HIV PJA: How do you think the results and conclusions of this study impact HIV prevention efforts in Atlanta?
CS: I think if anything, it should inspire us to take action. And not merely having more testing events, or more social marketing campaigns. We need community development and community restoration, which must be a public health priority for black gay and bisexual men.
I think that we need to do a better job of not merely proliferating interventions, which in my opinion, only address the problem partially, and absolutely committing to the building of community institutions. The investment in interventions leads to this kind of "trickle-down" approach to Public Health, where the large community organization gets funded and creates a program, which is usually under resourced, to serve the population. They will at best hire a community member or volunteer to run the organization, at best, but at the same time erecting a number of institutional obstacles for them to run the program. Or the smaller minority organization is funded, but again, the expectations around infrastructure and administrative burden becomes unmanageable. So my question is, what other models can we imagine to invest in young black gay and bisexual men, and how do we best implement that?
In Atlanta, the "black gay mecca," there should be a black LGBT community center, where young black queer folk can learn about their history and culture. There needs to be an LGBT Center on the campus of one of our many HBCUs in Atlanta. There should also be funds for social entrepreneurship, to adequately grapple with this issue, we want to inspire young black gay and bisexual men to not just strive to be middle or senior managers within already established and in many ways compromised bureaucracies, but leaders, entrepreneurs, and visionaries. Innovation should be the goal, constantly.
Though I recognize the value of strategies like PrEP, we must remember that PrEP is a valuable strategy, clearly, an effective strategy obviously, but not a vision. We need to have a vision for young black gay and bisexual men. We need to also commit to investing in young black gay and bisexual men, not merely "protecting," them from HIV, but seeing them as valuable as we are all valuable, and seeing their humanity. The question shouldn't stop at how do we prevent them from getting HIV? Though yes, that's a question we should ask, but also and I think more fundamentally "what is our vision for young black gay and bisexual men?" A conversation that obviously young black gay and bisexual men should be leaders in.
HIV PJA: What recommendations do you have for public health and policy?
CS: Though I recognize at grappling with HIV from the policy level is important, evident in the calls for advocates to ensure the expansion of Medicaid in states like GA, and greater access to PrEP; we cannot afford to ignore the importance of intervention on the cultural level. We must find within black gay and bi men's culture, the sacred spaces, rituals, narratives that can serve as sources of resilience, inspiration, and provide the blueprints for our collective protection.
We must also better understand what's working, how young black gay men are remaining negative. Especially in these high-risk areas. We should also have discussion circles, across generations to share strategies for remaining negative, among black gay and bi men.
We need to develop learning communities particularly across the south, bringing together researchers, journalists, people from the private sector, community activists, funders, artists, for a robust response.
It's also critical to not only recognize the importance of and commit to investing in better educational outcomes for young black men, but also investing in the health of young black men. I see them as intricately tied. The same structural factors that drive poor health outcomes also drive poor educational outcomes. They reinforce each other. We want to think about all of the vulnerabilities that young black men in this country face, including those that are queer.
HIV PJA: What can we do to effectively address the epidemic among young black gay and bisexual men more effectively and fundamentally?
CS: Our work is to do four things:
- Work on the policy level to ensure access to all of the HIV prevention tools we have in our arsenal. Ensure that there is access.
- Work to build and sustain black gay and bisexual men's institutions, and not just interventions or programs, but actual community institutions. More faith spaces. More cultural spaces. More community meeting spaces. Civic organizations. Think Tanks. Places where culture can thrive, stories can be passed on, intergenerational dialogues can happen, art can be produced.
- Develop a research and policy agenda for young black gay and bisexual men where we understand more fundamentally what's happening with them. There is still so much we don't understand.
- Develop interventions that are centered in pleasure. I think there has been a false perception that gets circulated that young black gay and bisexual men are not sufficiently "afraid," of HIV, and I think that's inherently problematic. What I find is a kind of spectrum of emotion from intense fear to powerlessness to a kind of numbness. Part of the impact on structural violence on our lives is that it inhibits our emotional spectrum. We are often in a state of anxiety or ambivalence.
My generation of black gay men, those of us that were born in the 80's and came into our sexuality in the late 90's and early 2000's, the Post-Protease generation, have been bombarded with these apocalyptic depictions of our desires. We learn shame and fear before we learn pleasure and I think that significantly diminishes our agency. For those coming out now, in this current landscape, it's even more abysmal, since they have fewer examples of thriving black gay men's communities. They are facing a moment where certainly there are more athletes and entertainers that are coming out, but fewer actual places where they can be affirmed.