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The Rising Rates of HIV Among Black and Latino Men: What's Going On?

June 23, 2010

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While the U.S. Centers for Disease Control and Prevention (CDC) estimates that men who have sex with men (MSM) account for just 4 percent of the U.S. male population aged 13 and older, the rate of new HIV diagnoses among MSM in the U.S. is more than 44 times that of other men. And if we dig a little deeper into these stats, we find that African-American and Latino MSM are disproportionately bearing the brunt of these new infections.

What are the contributing factors to these numbers? Is it a combination of homophobia, economic instability, racism, condom fatigue, naivety and a lack of culturally competent prevention approaches? Or is something else at play?

In an exclusive, roundtable discussion moderated by Kenyon Farrow -- activist, journalist and the executive director of Queers for Economic Justice -- we attempt to explore these issues, without pathologizing these two communities. We look at what is being done right, what is going terribly wrong and what is being overlooked in terms of HIV/AIDS prevention, education, treatment and testing.

Kenyon Farrow

Kenyon Farrow, Executive Director of Queers for Economic Justice

Kenyon Farrow: This is Kenyon Farrow, executive director of Queers for Economic Justice, reporting for Today, we're having a roundtable discussing the rising rates of HIV transmission among black and Latino men. Participating in this discussion are Vaughn Taylor-Akutagawa, who is the deputy executive director of Gay Men of African Descent (GMAD); Sheldon Fields, who is an associate professor of nursing at the University of Rochester Medical Center, in the School of Nursing; and, last but not least, Francisco Roque, the director of community health at New York City's Gay Men's Health Crisis (GMHC).


I want to thank you all for joining me. I want to ask a question about what's not working. Most of us are familiar with the various statistics that have come out in the last couple of years related to rising infection rates among black and Latino men who have sex with men. Last year, the CDC released some data showing that MSM in the U.S., in general, are 50 times more likely to have HIV than the general population. And we know those numbers are being largely driven by men of color, particularly black and Latino men who have sex with men.

I first want to ask Sheldon: What do you think isn't working so far?

Sheldon D. Fields, Ph.D., R.N.

Sheldon D. Fields, Ph.D., R.N., Associate Professor of Nursing at the University of Rochester Medical Center -- School of Nursing

Sheldon Fields: In terms of what's not working: Clearly, we're not being effective at getting the message out to a new generation of MSM about how to protect themselves. We're not doing a good enough job. The results speak for themselves. And in that vein, in terms of the types of research that we are doing, we talk a lot about innovation in health science and research. But then the NIH [U.S. National Institutes of Health] and the CDC are not the first ones to really fund true innovation. And a lot of innovative things that we can do are at the very, very basic community level -- that we have not yet been able to connect the community that's most at risk with academic institutions, in order to jointly partner to do the types of research that we probably ... well, not even probably ... that we do need to be doing to produce better outcomes.

At the moment, we keep doing the same thing, and that's the definition of insanity. We're doing the same thing; we're not getting any different results.

Kenyon Farrow: I'll ask also Vaughn and Francisco to weigh in on this, but Vaughn first. As a person, as Sheldon mentioned, who provides community-based prevention for black, gay men in New York City: From your perspective, what do you think isn't working?

Vaughn Taylor-Akutagawa

Vaughn Taylor-Akutagawa, Deputy Executive Director of Gay Men of African Descent

Vaughn Taylor-Akutagawa: We don't have real conversations that are tangible for the people that we reach. There's no concept about threat personalization. We have to balance the unique conversation between talking about HIV as something that you do not want to get with the sensibilities of those who are living with HIV. And often, the message about living a healthier life, with access to services and a chronic managed disease, makes the threat of HIV not seem imminent.

We don't have classes in which we can actually talk about effective harm- and risk-reduction acquisition for young men, or for men across the continuum. We get them in a room; we mention, allude to, sex; but actual concrete demonstrations about how they negotiate sex aren't there. If we follow what our funders want, our funders want us to pretend as if male negotiation of sex is verbal. And it's generally not. If you look at any level of data, it's assumptive, inferential and people just do it. If you look online, people say, "What's up?" They give you directions to the house that they are quick to unlock. And then there's activity. There are no other discussions.

So we're stuck. And particularly for our gay organizations, serving gay men, we have to do an interesting dance around how do we, as peers, interact with people in the community, but still maintain professional boundaries.

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