What Is It That Young Black Gay Men Don’t Get About HIV?
High rate of new infections points to a disconnect between prevention messages and their targets
White men and women get it. Latinos and Latinas get it. Even black women, who bear a disproportionate share of HIV infections, get it.
But young black gay men, based on the spike in HIV infections among them, apparently do not get it.
What is "it"? The message that HIV transmission isn’t one of Aesop’s fables or something as intangible as Jim Crow-era segregation may seem today. The message that HIV is real. There is risk. And there’s no cure, despite much lauded advances in treatment that have made the disease manageable.
That’s a consciousness that AIDS activists and some political leaders worry is nearly absent from the minds of young black gay men, who make up more than half of all new HIV infections annually, according to the latest figures released by the U.S. Centers for Disease Control and Prevention.
When the CDC first sounded the alarm about young black gay men and their high risk for the disease half a decade ago, Tony Ray was in his late teens. Today, the 26-year-old New York City-based AIDS activist says not much has changed about the hyper-masculine, anti-gay communities in which he and his peers live.
“Stigma is the biggest factor” contributing to the high burden of new HIV infection rates among young black men, says Ray, who is co-chair of the Campaign to End AIDS in Youth Council and a community activist for Housing Works, an organization fighting homelessness among those infected.
“If you have a society that says you have to be out and open, but doesn’t allow you to come out and get the affection [you] deserve, you are more likely to live in shame,” Ray says.
[ALSO READ: 10 Things You Can Do to Fight HIV]
Shame fosters a host of unhealthy behaviors among black men, Ray adds. He’s known his peers to seek discreet sexual encounters with men on “hook up” websites and, out of desperation, compromise their safety to attract other men who don’t “play safe” and are more likely to be HIV positive. And even among openly gay young black men, Ray says, conversations about condom use and HIV status don’t take place at the moment they should.
The emphasis on hyper-masculinity in the black community doesn’t help either. Young men understand very early on the status that comes with dominating and bedding women, even if they are having sex with other men, Ray says.
The spike in new HIV infections among this group seems to be a byproduct of shame, stigma and lack of effective sexual health education, most activists and sexual health experts agree.
The CDC estimates that 1.1 million people in the U.S. are HIV positive, with 50,000 newly infected each year and 1 in 4 occurring in people ages 13 through 24. In 2010, 1,000 young people were infected each month. Young black men who have sex with men (MSM) saw a 48 percent jump in new HIV infections from 2006 to 2009, according to CDC data.
With millions of dollars in government funding already going toward helping community groups test, prevent and educate high-risk demographics, some sexual health experts are beyond frustrated by the latest youth HIV statistics.
“I had to really kind of think about where this is coming from,” says Michele Luc, a sexual health and research professional at the Cornell University Cooperative Extension in New York City who has worked in the AIDS prevention community for nearly two decades.
“[Young people] are bombarded with information, so much that they feel like, ‘We get it! We get it,” Luc says. “[Young people] don’t have a face to attach to the disease like there was in the late 1980s and through the 1990s. For me, as a black female, when Eazy-E died, when Magic Johnson came out [as HIV positive], these were people [my generation] knew and loved.”
[ALSO READ: To Be Young, HIV+ and Black]
Luc compares young people’s understanding of the HIV pandemic to their understanding of how blatant racism and racial violence shaped daily life for African Americans half a century ago.
“They’ll say, ‘What? People are still getting AIDS?’ as though it was as foreign to them as burning crosses and hooded Ku Klux Klan members,” Luc says, adding that some of the messages to “scare young people straight” on HIV prevention have been flawed.
Luc says that while treatment methods have advanced, she believes young people should better understand the full trajectory of the disease, and not only that pills can extend their lives. Also, much of the government funded education curricula doesn’t employ language and terms that are inclusive of gays, lesbians, transgendered individuals and those questioning their sexual identity, she says.
On Capitol Hill, members of Congress aren’t hearing enough about it from their constituents to collectively do anything meaningful about the HIV infection rates for young black men. Rep. Barbara Lee, a Democrat representing Oakland, Calif, where African Americans made up 72 percent of all new cases of HIV in 2007, is issuing a challenge to the black community.
“We need to hear from African Americans,” Lee says. “It deeply concerns me…I say, it’s a state of emergency.”
Lee says that while she often hears from local activists in her district, she believes too few House members are feeling the same fire from other hard-hit constituencies. She’s been on the forefront of HIV prevention initiatives, having drafted and introduced legislation that, among several key aims, seeks to end the criminalization in some areas of people who knowingly or unknowingly transmit HIV to another, a reality that experts and activists say scares many who are infected from coming forward for testing at all.
“[The high rate of new infections among young black gay men] is an issue that is on the table,” Lee says. “But we haven’t had the push from the outside. Those who raise the loudest noise, get the response.”
Ray believes that response should come from his peers. Although he trains local activists, whom he describes as “amazing” and “motivated in the fight,” even they are not enough.
“My motto has always been to be the change you want to see in your community,” Ray says. The problem is “no one wants to be that change.”
Ray and others say young black men will have to think differently and act with a sense of urgency in order to move the needle and reduce their risk.
Right now, however, they don’t get it.