What do you think is the most critical issue facing the African-American community?
It depends on what part of the community we're talking about. Whatever we think about the studies themselves, every study of HIV amongst black gay men shows shocking numbers. That is a segment of the black community that is at the most risk, and that we have done the least to respond to.
How would you best address AIDS in the black gay community?
When I talk to people who are dealing with the epidemic in the South, which is uniquely black and largely heterosexual, the overwhelming feeling is that stigma is still the main problem. I think that may be true amongst black gay men as well. We're still at a stage in the black community where the most important thing remains fear and stigma surrounding not the disease itself, but the things that are associated with the disease.
I'd have a Nobel Prize if I could answer how to end that stigma. There are sort of two routes. One is wide scale, just pushing the conversation upon and within the community, which we have seen a lot more of in recent years. Things like Kaiser and Viacom's "Know HIV/AIDS" campaign. They placed ads on popular black shows and in the subway. They had Common and Alicia Keys and people like that pushing the awareness end of it. But sometimes I think that for every billboard looked at by 20 million people, I would trade one substantive conversation between 20 people about decisions we make and don't make in our sexual and romantic lives.
A lot of HIV prevention talks at people -- and the more at-risk the group is, the more talking at gets done. We need to be coming up with ways to spur dialogue instead.
Where is the most progress being made in combating the epidemic in the African-American community? Where is the least progress being made?
I think the least progress is being made in keeping people healthy and alive. African Americans are much more likely to die of AIDS once they get HIV. And we are far more reliant on public care systems that are either collapsed or collapsing. Yes, everybody's doing better than they were in 1995 -- but blacks are doing far less well than everybody else. The gap is persistent, and that, I think, is shameful.
But where we are making progress is slowing the pace of new infections. It's slow, but in 2004 the CDC [U.S. Centers for Disease Control and Prevention] was reporting a 6 percent drop in new infections, or something like that. And then last World AIDS Day, there was a 5 percent drop among African Americans overall -- largely driven, I think, by New York's success among injection drug users. We see success where we've made actual commitments in prevention, like needle exchange programs. I think the place where we've had the most substantive dialogue in the black community is amongst black women. We've had a lot of energy around that in recent years.
Has progress been made in the black church or is that the weakest link?
I'm always careful when I talk about the church, because I'm not an active participant, and I think a lot of stones get thrown at the black church by people who aren't involved. If you look at Balm in Gilead's work, I think it's true that there are far more black congregations engaged now than in the past.
The black church is no more awful than other churches as a whole. Institutional religion as a whole has not been good on this issue. The Catholic Church is probably far worse in terms of its global impact on slowing down progress.
I do think, however, that the black church is uniquely important in the black community, particularly in the South, so that's why it's fair to talk about it. I think that everybody I talk to who does know the black church says we're making progress. But there's plenty left to do.
As a journalist writing about AIDS, what are the biggest obstacles you encounter?
I have noticed that the more directly I want to talk about sex, the more difficult it is. And it's across the board -- black publications, lefty publications. I had a piece that was essentially arguing that we censor the conversation about sex too much in HIV prevention, and the piece itself ended up getting kind of censored. I regularly encounter difficulty in getting honest sexual conversations into print.
Ideally, I like to try to write from my own perspective. I think it's important to say, "OK, I'm talking about sex and disease, and here's how it applies to me in my personal life." I think more people need to be standing up and saying, "Here's where I'm at. Anybody else can help me out on this? What else do you have to say?" I have trouble getting those conversations going.
What are the top myths about HIV that you encounter in the African-American community? What is the best way to counter them?
There are many of them. I think the top myth is this "down low" business. I do think we're effectively countering it at this point. But the very notions involved in the obsession with the down low -- [that there are] these hidden "gay vectors," and that if we could just ferret them out, everything would be OK!
Through dialogue, the down low has started to be demystified. I've been in a number of conversations where that myth has been broken down -- where people came to the table, both gay men and straight women. And notably, not straight men. Both sides came with all of their baggage surrounding that conversation, and through very difficult dialogue come out at the other end with a more nuanced understanding of their own risks and roles.
I was at a meeting at the National Association of Black Journalists last year about the down low. Standing room only, full of black women journalists. So, highly literate, engaged people on this topic. Within moments, it was a very emotional debate about the risk that "hidden gay men" present to straight black women.
By the end of it, we had gotten around to the point where we were talking about the responsibilities that straight women have to protect themselves. This isn't about the hidden vector, this is about what kind of relationships you accept and won't accept. Instead of talking about the outside threat, [we were] talking about the inside threat.
Is there one way in particular you argue against the myth of the down low?
My main point is there's absolutely no evidence. It is absolute conjecture. Just one day somebody said, "Huh, there's all these straight women who said they had no risk other than the men they have sex with, and there's all these gay men who are closeted. Oh! It must be that there is this down low thing that's spreading disease."
It's totally beside the point, even if that down low guy does exist. For the woman in that relationship, the issue is not if he's on the down low -- the issue is why is she accepting this relationship, because it's clearly not a mutually loving relationship.
How is the HIV epidemic different in the black community than in other communities?
I think the black and Latino community are different from the white community in the sense that the stigma appears to be so much stronger. And due to my insulated New York life, I've only recently started to realize just how significant the stigma remains in black communities outside of major urban areas.
In October, we had a bunch of black journalists at a meeting at the Black AIDS Institute, the vast majority [of them] from Southern states. And time and time again, our conversation just kept returning to they can't find people to interview. We were coming up with story ideas, but they kept coming up against "But how do I find people who will talk about this?" And then it would inevitably lead to personal anecdotes, friends they knew, and "This person died, and I never knew." That stigma still remains.
Do you think activism is an effective way to fight the epidemic?
I think there are far too many activists that talk at people. With all social change, it can't be about talking at people. Even more so with HIV and AIDS. We're talking about such intimate decisions that people are making in their lives, and we so desperately want to make them black and white things. As if we can give you a lecture -- a good sound set of principles to work from -- and that's going to make everything OK. And I don't think that's at all what this is.
There's a gazillion little bitty problems that everybody has in their lives, that they're exasperated by, and then there's this virus out there that preys on those moments of vulnerability. Maybe if we focus less on "How can we stop this epidemic?" and more on "How can we help individuals become as active as they possibly can in decisions about their lives?"
Don't get me wrong -- there are all kinds of activism, and it all has a role. For instance, we need far more marching in the streets, [more] anger surrounding the way our government behaves. And that is definitely not talking at people -- that's shouting. We need more shouting.
But when you get down to the level of getting people healthy -- whether that means keeping them from becoming HIV positive, or being healthy once they're HIV positive -- that requires a whole different kind of activism, which is really more about personal testimony and creating spaces for people to think and talk about their intimate lives. Things we spend our lives being trained not to talk about.
What can be done to help African Americans get tested earlier and therefore get better results from HIV treatment?
Again, it's dealing with the fear surrounding the testing, and with the fatalism surrounding the results. You don't always want to know you're positive. I think that's one of the dangers of the CDC's "Prevention for Positives" idea -- to find the folks who are positive and get them into care. It sounds great, but there are vast swaths of this country where we're still just trying to convince people that it's OK to go in for a test. The less threatening that process feels, the more likely it is to work. That's a principle that's gotta be maintained.
What are your hopes and fears for the next generations of African Americans as they face the risks of HIV?
It's hard for me to divorce my thoughts about HIV and AIDS and the future of African Americans from my thoughts about the place African Americans have in our society.
There was a story on CNN about this murder-suicide in Atlanta, a family displaced by [Hurricane] Katrina. The guy beat his wife to death, beat a 4-year-old near death, left the infant lying there, and then shot himself. That speaks to deep, deep psychic problems in that family, obviously.
But that sort of deep psychic tear exists. Katrina is one high-profile example of how it created that for a whole bunch of folks. That exists on a wide scale in black communities all over the country, perhaps less dramatically. The day-to-day trauma that people face when you're black and poor. And it's been going on for generations. My fear is that it will continue.
I don't see anything trying to address that trauma. If you can't do that, how can we get to dealing with HIV? I don't see anything dealing with whether you wear a condom or not, or whether you go and get treatment, when you're dealing with that kind of day-to-day trauma, and it was unaddressed in your parents, it was unaddressed in your parents' parents .
My hopes are that as a community, we will be able to recognize the cycle of that trauma, and be able to start answering it on communal levels. That we'll stop waiting for someone to come along to fix it. That we'll stop waiting for a new leader. That something will happen to spark neighborhood after neighborhood to start taking care of each other.
Can you recommend one action that everyone can take to end the epidemic?
Stand up and talk to somebody -- preferably whoever you're sleeping with -- about sex, and how you have sex, and why you have it, and sex and love, and all of the emotions surrounding relationships. If everyone could just have that conversation with themselves and with others around them, I think we would be making progress.
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