February 19, 2001
Phill Wilson began the panel by paraphrasing a line from Louis Carroll's Alice in Wonderland. In the story, Alice finds herself in a place where, "What is, is not, and what is not, is."
This line, Mr. Wilson explained, is a good analogy for the challenges faced by those attempting to serve black men who have sex with men, be they gay identified or not. He referenced a recent report from the Retroviruses Conference this past January in Chicago, which described the rate of infection among young gay men (23-29 years of age) in several U.S. metropolitan cities. That study, which alarmed most who heard it or read of it, showed that 33% of young gay black men in those cities are HIV positive. He then left a challenge to the panelists: to explain, "How did this happen?"
The first panelist, James King from Ohio, began with the disclaimer that he is not a scientist or doctor. He did not come to the conference with the usual types of degrees and qualifications. He noted that he is neither a sex educator nor a prevention expert. Rather, he is a member of what he called a secret society, a fraternity of men who are "on the DL." DL stands for "down low," implying secrecy and hiding. In the African American community, if you say that a guy is "on the DL," you are implying that he is certainly up to no good, and probably having sex with other men. James took the courageous step of outing himself as a man on the DL. While careful to explain that does not identify him as gay or bisexual, King explained what motivated him to come to the conference and speak out.
He said he is a deacon in his church and a father. About a year ago, the pastor of his church called together a brotherhood retreat to discuss what could be done about the growing number of deaths among the men of his congregation, many from AIDS. King was asked by the pastor to come to this retreat and take a leadership role. He refused. Soon after he found out that his daughter had contracted a sexually transmitted disease, probably from a man on the DL. Frightening as this was, it was still not enough to encourage him to speak out. He explained how much he had to lose: his standing in the church; his family; his friends; and possibly even his job. It was several months later when his best friend, also a man on the DL, told him that he had recently tested HIV positive. His friend, a married man, refused to tell his wife about the diagnosis. His fear? That he would lose the very same things that James feared losing.
This finally inspired James to do something, and he decided to speak out publicly about the issue. He first told his parents and his children, then put the word out among AIDS service providers that he was ready to talk openly with others. Needless to say, although many AIDS educators wanted his message, among men like himself the result was extremely negative. The first time he spoke publicly was in Jacksonville, Mississippi, safely far from his home. There he described his personal experiences, and the reasons why current HIV prevention efforts would never work for men like him. A woman in the Jacksonville audience became so angry that she physically jumped him and had to be pulled off by others in the crowd. It turned out that she had been infected by a man just like James.
James' message is not an encouraging or hopeful one. He claims that efforts to reach men like him will almost invariably fail. He explains it this way: "I don't think of myself as gay. I'm not gay! I don't look gay, and nobody can tell. I don't go to gay clubs and I don't talk to gay people. I go to straight clubs. The pickings are better there."
Upon further questions from the audience, particularly those who asked whether the behavior of men like him could be changed, his response was solid and emphatic. "You can't [change men like me]! The sisters would do better to take care of themselves."
Whether we like his message or not, he's probably right. Even if educators can devise strategies to find men like James, what are the chances that they will listen? James clearly did not believe that much could be done for men like him. Although he did not answer Wilson's question, "What can be done?" he did speak truthfully and he did speak out. Perhaps more disappointing than King's conclusion that nothing much could be done was the fact that it has taken twenty years for someone like him to stand up at a conference like this and tell their story, to "come out."
Maurice Franklin was next on the panel to speak. He is the Director of Capacity Building for the Northeast Region for Gay Men of African Descent (GMAD), a community-based organization in New York City. Franklin began his speech with a question: "Are we better off now, twenty years into the epidemic, than we were in 1981?" His answer was a resounding, "No!" He did, however, have some strategies for what we could do about black men who identify as gay or bisexual.
He quoted statistics showing that although 20% of all people living with AIDS are in New York State -- most of them African American -- there are only three AIDS organizations run by and for African Americans in the state. Out of those three organizations, he claimed that they "have just enough funding to fail." He called for us to advocate for increased funding for organizations like these, funding especially for capacity building* and infrastructure. He called for us all to encourage the government to ensure that when funding is given to any organization, that they be held accountable for reporting their successes and failures. Who had they targeted? Who did they reach? What were the outcomes? Did they accomplish what they set out to do?
He also called for behavioral research on young gay and bi African American men, to better lead our prevention efforts. In addition, he said it is crucial that such men be chosen for planning councils throughout the country. African Americans, he noted, should also begin to lead campaigns against homophobia and stigma.
While I agree with Franklin in principle, I have also found it to be much more difficult to put many of these recommendations into practice. We do need the involvement of young gay/bi black men on planning councils. Unfortunately, these are the very same men who he and other presenters described as being most mistrustful of government and unentitled to healthcare. These very same men are often unable to advocate for themselves in their daily lives. In my experience, it is a lot to ask that these same men now join government sponsored planning bodies to advocate not only for themselves but others. It's not that it doesn't happen. It does, and when it does, it works. Rather, it is so difficult to find and support young men who feel able to do this kind of advocacy. We do need to keep trying, but it is an uphill battle.
Wilson, once again in his role of moderator, then posed another question to the panelists. He mentioned the study which had shown such an alarming prevalence of HIV among young gay men. This same study also reported that although young black men were taking the same or fewer risks than white or Latino gay men, the rate of infection was greater among blacks. He asked the panelists how this could happen.
Franklin wondered if it was the social stigma around sexuality and homosexuality among gay black men. I believe his point was that perhaps they weren't being entirely truthful to the researchers about their actual sex practices. While this may be true, it is also true that the larger the pool of infected people, the easier it is to become infected. When the number of infected individuals is as high as 33%, as it was among African Americans in this study, the risk of becoming infected is astronomically higher than for a group of men whose infection rate is 12%, as in the Caucasian population, or lower. I'm not aware of how much the researchers looked for the frequency with which these men slept with men of another race/ethnicity, but my own experiences in prevention and the research I've seen, indicates that most people sleep predominantly with people of their own race/ethnicity. This would mean that Caucasian men (with a pool of only 12% infection) would have a much lower risk for becoming infected than African American men (with a pool of 33% infection) even if their actual behavior was exactly the same.
When Wilson again turned the question back to "what can be done?" the answers, unfortunately, were essentially the same things we've been hearing for years.
It is not that these strategies are not still critically needed. It is rather that government and private charities have been so slow or stingy with funding to accomplish such things. It is also the molasses like pace of the leadership in the African American community to respond to and acknowledge the problem. As much as we applaud the congressional black caucus' efforts to raise additional funding targeted to African Americans, it is regrettable that it took so long for this to happen. It is even more regrettable that it took such an extraordinary effort by a group of black legislators to force the government to take action on a problem they already knew was way out of control.
* Note: Unlike Infrastructure Development, which refers to issues such as management, accounting, and reporting structures, Capacity Building refers to other issues specific to the successful completion of a given project. Some of these issues can be: Is your organization able to provide services within a location that is accessible to the target populations? Does your organization provide sufficient staff and volunteers to the project, who are comfortable with and knowledgeable of the circumstances and cultures of the target population? Does your organization provide the tools (i.e., computers, phones, resource materials) that will allow your staff to successfully serve your target population?