black queer men contract hiv/aids at epidemic levels

The CDC announced last Thursday that the city of Atlanta “remains in an HIV/AIDS health crisis and ranks fourth in the nation for new HIV diagnoses.” This statement comes two years after Dr. Carlos del Rio, the co-director for Emory Center for AIDS research stated “Downtown Atlanta is as bad as Zimbabwe or Harare or Durban .” 

The correlation of an African epidemic to a Black American one paints a portrait of HIV that is disingenuous on its face. As someone who has worked in the field, the African epidemic rarely comes up when discussing HIV in the United States. Using the African epidemic as a barometer is a fear tactic, and a way to further stigmatize Black men with higher infection rates in the United States. Furthermore, it is anti-Black to use the African epidemic as a way to fear monger Black Americans at risk for HIV in a way that says “you don’t want to be like them.”    

Suffice to say, my response to all of this is pretty simple: We been knew.  The truth is  that HIV has never left our community and continues to be an epidemic not only in centralized locations, but across the board spreading over various demographics. One can’t be fooled into thinking that just because it doesn’t look like the “death sentence” it once was, that we have moved to a place where it is still not a priority. HIV is still a death sentence for many, especially globally. In the States, there are still people who either don’t have access or are so deeply stigmatized that they refuse to seek treatment when needed. I’ve seen people from all walks of Black community, despite class and gender be harmed by this stigma.

HIV is still a complicated subject in Black in communities. Although Black men who have sex with men are contracting the virus at epidemic level rates (50% of Black msm’s will contract over their lifetime), Black women are also one of the highest carriers of the virus and still being infected at high levels. This mistruth about the virus is part and parcel why the virus has never left our community. There has never been a point in this country where the healthcare system was something to be trusted by Black people. From the beginnings of enslavement in this country, Black folks were used as guinea pigs for experiments and treatments in this country. It is not lost on us what was done to Black men during the Tuskegee experiment.—where syphilis treatment was withheld from Black men for more than 30 years, affecting generations of families. The story of Henrietta Lacks, and theft of her cells known as “Hela” that have been used to fight cancer and create some of the first HIV AZT cocktails, while never gaining consent for use and making billions in profits while her family struggled for generations after. When the epidemic first started, the Reagan administration completely ignored it, and wouldn’t even use the acronym HIV until three years after it began and thousands had already died. Such continued ignorance of the epidemic was part and parcel, as the communities it infected the most were gay and Black, and simply not seen as a priority. So mistrust grew.

But even among those who know their community is infected at higher levels, there remains a stigma that prevents people who are HIV negative or unknowing of their status to get tested—and those who are positive, to seek treatment or care. We often talk about people needing “access”, which is still true, especially in places hit hardest by the epidemic. What we rarely talk about is utilization of services after access has been created, which is tied to a much deeper history of discrimination in healthcare towards Black people, based on the intersections of race, gender and sexuality.

We have also seen how healthcare discrimination plays out in other ways for our community when we look at the intersections of race and gender. Black women dying from pregnancy at more than four times the rate of white women. Black folks being refused pain medications by doctors who don’t believe we are in pain, or assume our threshold for pain is much higher than other races. When we see these atrocities played out daily, it does something to us—creating mistrust with the healthcare community that forces many Black people to only seek medical attention when the situation is dire. This means even when access is provided, utilization of those services is still at a low level because of the history of mistrust. Even in my own experience, when I worked for Us Helping Us in Washington D.C., people in the community referred to our building as the AIDS building. This type of stigmatizing prevented people from entering the front doors. This must change.

Being public about my own HIV positive status, I am asked questions all the time by Black and brown folks around the world about the virus. I was shocked with some of the antiquated ideas we still hold about the HIV: I was rendered shocked at how many people still think you can get HIV from kissing or saliva exchange, or who are unsure about how the virus is transmitted in general, or who use HIV and AIDS interchangeably. Lack of knowledge around the virus prevents people from taking agency in their own healthcare. You can’t fight what you don’t understand or know. As easy as it is to drag the healthcare industry, we must talk solutions. Cultural competency has become the new buzz phrase in how “we get white folk to understand the issues of Black and brown folks” but it’s much more than just competency. Our community has been so harmed that in places and spaces it has become damn near irreparable. This means the medical industry must meet people where they are, which could even mean in their own homes. Creating access is null in void for the person who won’t ever leave their home to seek healthcare because of the aforementioned circumstances. The trust between the Black community and the healthcare industry has been severely damaged, but it isn’t irreparable. To build that back would take an effort by the healthcare industry to show change around the treatment of conditions that primarily affect Black communities. And although on a macro level we are seeing attempts at defunding of HIV research and prevention, we can’t let that affect the micro level work that needs to be done to truly combat the epidemic. Healthcare should feel like home. It shouldn’t be a place that immediately strikes fear in people. Folks should feel safe when visiting their provider for any type of care, as it often times people are most vulnerable when in that setting.

Atlanta, GA is the home of the CDC both metaphorically and literally—the institution rests in the heart of the city. For the epidemic to be in the city’s own backyard speaks volumes about the disconnect in care and services of healthcare and the populations it serves. HIV is a virus that we can beat. However, it will require the regaining of the trust that has been lost with the healthcare community, and a concentrated effort to save a community where the epidemic never left.