On 7th of February, The United States acknowledged National Black HIV AIDS Awareness Day (#NBHAAD). The Internet was filled with happy slogans about getting tested, “HIV stops with Me” and other feel good memes, along side dire statistics of HIV within the Black Gay/Bi male community. What was lacking, were solutions.
We at GMJ are not claiming to have THE answers, rather we, as gay males of colour, some of whom are Black and HIV positive long-term survivors, have some thoughts that might work for large portions of this demographic. For us, there is no need to repeat the negative and often soul crushing predictions about Black gay HIV infection because these are not facts and each man still has choices in his life about what to do with his sexual education, experience and personal growth. The future is not written for anyone.
Any possible solutions must be tempered by the dual burden/blessing of being Black and gay male in America. From low education to poverty and victims of racism and homophobia, this group is doing time on two crosses without the necessary resources to free themselves from either. When we look at the locations where HIV is hitting this community the hardest, they are in the poorest parts of the American South, also known as the Bible Belt, where sex education, as Planned Parenthood states, “programming varies widely. Currently, 24 states and the District of Columbia mandate sex education and 34 states mandate HIV education. Although almost every state has some guidance on how and when sex education should be taught, decisions are often left up to individual school districts.” This means that over half of American school children go without sex education and the majority are barred from learning about gay male sex.
In Alabama, Louisiana, Oklahoma, Mississippi, South Carolina and Texas, they pertain specifically to health courses, with most stating that teachers cannot instruct students on LGBTQ sexual health. In Oklahoma, the law requires that AIDS education include the false claim that “engaging in homosexual activity” is one of the behaviors “primarily responsible for contact with the AIDS virus.” Individually, the most we can do to address this disparity is VOTE for those that hold our values and seek to increase sex education for all, including Black gay males. Until then, self-education and community sharing of facts and not fear is one way we can help reduce the infection rate and disprove the predictions. Stigma around HIV stems from a lack of education but also a fear of the unknown. This virus has been with us for over four (4) decades. It is horrifying that we are still at the starting line for educating most of the American population.
Condom usage
The myth has been that Black gay males don’t use condoms. Studies have proven that compared to their white counterparts, Black gay males use them more often, but the issue is one of “user error”.
“According to our data, condoms may be used more frequently by black (men who have sex with men), but they are also used less effectively and with more errors,” the researchers write in the journal Sexually Transmitted Infections.
“Researchers also found that Black men were more likely to report incorrectly using condoms, compared to white men. For example, black men were more likely to completely unroll condoms before applying them and were also more likely to use oil-based lubricants, which can weaken some condoms and cause them to break. Black men were also more likely to report issues with how condoms fit or felt.”
The truth is that no guy really loves using condoms but they do add a level of protection against HIV. Proper sex education in school about how to use a condom would solve this problem but also purchasing better quality ones, if they can be afforded, and HIV organizations and governments, like the City of New York, providing a variety of sizes to choose from would also reduce the rates of infection while increasing the pleasure of the user, making him more likely to use a condom in the future.
No conversation about condoms is complete without discussing lubrication. As the researchers above found, oil based lube is very bad for rubbers. Not enough guys know this. Water and silicone are the best and you must use a good deal when having anal sex. Condoms should be changed at least every 13 minutes of sexual intercourse, and never used with more than one partner.
PrEP
The new miracle pill that too many white gay men tried to stop from being circulated could have been stopping HIV infections for years now. Making matter much worse, many American doctors are not aware of this medication, which means they cannot recommend or prescribe it to high risk patients like Black gay males. According to the Centers for Disease Control and Prevention, one in three primary care physicians and nurses have never heard of PrEP, the medicinal strategy proven to prevent HIV-negative people from contracting the virus when taken correctly. Could this be why nearly 60 percent of gay/bisexual men are also unaware of PrEP, as the Advocate has reported? Black gay males’ knowledge and access to this medication is limited by not only their personal financial resources but also a system that is convinced it does not exist.
Making sure that conversations about the facts regarding PrEP and how effective it is in preventing HIV infection should be a mantra for every HIV/GLBT organization and governmental healthcare agency. This medication should also be provided to high risk groups at a very low cost. States could also follow the example of Florida, yes Florida, and provide the medication for free. Many don’t even know that the makers of PrEP, Gilead Science, have a program which provides eligible guys the medication for free. Now it is even common for major health insurance companies to pay for PrEP. Yes, it is expensive but there are various ways to obtain this medication.
We recommend all sexually active gay males get tested every three (3) months for HIV and all other STDs. This can be an issue for many Black gay males if they are without health insurance, a primary care doctor they trust or are able to leave work/school for the time it takes to get the tests and return for the results. But these are the hard choices we must make as men in this world. Many major cities have mobile testing units that are operated by HIV organizations that may also offer other long-term services for those who test positive. But even if you test negative, the work does not end here. It is important to think about how you stayed negative (dumb luck or active work?) and how to continue this outcome.
Coverage:
- Free at many GLBT centers/organizations
- Free at mobile testing sites
- Many hospitals have free clinics
- Medicaid is available for working adult males without insurance
Testing Positive:
- Getting an HIV specialist or doctor with experience treating HIV is important
- ADAP, The AIDS Drug Assistance Program, provides coverage for doctors visits and a host of medications, for free!
- Creating a support network of friends/family or joining a group is helpful
- Taking your medication as directed and getting to Undetectable
- Reduce/stop smoking cigarettes
- Reduce/stop illegal drug usage
Testing Negative:
Even if you test negative for HIV, or any other STD, one test is not the end of the story. The goal is to stay HIV free. This mean watching your behaviours and taking responsibility for your overall sexual actions and health. Getting the facts about HIV may seem hard but, now more than ever, the truth is out there. The Internet holds a wealth of information and should be used for more than just finding your next hook-up, take out delivery or Uber.
Govt/Non-profit/HIV/GLBT organizations
No man is an island. Too often we speak in large generalizations about minorities, especially Black gay males. But they are individuals with different backgrounds, levels of education, sexual habits and experiences. These organizations need to learn to adapt and become better partners for Black gay males. This means creating programming that suits their needs, not those of the organization’s first. One size obviously has not been fitting all, as the number of gay males contracting HIV in general has been rising in many states. But comfort should be taken from cities like:
New York, where the state has done things like increase the number of needle exchanges and send out teams to educate doctors on the use of a drug approved in 2012 that staves off infection, known as PrEP. It has also tried innovative approaches, like placing geo-targeted ads on homosexual dating apps like Grindr and Adam4Adam and offering users at-home H.I.V. tests.
and Washington D.C. where the government has increased involvement and provided an active listening ear which has shown a stark decrease in infection, including for Black gay males. The 74 percent decline in new cases — from 1,333 in 2007 to 347 in 2016 — can be attributed to factors that include a needle-exchange program, condom distribution and increasing use of preventive medication to halt the spread of the disease, city officials say. To be clear The District is still in a state of an HIV/AIDS epidemic but at least they are fighting back!
But our non-profits have a very long way to go to earn back the mantle of being leaders in HIV education and prevention. As VICE reported back in 2016, an arm of AIDS Project Los Angeles (APLA), revealed that only 1 in 10 young Californian men who have sex with men (MSM) have used PrEP, the HIV-prevention therapy that can be 99 percent effective in reducing transmission during anal sex with daily use. This was in part due to the tireless work of Michael Weinstein, the president of the AIDS Healthcare Foundation (AHF) who is a major opponent of PrEP, spending large amounts of donated cash and government grants to fight its rollout. Even in major cities like New York and Chicago, GLBT organizations have become great at raising money but not very effective in slowing down and halting the spread of HIV in gay males. Some basic changes that can assist Black gay males are:
- Hiring QUALIFIED Gay (Black) males of colour in Executive management positions
- Create programming that is specific to the needs of gay males
- Create programming that is culturally educated not allegedly “sensitive”
- Hire Gay Black males for intake with clients
- Hire gay males with actual community participation experience
- Ask questions and LISTEN to the answers given and provide services as needed
- Learn about the real lives of gay males, not foster up stereotypes and caricatures
- Create programming that is more than just “Youth” focused
- Re-tool resources to allow for variable hours of operation for HIV testing, education and treatment
- Educate staff and clients about the factual effectiveness of PrEP
- Promote #UequalsU and the science of ZERO chance of infection
- Speak to Black gay males the way you would white people; with compassion, understanding, and giving the benefit of the doubt to their words and experiences.
One final note about Non-profits. They are funded by the government, donations and foundations. These foundations also need to change how they fund organizations and which ones they support. Bigger and older doesn’t mean better. The world changes fast and new ideas need to be funded to keep up with them. Most non-profits have little to no substantial Internet presence and provide no information about HIV treatment, prevention or STD information, leaving guys helpless until the next business day. Grants need to be distributed based on real life function not old school methods which are proven to not work.
Live Your Life
No matter our race, we all face challenges based on homophobia. Yes, racism is an added stressor but we can all find strength in our heritage to overcome this obstacle just like our ancestors survived much worse. The predictions of the demise of the Black gay man are just as much a wish by some, as a scare tactic. But there is no crystal ball that has shown your future HIV status. You have all of the control and power in that. Educate yourself, face your fears and stay negative. If you are positive or convert, remember that your life is not over, take your meds, get to undetectable and keep joy in your heart. The rumours of our demise have been circulating for hundreds of years, yet we are still here. Don’t stop now just because the message showed up on a Tweet. You can do this.
Black Boy Joy!
If you would like to read more from our site about Black Gay males and HIV:
Tags: Black gay male, condoms, HIV, HiV Education, HIV prevention, HIV testing, PrEP
