How to Meet the HIV Prevention Needs of Young Gay Men of Color?

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The latest U.S. HIV/AIDS surveillance results from CDC have not yielded good news for gay men. HIV rates have risen among this group -- particularly sharply among young men. Young gay men of color, who make up a tiny portion of the U.S. population, saw more new HIV cases than any other segment of the gay male population. The global HIV/AIDS landscape for young gay men offers a similar picture of increased vulnerability and scant resources.

It's easy to get bogged down in such dismal numbers. But before these data are allowed to eclipse the complex lives they represent, consider these diverse and thoughtful responses from community members to the question: How best to support young gay men of color in terms of HIV prevention? Hint: Their answers go far beyond what numbers can describe.

Tim'm T. West

Center on Halsted, Chicago

HIV can only be effectively addressed when the spiritual damage done in Black churches is resolved, the stubborn denial of homophobic families stops, and the insidious hypocrisy of a post-racial America is addressed. How are young men daily reminded of how little they are valued to value the harm reduction and prevention models many believe will protect them?

Jasan Ward

MOCHA Center, Rochester, N.Y.

In order to create and implement effective HIV prevention interventions, programs and services for young gay men of color, they need to systematically address the issues of homelessness, unemployment, education, mental health, stigma, gender identity, sexual orientation, sexual health, homophobia, and substance abuse. If our young gay men of color are not stable, where they don't feel healthy, happy, and whole on all levels that impact their lives, how can we expect them to care about their HIV status, let alone whether their sexual behaviors may impact the HIV status of another person!

Marvell L. Terry, II

The Red Door Foundation / Young Black Gay Men's Leadership Initiative, Memphis, Tenn.

The needs of my community would be best addressed, I believe, by empowering my peers, young gay men of color, to take an active role in creating and sustaining prevention strategies. Therefore, that may be us grabbing a chair and sitting at the table when there was never an intention to include us in the beginning. We know our needs better than anyone else but always request the help of others to walk beside us; but we must become empowered to lead our own movement.

Charles Stephens

Emory University, Atlanta, Ga.

Because young black gay men are not just a problem to be solved, a burden, nor mere data, we must rethink not only our approach, but our paradigm. With the "clinical turn" in HIV prevention, and the flattening of young black gay maleness into essentially an always-at-risk population, we are robbed of our ability to imagine them as anything other than risk. This serves as the most unfortunate kind of objectification, and displaces young black gay men from an identity, a community, a history, and a culture.

We must create locations for sexual health education, culture awareness, and community empowerment that exist outside of bureaucracies. Approaches rooted in popular-education models that build upon and assume the humanity and agency of young black gay men. Cultural awareness and sexual identity empowerment must also be indispensable to sexual health education and community building. The consequence of distancing young black gay men from their history, and culture, even in the service of their protection, is to save their lives but murder their souls. We must insist upon scientific and cultural innovation in the new HIV/AIDS prevention landscape.

Anthony Roberts, Jr.

Young Black Gay Men's Leadership Initiative, Daytona Beach, Fla.

I think young gay men of color must own this fight. We are an educated, diverse and powerful demographic that has to come together to combat the epidemic. We need more youth and young adult leaders that are courageous and motivated to demand change. We must ensure that the programming, funding and policy voices have our best interest in mind and include us in the room. As a community, we must be more proactive about our health and sexual behaviors, rather than reactive surrounding HIV transmissions. I care because I can't wait for someone else to take action.

Kenneth Reed

Access, Care and Resources for Health, New York City

I think, first and foremost, we need to be able to meet them where they are at. And by that, I mean, literally, go to where they are congregating, meeting them in the bars, the clubs, wherever their social network resides. That's number one.

Then, I would say, definitely offering things that are strategically targeting their needs, whatever's putting them at risk, making sure that our services can remedy those things, be a support to those issues that they're dealing with. Also, linking them to those supports that may be able to help with their cofactors of housing, drug addiction, even if it's family issues that they're having -- having some kind of support that can link them to the services that they need.

Harlan Pruden (First Nations Cree)

As we have heard over and over since the release of the U.S. National HIV/AIDS Strategy, resources must follow the disease and the data. This does not hold true for the male Two-Spirit community and as a result our young male Two-Spirits will pay the heaviest toll.

Nationally, the male Two-Spirit community is bearing the brunt of this disease, accounting for over 50 percent of new cases in the Native community. If the spigot is ever opened (a dream at this point), resources need to be culturally appropriate and promote and reclaim our people's culture. If it does not, then the non-Native approaches, programs and services are today's colonizing tools.

The harsh reality is we are the indigenous peoples of this land. The time is now for the resources to begin to flow to the many unfunded Two-Spirit organizations and this community. Anything less is unconscionable.

Theodore Kerr

Visual AIDS, New York City

I have to say, I get really frustrated at AIDS-related events when a fellow white gay guy will declare something like, "And what about the young black men getting HIV at an alarming rate? We have to do something!" The concern is justified and not incorrect, but I am surprised they can't see what is wrong with what they are saying. These white guys often have the experience to know from their own lives that advocating based on demographic is a bad idea. Pathologizing groups of people rarely leads to the approaches needed to address the everyday realities of living.

And, such statements concern me that the speaker thinks it is their duty to "do something" without considering or finding out what is already being done, assuming nothing is being done. There is no shortage of amazing leadership concerning queer people of color wellness. The summer I met Kenyon Farrow, Pato Herbert, Coco Jervis, Charles Long, Amy Sadao and Nelson Santos was a watershed season I am still learning from.

So in response to the question, for me -- as a white gay guy -- when it comes to "serving the needs of young gay men of color," it is about getting out of the way and making myself available to work. It is about listening and collaborating. It's about being available, vulnerable and not involving myself if I am not needed.

Seth Girod

Evergreen Health Services, Buffalo, N.Y.

I think actually talking to them and finding out what they need. I think it's really easy to sit behind a desk and have stuff trickle down from the administration, but on top of doing the stuff that you're funded to do, it's really important to talk to your clients and build a relationship with them so they feel comfortable telling you what's really going in their life.

Twofold answer: talk to them; build a relationship; find out what they actually need; then tackle it the best way you can.

Kate Gallivan

Evergreen Health Services, Buffalo, N.Y.

I think we have to start by creating safe space for them, a place where they feel safe, they feel welcome, they feel cared for. I think we have to look at the whole person, not just the HIV-related needs or the HIV services, not just about condoms and prevention education. Look at the whole person and be present to what's happening for that person and how do we keep that person engaged with us. It's really an individual-level kind of work with great respect for each individual that we're fortunate enough to have come and see us.

Daniel Driffin

Young Black Gay Men's Leadership Initiative, Atlanta, Ga.

I believe the answer starts with advocates, researchers, policy makers and physicians actively bring young gay/bisexual and trans-identified men of color to the table during all levels of communication around the development, implementation and evaluation of research projects aimed to find out information around our lives.

We know a handful of determinants inherently place young people more at risk for HIV. We should determine a way that goes to eliminate those barriers. If a gay/bisexual or transgender youth presents as homeless we can send him/her to a safe, culturally sensitive, temporary housing situation organized under the U.S. Department of Housing and Urban Development and other local/state or federal agencies. While in this program it would also make most sense to take part in other life-skills development around job readiness education, and even the importance of having a positive support system.

Brandon Wollerson

Travis County Integral Care, Austin, Texas

I think it first starts with listening to them, and involving them in the creation of our prevention strategies. That way, we are talking "with" them, and not "to" them. I think we have to start having an honest discussion about PrEP. With expanded knowledge of the benefits of PrEP, I think we have to also think about access to PrEP. How do we ensure that the newest "tool" in the prevention tool belt is accessible to all, regardless of socioeconomic status?

I think we've begun to really engage in the conversation of eliminating stigma through projects such as The Stigma Project and the blog "I'm Still Josh." I would like to see communities of faith step up to the plate, and begin to engage in faithful dialog that creates a spirit of safety and openness to young gay men of color. By doing this, we begin to address the shame and internalized homophobia that further perpetuate HIV-related risk factors.

Pete Carney

Long Island Crisis Center, Long Island, N.Y.

I think it would be most important to create safe spaces so that young men of color have a place of belonging, a place to call their own, where they can get education, support services and a welcoming environment that's designed for their needs.

Katherine Cantrell

Travis County Integral Care, Austin, Texas

In terms of HIV and who is testing positive, we already know the number of cases among young gay men of color is increasing. What is left undetermined is a real reason or solution to this. Yes, HIV in this particular group is being transmitted via unprotected anal sex, that we have determined. But what can we do as prevention providers to reduce their exposure to HIV? That is our real mission.

What are we missing? Where can we bridge the gap? Prevention programs often use interventions that solely focus on reducing "problem behaviors." This strategy, unfortunately, limits our ability to meet these young people's needs. Sure, we can provide them with condoms and pamphlets and education, but what young gay men of color need is motivation.

To reach this population, these young men need to be mobilized and educated to support each other about safer sex. As providers, we need to embed prevention strategies into already existing social communities. We have to meet them where they already are. We have to accept that empowerment among young gay men of color is a defining factor for prevention.