Will the ManDate Model Tackle HIV Rates in Black Gay Men?

The State of Black Gay Men's Health

Thirty-five years into the HIV/AIDS epidemic, the state of black, gay men's health is central to the discussion about how to eradicate the virus. For black, gay men, the narrative has grown increasingly scary, as we are now the U.S. group most affected by HIV and other sexually transmitted infections (STIs). Fortunately for us, this concern has not gone on deaf ears, and many institutions and organizations have begun to focus on black, gay men in order to change this grim narrative.

On May 25, 2016, a panel discussion was held at the National Institutes of Health (NIH) on the state of health of black, gay men and the need to increase funding for this marginalized population. The "ManDate Health Model" looks at the financial, political, sexual, emotional, spiritual, intellectual, psychological, physical and social aspects of black, gay men. These nine areas of health and wellness are used to assess why a black, gay man might be excelling in some areas while failing in other, and how the intersections between being black and gay increase the odds of acquiring HIV and STIs compared with our white and Latino counterparts.

The intersecting disparities of black, gay men combine to create overlapping oppressions and marginalization, resulting in us contracting HIV at a much higher rate than other races and groups. Black, gay men experience poverty, incarceration, crime, unemployment, unprotected sex, racism and mistrust of health care, among other health disparities. These in turn drive sexual prejudice, lack of access to health care, mental health issues, homelessness, alcohol/substance abuse and acquisition of HIV/STIs.

As a consequence, despite the fact that black, gay men use condoms more than other gay men, have fewer sex partners on average and get tested more often, they are three times more likely to contract HIV.

In effort to change this story, the NIH panel discussed the need for an intervention called "Project Healthy Living" (PHL), which would specifically focus on HIV awareness and reductions in new infections. PHL was developed by a working group of black gay/bisexual/same gender loving men from the District of Columbia to help address and combat the unique challenges we face. Their goal is to improve sexual health outcomes and influence healthy choices for black, gay men and their sexual networks through a series of interventions that aim to reduce risk and increased access to testing, care and treatment.

The program focuses on thee service areas: building community, promoting health and fostering communication. Using the "Mandate Health Model," PHL addresses concerns from the nine health and wellness areas to help bring about positive change in the way black, gay men approach HIV. This intervention helps overcome the lack of programs for black, gay men needing assistance with HIV education and resources. The community building aspect helps to tackle social risk factors derived from the lack of support systems, discrimination and homophobia. It also addresses the behavioral risk factors that prevent black, gay men from engaging in healthier sexual practices. Finally, it addresses HIV and STIs and attempts to change their disproportionate impact on our community.

A recent Centers for Disease Control and Prevention report projects that 50% of black gay men will contract HIV in their lifetimes. Because the likelihood is even greater for those who live in the South, where resources and education are much more limited, PHL seeks to expand its work in the region. They seek to connect with existing agencies to reinforce what is already being done, but also to connect with populations that traditional outreach methods have historically struggled to reach.

Though we have come far in this epidemic, for many marginalized populations the war is far from over. Thankfully, those people most affected by the virus are now being allowed in the room to share their stories and bring about the change needed to end the epidemic for black, gay men, once and for all.