To Be Young, HIV+ and Black
As Dec. 1 marks World AIDS Day, examining how we can fight the epidemic claiming our youth.
After then 19-year-old LaQwanna Finkley complained about a headache for the umpteenth time, her mother sent her to the clinic. It was a visit that would change everything.
“The doctor gave me a full physical and blood work, and she asked if I wanted to take an HIV test,” the Bronx, New York, native says. “I said, ‘Sure, no problem.’ A week later, she told me that everything came back negative, except for my HIV test.”
Finkley’s response to the news doesn’t at all surprise those who know the upbeat, pragmatic young woman: “Okay. What do I have to do next?”
Finkley, born legally blind and often bullied as a child, viewed the diagnosis as just another challenge to overcome. “I knew that this was a task that God had for me; that He needed me to do something for Him. Even if I am scared, I’m still gonna use this situation to glorify God,” she explains.
She believes she contracted the disease from unprotected sex with a philandering ex-boyfriend, but her diagnosis hasn’t stopped her from living her life. Five years later, the relatively healthy 24-year-old is in a loving relationship with the man she was dating when she found out her status (he’s HIV-negative and gets tested every six months). Finkley spends her days working with at-risk teens in New York City’s Young Adult Internship Program, where her straight-talking tendencies are put to great use educating a rotating class of teens to the realities of the disease. “I tell them that some people don’t get a second chance; my second chance is for you not to become positive,” she says.
To say it’s necessary work is an understatement; young black men and women are contracting HIV at an unprecedented rate. According to the Centers for Disease, Control and Prevention, 26 percent of all new HIV infections occur in youth ages 13 to 24. But while blacks ages 13 to 19 make up just 15 percent of the teen population, they represent 60 percent of new teenage HIV infections. And because the risk of contracting the disease is increased in communities where a higher percentage of people already have it, black teens are more likely to join the ranks of the infected.
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Why are the numbers so heartbreakingly high? Poverty, for one. A 2010 CDC study found that “poverty is the single most important demographic factor associated with HIV infection among inner-city heterosexuals.” Nationwide, 35 percent of African Americans are living at or below the poverty threshold, which the Census Bureau defines as $22,811 for a family of four. Accordingly, the president’s National HIV/AIDS Strategy focuses resources in socioeconomically depressed areas.
“As a nation, we must work to eradicate poverty. Housing insecurity, homelessness, high unemployment, violence, illiteracy, high rates of incarceration—all by-products of poverty—contribute to higher rates of HIV/AIDS and other epidemics in our communities,” says C. Virginia Fields, president and CEO of the National Black Leadership Commission on AIDS (NBLCA). “Women and children are especially vulnerable to poverty in America. A renewed war on poverty will greatly enhance the nation’s disease prevention and health promotion efforts.”
Education is another important factor, says Angel Brown, senior program manager for GLBTQ health and rights at Advocates for Youth. “There is often a lack of information and resources given to our youth. We all know racism and its impact on the African American community is real,” she says. “Black teens, like all teens, need education and resources within their communities; supportive families and communities; and skills-building to help them make responsible decisions regarding their sexual and reproductive health. They also need comprehensive sex education within their schools.”
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Prevailing attitudes in the often socially conservative black community also play a role. “HIV stigma and homophobia continue to plague communities of color and are the driving forces for youth not getting tested for HIV, or testing late,” says Lissette Marrero, deputy director of the Adolescent AIDS Program. “They also contribute to the lack of condom use. If you can’t say you are gay in your community, you will not be able to negotiate condom use.”
The fallout of that stigma isn’t lost on Lawrence Stallworth II, who contracted HIV from unprotected sex when he was just 17. As the community education and outreach coordinator at the AIDS Taskforce of Greater Cleveland, he’s well aware of the barriers facing black men who have sex with men (MSM), a group who represent 54 percent of new HIV infections among all young MSM.
“The black community doesn’t talk about homosexuality. But it needs to be something we’re able to have a conversation about, so we can make smart, adult decisions and not rash, emotional ones,” says Stallworth, now 21. “If we don’t do something now, we’re pretty much being the harbinger of our own genocide. Ignorance is death in this case.”
Stallworth found out about his status after he spent two weeks on the couch, too sick to keep down food. When he went to the hospital, he was rehydrated and sent home. It was at his follow-up appointment that his pediatrician broke the news to him. “I was shocked, and I was scared and I was hurt, all at once,” he remembers. “But then I decided that I could either let this beat me, or I could overcome it and help other people.”
An activist with Advocates for Youth, Stallworth has appeared before the President’s Advisory Council on HIV and AIDS, and he spoke on the floor of the United Nations during a briefing on World AIDS Day last year. “I get to go to work and say every day that I’m helping people,” he says. “It’s a wonderful thing to be able to take your own tragedy and turn it into something that educates people, and it’s a fantastic feeling to be so young and doing my part to help society.”
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His is an attitude that can go a long way toward addressing the issues that lie behind the statistics. It will take both personal and community responsibility to lower infection rates. The first step is to educate yourself on the disease and its transmission. Then get tested. The CDC recommends routine screening, and testing any time you get tested for other sexually transmitted infections; many sites offer free, confidential testing. Those at higher risk, including MSM and anyone having sex with more than one person (or whose partner is not monogamous) should be tested annually. If you are positive, seek immediate care—when you have your viral load under control, it’s better for the entire community, because it can reduce the chances of transmission.
Then take responsibility for at least one young person. Whether it’s your child, little brother, niece or mentee. Have the hard conversation about his or her risk for this disease. Share the numbers, answer any questions about having safer sex, encourage him or her to get tested, and support him or her if help is needed.
Then look to the greater community. On the policy side, the NBLCA is advocating for the National Black Clergy for the Elimination of HIV/AIDS Act, which U.S. Rep. Charles B. Rangel (D-NY) and U.S. Sen. Kirsten E. Gillibrand (D-NY) plan to reintroduce in January. If passed, the legislation could go a long way toward improving the situation. It would authorize the Office of Minority Health of the Department of Health and Human Services to make grants to public health agencies and faith-based organizations with the specific purpose of providing HIV/AIDS prevention, testing, treatment and care for African Americans; provide services to at-risk and HIV+ black youth, particularly those who are homeless or in detention centers or foster care; and require the CDC to dedicate more resources to risk-prevention education for black youth, women and MSM. Tell your members of Congress that you support this act.
“Your voice can and will make a difference in how policies and funds affect your community. As a former elected official, I cannot stress the importance of this enough!” Fields says.
NBLCA is also holding community town hall meetings around the country to develop national and local strategies to address the health disparities surrounding black infection rates. Attend one in your neighborhood.
Advocates for Youth is pushing the federal government to make April 10 National Youth HIV & Awareness Day; the hope is to call more attention (and resources) to how this epidemic is affecting our youth. Sign the petition to ask President Barack Obama, Congress and the U.S. Department of Health and Human Services to make it so.
In the end, like so many of the issues that loom large in the black community, this epidemic comes down to taking personal responsibility.
Perhaps Brown says it best: “You don’t have to be a doctor or public health official to make a difference. As a community, we have a responsibility to our young people. If every adult committed themselves to ensuring young people’s right to lead healthy lives and worked to promote their overall well being, we would see a drastic decrease in negative sexual health outcomes.”