While the lifetime risk of a positive HIV diagnosis has fallen from 1 in 78 Americans overall in 2005 to 1 in 99 today, the decline has not been distributed equally among the U.S. population. For the foreseeable future, the CDC estimates that gay, bisexual, black and Hispanic people will continue to bear the brunt of the HIV epidemic. The new study is the first time that the CDC has estimated lifetime HIV risk based on race. This was part of a story which was reported on by Samantha Allen of the Daily Beast.
In the last 24-hours I have seen many people's opinions about what this means and going a step further to determine why this is the case. This was part of a response which was provided by Charlay Banjee
"What I've been thinking is that no where in the CDC report does it point to the following as factors of HIV contraction for Black MSM: stigma, racist medical practices, heteronormativity, lack of self-efficacy, historical lack of cultural competency especially in consideration of intersectionality within msm populations, economic disenfranchisement, lack of Black-led health centers (non profits and hospitals/clinics included), HIV medicine-induced illnesses...
Also missing is how "msm" communities and practices therein have specific needs that no universal plan of action can "fix." The myopia of using "msm" as an all-inclusive label speaks to the laziness of the CDC in recognizing that Black queer- and straight- identified people are complex. Black DL men do not have the same concerns as openly gay Black men. Some "men" do not identify as men. The young do not live as the older. Those who try to claim risks for a community need to know the community. The CDC does not know.
Reports like this increase the anxiety that perpetuates the same behavior that puts ppl at risk for contacting HIV. Dr. Jeffrey McCune said it best that we need paired with these reports possibilities of getting toward a lower rate of contraction. Also, the panic over the 1 in 2 number, though understandable as we want fewer people contracting HIV, speaks to our overall internalized stigma of the virus and too shows rightfully so what little faith we have in current modes of prevention. It's a thin line: prevention for health's sake versus prevention for alleviating our own fear.
We can do the work but I'm not sure we know anymore what that work looks like because for so long it has been the antithesis of Black radical empowerment. I don't have the answers, and it's ok that we don't. We've yet to be honest enough."
Also missing is how "msm" communities and practices therein have specific needs that no universal plan of action can "fix." The myopia of using "msm" as an all-inclusive label speaks to the laziness of the CDC in recognizing that Black queer- and straight- identified people are complex. Black DL men do not have the same concerns as openly gay Black men. Some "men" do not identify as men. The young do not live as the older. Those who try to claim risks for a community need to know the community. The CDC does not know.
Reports like this increase the anxiety that perpetuates the same behavior that puts ppl at risk for contacting HIV. Dr. Jeffrey McCune said it best that we need paired with these reports possibilities of getting toward a lower rate of contraction. Also, the panic over the 1 in 2 number, though understandable as we want fewer people contracting HIV, speaks to our overall internalized stigma of the virus and too shows rightfully so what little faith we have in current modes of prevention. It's a thin line: prevention for health's sake versus prevention for alleviating our own fear.
We can do the work but I'm not sure we know anymore what that work looks like because for so long it has been the antithesis of Black radical empowerment. I don't have the answers, and it's ok that we don't. We've yet to be honest enough."
As a person who has worked tirelessly regarding HIV education and prevention the statistic was not surprising. Additionally it is a known fact that HIV prevention occurs in cycles. The money and focus was on white MSM early on and then their numbers started to drop. Then the money and focus gets moved to the next group. We know that there are social inequalities which contribute to HIV exposure. Poverty, lack of education, drug use and the list goes on. What is the answer?
CDC data collection and reporting leaves a lot to be desired in every realm of epi-data. The purpose of the data which was reported at CROI was to sound an alarm, which those of us working in HIV prevention, has already known. Human behavior is very dynamic and complex. That being said, communities of color will have the best chance of tackling HIV rates in their own communities. "Nothing about us, without us." This is why we have been trying to engage the faith-based communities and leaders to take the lead on HIV. This has been something that many will not do. When was the last time that we heard Reverend Al Sharpton talking about HIV infection rates in the black community?
Dr. Jeffrey McCune shared his thoughts regarding the announcement of the data by saying, "Scientific Racism is when scientists predict 50% of "black gay men will have HIV" before it even acknowledges that we exist outside a larger white gay paradigm. Consequently, suggesting something to the tune of "if you black and gay HIV is inevitable, just cause you black and gay." And to that point, scientific racism is when such predictions aren't immediately followed up with preventative measures to curb such probability. Finally, I am curious as to what such predictions do in terms of discouraging HIV-testing and conjuring all types of anxieties around sex and sexuality within the black gay community, as well as the impact of such salacious news within the communities in which they live, reside, and love."
Please let me know you thoughts regarding the release of this study and this data...
