picture it: a summer night in New York City, still an epicenter of the U.S. HIV epidemic. In the face of the ongoing sequester, and as city HIV prevention funding is being slashed despite rising HIV rates among youth, a group of people gathered at the headquarters of Gay Men's Health Crisis (GMHC) to hear how leaders of some of the city's biggest agencies serving young gay men of color -- GMHC, the Ali Forney Center, the Hetrick-Martin Institute, and more -- plan to do that work with fewer coins in their coffers.

With a new phase of the HIV epidemic on the horizon -- one that, at present rates, will see half of our college-aged gay men positive by age 50 -- the panel was assembled for two reasons: to start some outrage about HIV among youth while also calling for a return to empathy as the basis of care for young gay men of color. In a world where young gay men of color are constantly misrepresented, or worse, ignored, GMHC hoped to give a voice to this population.

After a short opening statement, reproduced here in full, every panelist was given five to 10 minutes to describe what their organizations were doing for this city's most vulnerable sons. A brief excerpt of what each panelist had to say follows their video clip.


Moderator Opening Remarks: Mathew Rodriguez -- Editorial Project Manager, TheBody.com

Inspiring stories of people living with HIV.

If you want to read along, begin watching at 5:32 on the video.

Thank you all for coming here today. I would like to say that we are convened for a happier reason, but there is a stark truth hanging in the air. The reason we are all here is because there is a good chance that I, many people in the room and many people who look like me could become HIV positive. From 2008 to 2010, according to the Centers for Disease Control and Prevention (CDC), new HIV infections remained steady nationally, but rose a whopping 22 percent in young gay men. And, of course, young gay men of color shouldered most of that burden unfairly. At the current rates, more than half of college-aged gay men will become HIV positive by the time they are 50 years old.

These men who are at risk for becoming HIV positive, they are my friends. They are men with whom I am intimate on many levels. They are my intimate friends with whom I share secrets, they are my lovers -- whether potential or former -- and they are people for whom I care deeply. And that is the secret to being in this field. In their essay "The Soul of Our Work," Dr. George Ayala and artist Pato Hebert said that "to do this work well, you really have to love gay men," and if you don't, "could you do this work well?" and they go on to point out that we as queer people "make ourselves through storytelling" and we have to make sure that "storytelling is a top priority." And in that vein, I have a story to tell.

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I don't remember my first HIV test. I remember my second test, which I volunteered for on Nov. 13, 2011, one month to the date after I held my father's hand while he passed away from an opportunistic infection in his liver. The first time I was tested was as a child, because my father was diagnosed with HIV around the time of my birth in April of 1989. When I came out, one of the first things that was given to me -- besides unending support -- was a warning about staying HIV negative. Of course, for my mother, that warning came from a place of understanding of what my path might look like. For me, and for the hundreds of thousands of gay men of color like me, the moments of intimacy that we share with others are tainted. For many of us, sex is only a stone's throw away from death, and we can't think of one without thinking of the other. And this is not any fault of our own. We inherited a crisis that we don't know how to navigate properly. On the flyer for this very event, the image of life-saving devices are imposed onto condoms. But you know what that implies? That we've already gone overboard.

Being a young gay man of color is not an easy task in today's world. Many people think that "coming out" is a happy process that is a process of addition. You learn more about yourself, you accept being gay, and you are welcomed into this community. But that's not the case. Coming out is not a process of addition, it is a process of subtraction, where young gay men of color have to unlearn many of the negative things that we are taught about ourselves every day -- the shame, the stigma, the hate -- and we turn those things into a celebration. We have to find ourselves underneath everything that is piled onto us. I was once taught by an activist that when you see an older gay man -- about 50 or older -- on the street, you always look at him with respect, because that man has survived the plague years, and he has seen the epidemic of the plague face-to-face and I respect each of them everyday. But now, I ask you all in this room and on this panel, to perform a similar exercise. When you meet a young gay man of color, know this: They have fought and are fighting in the trenches of this generation's war on AIDS. We have been kept away from their true selves. We have dealt with institutional racism, sexism, homophobia and sex-negative attitudes since birth. And we need your help to find ourselves. If you don't love young gay men of color, then what are you doing here?

Dr. Perry N. Halkitis -- Director, Center for Health, Identity, Behavior & Prevention Studies, NYU

Inspiring stories of people living with HIV.

If you want to follow along with the text, begin watching the video at 2:01.

In describing a recent study done with 600 young gay men of color who are at least 18 years old, Dr. Halkitis gave some of the data on the seroconversion rates of the participants, 70 percent of which were men of color:

There are some statistics that are particularly troubling to me from this study. In our study so far, all of the men when they started out had to be HIV negative, and we've been following them every six months, we test them every six months, and we assess their behaviors. And what we have found is, over the course of the last four years, that 6.2 percent -- we have a 6.2 percent infection rate. 6.2 percent of the men seroconverted during the course of this study. However, when you look at it broken down by race, the numbers are as follows: mixed race men -- 4.5 percent, Latino men -- 7 percent, white men -- .5 percent, and African American or black men -- 21.3 percent. That is an enormous disparity that tells us something about where this epidemic is lodged and speaks to us that this epidemic is more than just about a biological event.


Dr. Blayne Cutler -- Director, Bureau of HIV/AIDS Prevention, New York City Department of Health and Mental Hygiene

Inspiring stories of people living with HIV.

If you want to follow along with the text, begin watching the video at 8:30.

When describing next steps for the New York City Department of Health, Dr. Cutler said:

We look forward to continuing our partnership with GMHC, even during these very challenging fiscal times, to do what we can with whatever resources we do have. Do I expect that things might get even worse? I have to say that I absolutely do. But that has never stopped us in New York City before, and it's not going to stop us now.


Carl Siciliano -- Executive Director, Ali Forney Center

Inspiring stories of people living with HIV.

If you want to follow along with the text, begin watching the video at 2:16.

On the major failure of U.S. HIV prevention strategies for homeless LGBT youth, Carl Siciliano said:

So, obviously, HIV prevention is failing to work with homeless LGBT youth. So, I think the reason that it is failing to work is painfully obvious. And, it enrages me that the answer hasn't been incorporated into HIV prevention strategies. So, in the United States, last year, the conservative estimate is that 500,000 young people experienced homelessness. 500,000 young people between the ages of 13 and 24 experienced homelessness as unaccompanied minors, meaning they were on their own, they were not with their families. Somewhere between 20 to 40 percent of those are LGBT. So, up to 200,000 homeless LGBT youth in the country. And that's a conservative estimate. In the entire country, all of the homeless youth services only have the capacity to care for, on any level, 50,000 of those young people. So, 1 out of 10 homeless young people is able to be cared for on any level, and far fewer of those young people are able to access shelter.

We see the same thing in New York City. In New York City, the most recent survey done by the New York City Council in 2008 found that there were 3,800 homeless youth and about 1,600 of them were LGBT-identified. New York City provides 250 youth shelter beds. So, again there are more than ten times as many youth who can't access shelter than there are beds. Now, when a young person is homeless and doesn't have anywhere safe to stay -- they're hungry, they're cold, they're destitute -- they do what they have to do to survive. And studies show that youth who do not have shelter within three days, the majority of them will turn to prostitution in order to survive. Ninety percent of the young people in this country, according to a study cited in the New York Times last year, who were engaged in prostitution said that one of the biggest barriers to them getting out of prostitution was that they didn't have a place to stay.

Durell Knights -- Group Facilitator, Many Men, Many Voices, GMHC

Inspiring stories of people living with HIV.

If you want to follow along with the text, begin watching the video at 5:32.

In delivering an urgent call to action for young gay men of color, Durell Knights said:

We have to get out there and make some noise. If we don't take care of ourselves, nobody else is gonna do it for us. You can't stand back and wait for handouts and wait for this one to do this for you and that one to do that for you. We have to get out there just like when it was ACT UP and all those people were doing what they had to do to get the funding that they were getting. We have to do the same thing.


Shariff Gibbons -- Participant, Outstanding Beautiful Brothers, GMHC

Inspiring stories of people living with HIV.

If you want to follow along with the text, begin watching the video at 00:52.

When describing how GMHC's program Outstanding Beautiful Brothers offers a sense of community, Shariff Gibbons said:

The key to having a sense of community for [Outstanding Beautiful Brothers' (OBB)] members, is that it provides a place for support and it lets them know that they are not alone, and that's what's important for gay men of color, because, at least from my experience, if you are a gay man of color, it's like you almost don't exist. Because the terms "gay" and "man of color" aren't two things that are connected. But, here at OBB, it says that you exist and this is your community and this is a place you can go for support. And that's one of the key things that they use as a way of keeping us safe. By letting us know that you have support here, and you're not alone, and if you need it, you have the support of the staff, but it's also important that you have the support of each other.


Dominique Crisden -- Community Health Specialist, Community Health & Research, GMHC

Inspiring stories of people living with HIV.

If you want to follow along with the text, begin watching the video at 2:03.

On discussing the disconnect between prevention materials that only push condoms and the rising rates of HIV among young gay men of color and the slash in funding, Dominique Crisden said:

So, where's the disconnect at? I believe that the disconnect is: young black men don't feel like they matter. So, how do we feel like we matter? It's organizations like GMHC, and Hetrick-Martin, Ali Forney, The Door, the HEAT programs, that shelter these people and they teach these people self-pride. They teach the youth healthy conversations, because if I don't care about myself and I don't matter, why the hell am I going to tell you "I have HIV," or why the hell am I going to use a condom? I don't care about myself, I don't care about you, because the world doesn't care about me, because the world gave up on me. And, with the cutting of all this funding, that's the signal that we're sending out -- that we don't care. And it has to stop. And it has to stop with us. Like Durell said, when I came in here, I looked at the black men and I said, "It's great. I see you guys and I see you guys helping our community, but this is about my community. Where is my community?" This room should've been filled with black men; it should've been filled with black mothers. It should've been filled with black politicians, black religious leaders. Because the community is here, and honestly, it's not going to stop until we as a whole take pride and represent our community.

Thomas Krever -- Executive Director, Hetrick-Martin Institute

Inspiring stories of people living with HIV.

If you want to follow the text, begin watching the video at 00:17.

So, walk with me for a little bit. You ever go to a carnival, maybe Coney Island or wherever, and you see those games, the Whack-a-Mole? You get this big pole and you hit the mole and what happens? Where does the mole go? Right, two feet later, there's a mole. Hit the mole, where does the mole go? It kinda feels like this a little bit, about Whack-a-mole. It feels like an exercise in futility. My staff and I, we talk about the definition of insanity. It feels a little bit like that, like we're going to keep repeating and expecting different results. So, who really are the insane people here? The point is, going beyond the symptom and getting to the root.

Mathew Rodriguez is the editorial project manager for TheBody.com and TheBodyPRO.com.

Follow Mathew on Twitter: @mathewrodriguez.


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