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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 TheBody.com. 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).

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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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This article was provided by TheBody.com.
 

Reader Comments:

Comment by: Jack L (Vanwyksdorp) Fri., Dec. 28, 2012 at 12:48 am EST
just dropped in on this. While I agree about all the societal factors - homophobia > on the down lo > MSM etc. the thing that somehow is being missed is that sex is fundamentally about exchange of body fluids. Period. You can unpack this into power, feelings of completeness, powerful fantasies about sharing, possession and so on. Societal factors will increase the need. This is not to say good programs that make safety desirable can't have some impact. But lets recognize that sex is about exchange of body fluids and promote morning before and morning after solutions.
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Comment by: JC (Miami, FL) Fri., Jun. 3, 2011 at 11:27 pm EDT
This is a very old article but I still want to leave my 2 cents. I am a gay Hispanic male and in the Latino community there are a combination of family "honor", religion and culture factors involved leading men to live closeted lives (often married as well) resulting in these men seeking "men to men sex" through risky avenues which equals "the internet" period. There are tons of gay sex hookup sites as well as Craigslist personals and these men are on it - believe me on this. Some of these men use alcohol or drugs to over come their "fears or inhibitions" and "boom" the consequences of unprotected sex occur.
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Comment by: San (St> petersburg FL) Thu., Aug. 12, 2010 at 11:33 am EDT
Just wanted to support the comment from Drew(Sydney, Australia) . We need to make things happen... Dealing with churches is one of biggest chalenges.
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Comment by: WF (Baltimore, MD) Thu., Aug. 12, 2010 at 10:59 am EDT
All organized religions has historically been the cause of many events held in anathema today, and yes including perhaps as the cause for the rise of HIV rates among Black and Latinos, but some of the responsibility has to be taken on by the entire culture.

The stigma of being homosexual in these communities will perpetuate as long as homophobia is allowed to be a part of the community. Using terms like "DL", "MSM", "Same Sex Loving", do nothing more than support the denial of the reality that some men of color are gay, and fomenting the myth that only white men are be gay.

We are doing an injustice to ourselves, and the diaspora of the LGBTQ community by not addressing the real issues head on. Education about LGBTQ people in our communities is vital, and I will promise you that lifting the stigma of being gay will enhance self-worth and reduce unhealthy beliefs and behaviors.

People of color have to work at becoming a part of this society and end the self imposed apartheid. The LGBTQ movement is for all who identify as homosexual. Yes! Let's start using the term homosexual openly, and stop using these euphemisms that enshrines denial and ignorance. Until this happens the hiding, denial and the spread of this epidemic will continue to escalate.

I am a proud Afro-Caribbean, HIV poz homosexual man. I have nothing to ashamed about. I love men and will always to have sex with men. We have to stop coddling the low self-worth, bigotry and homophobia among our own people, and instead raise awareness of how these are elements of the rise of HIV in our communities; and that every man and woman has to take responsibility for their own behavior and well being. Self determination and responsibility will be a factor that will build a healthy community.

That is clearly the course of action that must be taken by each individual; and those that are in the position to educate have the responsibility to impart this knowledge and stop beating around the bush.
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Replies to this comment:
Comment by: NCFred (North Carolina) Sat., May. 14, 2011 at 2:45 am EDT
You have explained the problem in an excellent manner. I am a masculine African American man who is openly gay and HIV positive. I have been attacked by black churches because I asked several black ministers to include HIV awareness and prevention information with other information that they have at the church. The responses I got include things like "If a person has AIDS he deserves it because of abomination." None of the black churches in my town will even mention the word AIDS unless it is to condemn the people who have it. They don't understand that AIDS is not a "gay" disease. It is a blood disease. Because AIDS was initially associated primarily with gay white men, many black organizations such as the black church are refusing to participate in AIDS prevention and treatment efforts.


Comment by: gurlzone (New York) Thu., Aug. 12, 2010 at 10:44 am EDT
Just want to say that this is an amazing and thoughtful article. These men articulate the most important ideas I have heard yet about MSMOC and HIV. Is there a way to put this on my fb page?
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Comment by: MoreAnon (SoFlo) Mon., Jul. 26, 2010 at 7:05 pm EDT
Thank you gentlemen for the forum.
I must say that religion and the church is often accused of enforcing the many clandestine behaviors that oftentimes perpetuate the spread of HIV/AIDS, especially among men of color.
Pointing to the government [Drew AUS] as a source of this kind of societally influential pressure is, in my view, trying to find yet another scapegoat to point an accusatory finger at. I am aware of how vulnerable MSM, bisexual and gay men are to the pressures that are exerted by this[ese] group[s], but I believe that in 2010 (and beyond), it is FULL time now for this community to mobilize and become better informed LONG before sexual practices are even considered (this point was alluded to as a common thread throughout the article).

I also see where one of the panelists made a very key point: many people cannot even DEFINE what a community is, or where to find the people that comprise it much less to enforce and build on the information about STDs and the treatment base that is needed. My solution to this is that we need to encourage open dialogue with young men and women from an early age in the school AND church structures about sex, sexuality and the risks that are out there when such activities are taken into consideration.
Just like how various forms of prevention programs that exist start at an early stage [take for example, immunizations], we as a people need to start addressing a population that knows less and less about patience and seek all the pleasures that come with instant gratifications.
People need to be reminded of the ramifications of sexual practices in their various forms and be reminded of HOW it actually feels to be infected with a disease that has no cure as yet. When that point is driven home, I think more people will indeed start to wise up.
Thanks.
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Comment by: Drew (Sydney (AUS)) Thu., Jul. 8, 2010 at 1:47 am EDT
I think the elephant in the room with a rise in African American /Latino is the role of "the church".

In the African American Community the Protestant Churches in particular the Baptist Church has played a large role ..think Civil Rights Movement

And in the Latino Community the Roman Catholic Church plays a large part in family life.

The Church promotes a homophobic view point that makes it hard for many Gay black or latino men to come out ...thus creating an environment of denial. This can be seen with the concept of "the down low" where many Black and latino men who are in a heterosexual marriage have sex with men on the side.(MSM)

Just some food for thought. Im glad I now live in Australia with an HIV rate of 0.01% one of the lowest in the Western World, due to a proactive progressive Govt(Hawke / Labor) in the early 1980's unlike the denial illustrated by the Republican Reagan Admin, in the early days.

The Christian Churches in the United States have a strangle hold on the Republican Party...spewing hatred...very Un-Christian indeed.

Whereas here in Australia we have our First Female PM who is an out proud athiest...This would be political suicide in the United States.

Enjoyed the article.

Cheers Drew xxx
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Comment by: D. Smith (New York) Wed., Jun. 30, 2010 at 3:09 pm EDT
One of the main factors contributing to the spread of HIV in the minority community is "culture". Culture as I define it would consist of practices, behaviors and rituals which have become norms within our community. This factor alone sets in place an array of other conponets that operate to our community's detriment. Culture is continuously being create and influenced by powers which only desire to exploit our human capital potential for the maintenance of its prisons, judicial system, etc.

Freedom from HIV begins with our communities examing and creating new culture. We need to abolish behaviors (and I'm not speaking against peoples sexual freedoms, nor for the adoption of any fundalmentalist religous viewpoint), which lend themselves to our self destuction. Truthfully cultural practices that sustained us yesterday, may not work for us today. We must evolve in our thinking or risk self genocide.
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