Much of the recent HIV/AIDS data on Black gay and bisexual men -- or, "men who have sex with men" (MSM) in public health jargon -- has been sobering. A recent Centers for Disease Control study of more than 8,100 MSM found almost one in three Black MSM are HIV positive, compared to only 16 percent of white gay/ and bisexual men. The numbers were even higher in some cities.
Just like the recent reports of soaring black MSM seroconversions in Chicago, New York and other cities, the national data on barely made a "blip" on the local news. But as the rate of HIV infections among Black MSM in America and the Caribbean continue to skyrocket, their specific health needs reached a global platform at the 2011 Black Diaspora MSM Consultation in Punta Cana, Dominican Republic.
The weekend conference was held from March 31 to April 3 and organized by the Black AIDS Institute, the African & Black Global Diaspora Network (ABDGN) and the Black Gay Men's Network, a professional leadership community. The conference brought together 40+ researchers, policy makers, HIV/AIDS prevention advocates and physicians from four continents to organize around opportunities and threats Black MSM are facing across the Diaspora.
Four Continents Represented
The attendees represented four continents and more than 11 nations, including Barbados, Belize, Canada, Congo, Dominica, the Dominican Republic, France, Jamaica, Martinique, Mauritania, St. Lucia, Trinidad & Tobago, the United Nations and the United States. The youngest: An 18-year-old student activist from St. Lucia. The eldest: A 60-year-old clergyman from New York.
"Rarely will you see so many Black men who are leaders in their fields, around the world, all under one roof," said Black AIDS Institute President Phill Wilson at the March 31 beachfront evening welcome at the Melia Caribe Tropical. "This is an amazing opportunity."
"I'm proud of the turnout," said Sheldon DeSouza, the New York City-based activist and president of the BGMN. "This conference is exactly what the Network is striving to achieve."
An Overview of Black MSM HIV Epidemic
Most of the presentations at the 2011 Black Diaspora MSM Consultation were divided over two days into morning and afternoon sessions. The afternoon sessions included concurrent breakout sessions. The first morning, Friday April 1, included "The State of AIDS Among Black MSM", an overview of the Black MSM HIV epidemic in the hemisphere.
Toronto-based Paul Adomako, the executive director of ABDGN, illustrated the state of Black MSM HIV/AIDS in Canada. "The epidemic is focused around Ontario and Toronto," explained Adomako, who presented some new data on HIV caseloads among Caribbean and African ancestry.
Boston-based Gary Daffin of the Multicultural AIDS Coalition presented an overview of the Black MSM HIV epidemic in the USA. "It's mostly a younger epidemic," Daffin said, referring to the recent CDC data.
In the USA, Black poz MSM were least likely to be aware of their status. The numbers for younger Black MSM are even more startling: Among HIV-infected black MSM under age 30, 71 percent were unaware of their infection, according to the findings published in CDC's Morbidity and Mortality Weekly Report.
Discrimination in the Caribbean
Ian McKnight, co-founder of Jamaica AIDS Support for Life, and Trinidad-based Colin Robinson of CAISO, presented an overview of the Caribbean epidemic. McKnight ranked the number of HIV cases in the Caribbean, noting the nations were Haiti, the Dominican Republic, Jamaica, Cuba and the Bahamas, respectively. The Caribbean has the highest HIV rates outside of sub-Saharan Africa.
The Caribbean discussion created an animated conversation on discrimination and HIV criminalization, recently reported by the Black AIDS Institute. The problem in the Caribbean was "multi-layered", many attendees suggested. "Most Caribbean nations criminalize sodomy and it's a huge problem," noted one gay HIV/AIDs activist from Belize. In nations such as Barbados, Belize and Jamaica, "activists can be arrested for distributing condoms," he added and asked, "What incentive is there to test if you can be thrown in jail and there are no anti-retrovirals available?"
Caribbeans Proud of Progress on LGBT and HIV Issues
Despite some difficult legal and social environments, there were many success stories in the Caribbean.
"The perception I struggle with the most is that homophobia is unrelenting, we are all hiding under rocks, and there is no organizing," Colin Robinson of Trinidad & Tobago's CAISO tells BAW. "And it requires these brave people from the States to help us. Unfortunately, that is not limited to white people. Many African Americans, even though they may be well intentioned, have that same sense, 'We know what is best, we know what will save you.'"
Robinson says the last four years have "seen an exciting push and visibility around gay, lesbian, bisexual and transgender advocacy" in Trinidad, starting with a successful sexual orientation discrimination lawsuit in 2007. "We have a long history of organizing, especially around HIV and social issues that goes back 20 years. We've been celebrating pride for almost 20 years in Trinidad & Tobago," Robinson adds.
"Acceptance and tolerance is growing" in the South American nation of Suriname, says Kenneth van Emden, director of Suriname Men United, that nation's largest LGBT and HIV advocacy group. Van Emden says his group is active across Surinamese print and television media, which "is playing a very good role to inform and share MSM issues ... and create a gay-friendly environment in Suriname."
"Black Americans can get involved in the Caribbean," van Emden tells the Black AIDS Weekly. "By inviting Caribbean MSM organizations to meetings and conferences in America to get a better understanding on [our] issues."
"In virtually all of the Caribbean nations, there are active LGBT organizations," the United Nations Development Programme's Dr. Cheikh Traore told the BAW. Dr. Traore, a native of Mauritania, is the Senior Adviser on Sexual Diversity and is UNDP's first full-time staffer to focus on Black MSM issues. "In countries such as Haiti, Jamaica or Trinidad, these groups are active and have many successes to share in terms of raising awareness about the negative impact of homophobia or HIV prevention programs."
Traore adds that UNDP is involved "in several partnerships and initiatives" to improve MSM HIV programs "in the Dominican Republic, Jamaica, Haiti, Cuba and Guyana."
New Prevention Technologies
The highlight of the second day was a much-attended discussion on new prevention technologies and Black gay and bisexual men. Atlanta-based Dr. David Malebranche, MD, MPH, Assistant Professor of Medicine at Emory University, introduced the recent findings on as pre-exposure prophylaxis, or PrEP. The daily use of Truvada, an antiretroviral drug was proven to dramatically reduce new HIV infections of up to 73 percent. The Haitian-American physician is an expert on Black MSM HIV.
"There are many questions on implementing PrEP for Black men who have sex with men," Malebranche said, echoing the sentiments of the conference. PrEP's potential impact was recently reported by Black AIDS Weekly in "What Pre-Exposure Prophylaxis Could Mean for Black Gay/Bi Men."
"There are many limitations on the research," Malebranche said, citing a lack of Black MSM participants to resistance to false answers. "But it's not a magic pill. You can't take one pill and not modify behavior. It might work in some select audiences, but we must continue with condoms."
Looking Toward Washington 2012
"If there's anything we must leave here with, it's a focus on increasing Black and Black MSM issues at AIDS 2012 in Washington DC," said Black AIDS Institute President Phill Wilson.
At AIDS 2010 in Vienna, the Global Forum on MSM and HIV found that only 2.6 percent of all sessions were devoted to gay and bisexual men -- despite being the population most at risk for HIV. Attendees at the 2011 Black Diaspora MSM Consultation were determined to organize around increasing Black visibility at AIDS 2012, and strategized how to leverage media and organizing opportunities.
"And there is no way it shouldn't happen," added Wilson. "Not when the conference will be in America for the first time, where HIV is primarily a Black disease, and in our nation's capital which has the nation's highest HIV rate. We're going to make the focus on Black folks and Black MSM."
Rod McCullom has written and produced for ABC News and NBC, and his reporting and analysis have appeared in Ebony, The Advocate, ColorLines and other media.