Bias Behind Higher Rates of HIV in Black Gay Men?

Matt Schafer, Southern Voice, January 30, 2009

Gay and bisexual black men in America are the most likely people in the world to contract HIV, and community advocates say current efforts to stem the epidemic aren’t working.

“Gay black men are more likely to contract HIV than any other population in the country,” said Caudie Grissom, a counselor with Atlantabased National AIDS Education & Services for Minorities. “Even with all of our modern technology and medication, American black gay men are more likely to have HIV than people living in third world countries.”

NAESM sponsored the fifth annual National African-American MSM Leadership Conference on HIV/AIDS. Held Jan. 22-25 in Atlanta, it attracted hundreds of community organizers and activists from across the country. Asked why the rates of HIV and AIDS are higher among black men who have sex with men, answers ranged from poor federal services to stigma and discrimination within a mostly white medical profession.

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[Ernest] Hopkins is a vice-chair of the National Black Gay Men’s Advocacy Coalition, an organization that lobbies in Washington on gay health issues. Hopkins said major obstacles to lowering HIV rates among black men who have sex with men include a lack of research on HIV in the black community; prevention and health care models based on the idea that gay men live openly in communities like Midtown; and a shortage of doctors who are well-versed and comfortable treating black gay men, HIV positive or not.

In 2005, a five-city study conducted by the Centers for Disease Control & Prevention showed that of the gay and bisexual men who were surveyed, 46 percent of black men were HIV-positive. This meant black men who have sex with men were nearly twice as likely to be infected with HIV than other gay and bisexual men.

“There is really nothing out there for the black gay community, and that’s really an indictment on the CDC, on HRSA [Health Resources & Services Administration], on every level of HHS [Health & Human Services] and the other structures that are providing programs,” Hopkins said. “We just have not been prioritized. That’s due to homophobia and racism, just very clearly that’s it.”

Different community

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Gay identity is a larger question within the black community than in others, said participants at the conference. NAESM chose to use the term MSM, which stands for men who have sex with men, because it wants to reach black men who have homosexual sex but do not consider themselves gay.

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Hopkins called on successful African Americans to leave their high-level jobs to start nonprofits because there aren’t enough agencies out there to stem the infection rate in the black community.

Discriminating doctors?

“There was a study last year in New York City that talked about black gays were less likely to come out to their doctors than white gays, and therefore less likely to be tested for HIV,” Baker said. “What that study didn’t talk about is that there were very few black gay doctors for people to go to. Most of the white gay men in the study were going to white gay doctors.”

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Black men feel what Malebranche [David Malebranche, a physician and researcher at Emory University’s School of Medicine] called “racial stress,” sexual prejudice, gender role expectations and difficulties in the medical culture.

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Malebranche said that black men, especially on the lower end of the income scale, have difficulty finding doctors they feel comfortable with who understand the unique health risks that gay men face.

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Another factor could be a disproportionate amount of depression among black men. Dr. Linda Smith of NAESM said that 70 percent of black gay men develop some level of depression during their lives and most will not seek treatment.

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