Black Men Who Have Sex With Men At Disproportionate HIV Risk

(This article has been ripped off from sourced from this report.)

By the time a black gay man is 25, he has a one in four chance of having HIV. By the time he’s forty, he has a 60% chance of being infected with HIV. 

Black men who have sex with men are the only population in the United States where HIV infections are significantly increasing; the rate of new HIV infections among black men who have sex with men rose 20% from 2006 to 2009, and an astonishing 48% among young black men who have sex with men. Black gay and bi men are 1 in 500 Americans but 1 in 4 new cases of HIV. It starts very young: black men age 13 to 24 are 14 times more likely to be diagnosed with HIV than white men of the same age.

The obvious explanation for black men who have sex with men being more likely to be diagnosed with HIV is that they have riskier sexual behavior. However, studies suggest that this isn’t actually the case; in fact, black gay and bi men may be slightly more likely to take appropriate safer sex precautions than white gay and bi men. While certain sexual behaviors that black gay and bi men tend to practice contribute to their HIV risk (in particular, the early sexual debut and the tendency of many young black gay and bi men to have older partners), these behaviors do not provide the full explanation for why black men who have sex with men are far more likely to contract HIV.

Part of the explanation is that black gay and bi men tend to have sex with other black gay and bi men, who are more likely to have HIV and other STIs. It’s a self-perpetrating system. Even safer sex behavior is riskier if a quarter of your partners are HIV-positive. In addition, having other STIs can make it more likely that one gets infected with HIV. However, even that isn’t the full explanation: a lot of it comes down to the intersection racism, homophobia, and poverty.

Black men face racism, poverty, and homophobia, all affected by their gender. They are more likely to be unemployed, to experience violence, to become homeless, to be incarcerated, to have traumatic experiences, to endure childhood abuse, to have a poor education as children. All of these reduce the ability of black gay and bi men to access health care. If you’re not sure where your next meal is coming from, you’re not going to pay for an HIV test. If you’re homeless, you’re probably not able to maintain the extensive pill-taking schedule necessary to treat HIV.  This disparity is clearly evident in the data. Black gay men are less likely to be tested for HIV, to receive appropriate and timely care if HIV-positive, and to be given antiretroviral therapies (the last is particularly important, since it may prevent transmission). Black gay men are more likely than white gay men to have undiagnosed HIV.

Another reason that black men who have sex with men may be less likely to get treatment is the lack of culturally competent health care. Because of their race and sexual orientation, gay and bi black men may not necessarily trust that their provider will listen to them, not be racist or queerphobic, and to take them seriously. Many health care workers have not been trained to treat race and sexual orientation issues with sensitivity: for instance, many may not be familiar with orientation terms more popular in the black queer community than the white queer community (such as “same-gender-loving”) or with the particular ways that racism, queerphobia and HIV stigma manifests itself for queer black men.

But racism doesn’t only affect health care access. HIV prevention dollars are overwhelmingly spent on white people. Even though black men who have sex with men have been disproportionately likely to have HIV since the disease was called Gay-Related Immune Deficiency Syndrome, HIV is still stereotyped as a “white gay man’s disease.” While there have not been sufficient accountability studies done of how prevention dollars are spent, the studies that have been done suggest that a disproportionately small  amount of money is spent on queer people of color– even on basic initiatives such as testing.

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Ozy Frantz is a student at a well-respected Hippie College in the United States. Zie bases most of zir life decisions on Good Omens by Terry Pratchett and Neil Gaiman, and identifies more closely with Pinkie Pie than is probably necessary. Ozy can be contacted at [email protected] or on Twitter as @ozyfrantz. Writing is presently Ozy's primary means of support, so to tip the blogger, click here.

Comments

  1. The Wet One says:

    Ahhhh….

    The joys of being black in the U.S.

    It’s wonderful isn’t it?

  2. I’m surprised to not see any addressing of men who have sex with men but maintain that they are straight. Men in this group are less likely to use barrier during sex because doing so would give a sense of legitimacy to something that they feel guilt and shame for doing and less likely to get tested for HIV or any other STD, both out of fear that their test will come up positive and out of fear that someone will find out that they got tested and suspect that they are gay. While these issues affect closet cases of every race and ethnicity, black gay men have more to lose and less to gain by coming out than white gay men do, to say nothing of the stereotype that gayness is a “white” thing.

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  1. [...] in urban areas, continues to rise. (It’s also important to remember the ways that AIDS disproportionately affects some marginalized groups, such as young black men.) However, some new developments in HIV prevention have offered some new [...]

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