Four years ago, at age 19, Darion (name changed) tested HIV-positive. The Black gay Florida college student was "petrified." "I thought my life was over," he says. "So I tried to ignore it."
Even scarier than his diagnosis: What if his religious parents discovered he was "poz"?
"I was in college and on their insurance," he recalls. "I didn't see a doctor or get any meds until I moved out on my own. That was two years later."
Darion is one of an escalating number of Black gay and bisexual men -- "men who have sex with men," or MSM, in public-health jargon -- testing positive for HIV. The statistics are sobering: Their rate of new HIV diagnoses is more than 44 times higher than that of other men and more than 40 times that of women, according to Centers for Disease Control and Prevention (CDC) data.
In June 2008 the CDC reported being "especially concerned" about Black MSM ages 13 to 24. A steady stream of health departments has reported similar findings: New York. Chicago. Charlotte, N.C.
And infection rates have been increasing at "alarming" rates among young Black same-gender-loving men across the South, the CDC reported in 2009. "We need to make sure that HIV infection does not become a rite of passage for young Black men who have sex with men," The New York Times quoted Dr. Alexandra Oster, one of the CDC study's authors, as saying.
Knowing Your Status Is Key to Safety
Unprotected sex, complacency among younger men, multiple partners, ineffective prevention strategies and the high prevalence of other STDs contribute to climbing HIV rates.
Perhaps the most dangerous risk factor? Not knowing.
"It appears Black gay and bisexual men are less aware of their partners' serostatus," says Jim Pickett, director of advocacy at the AIDS Foundation of Chicago. "And more do not know their own serostatus."
A recent Chicago Department of Public Health survey found that 30 percent of Black Chicago MSM were HIV-positive. Two-thirds were unaware of their status. The higher HIV prevalence, combined with the "relatively closed sexual networks" in which Black MSM have relationships, increases the likelihood of exposure, says Pickett, echoing trends seen in national data.
"Oh Yeah, I Have HIV"
Darion, now 23, says, "I was having unprotected sex and knew it was wrong. But he said he loved me, and I thought he wouldn't hurt me. After about six months the symptoms began. "Uncontrollable throwing up, night sweats, dizziness," he says. "I thought I knew in the back of my head. Testing was confirmation."
Darion told his then-boyfriend, who said, " 'Oh yeah, I have HIV and I'm on meds.' Real nonchalant, like he forgot," Darion recounts.
"Too afraid" to tell his parents and "too paranoid" to visit a doctor and risk having medical bills sent to his parents, "For two years I was just in denial," Darion recalls. "But I've grown up. I have a wonderful doctor, I can tell him everything and I take my meds."
He also told his mom, who has become very supportive.
Darion describes his diagnosis as a wake-up call. "I've tried to talk to some younger boys here. I've seen so many kids in Jacksonville who are positive, even as young as 15, from doing it raw," he says, using slang for unprotected sex.
An estimated one in 13 young MSM in Jacksonville/Duval County has HIV, according to the Florida Department of Health, causing the Duval County Health Department to spearhead a new "Get Tested" campaign.
The Jacksonville Area Sexual Minority Youth Network "is now trying to reach young Black gay men before they become part of that statistic," reports The Florida Times-Union. "They're seeking out popular students to promote safe sex."
"When you're young, you think you're invincible," Darion says softly. "And Black people -- and Black gay men -- need to have more conversations in our community, about testing, sex and getting tested."
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.