About half of black gay men in America will be infected with HIV at some point in their lifetimes, according to a recent Centers for Disease Control and Prevention (CDC) study. That frightening statistic is surprising to many, as public perception in the U.S. is that HIV has largely been eradicated here. But for those who work in HIV research and advocacy, it’s not a surprising number at all.
For most people facing the disease, HIV is no longer seen as a death sentence but as more of a lifelong, manageable illness. Yet the policy and program efforts for treating and preventing the disease haven’t always extended fully to communities of color. The high rates of HIV among black gay men can be traced back to factors including stigma in the community, lack of health care and few community resources. The organizations and funds that are available often don’t go far enough or aren’t adapted to best serve the population.
“There needs to be a peer-to-peer health-care infrastructure in place that touches every single delivery point,” says Phill Wilson, president of the Black AIDS Institute, which works to stop the AIDS pandemic in black communities. “Often we’ll see community health programs where other gay black men are helping out at the screening and testing phase, but not in the health-care delivery phase -- which is the most vital.”
Alameda County, Calif., is hoping to change that. It was awarded state funds in March to improve coordination with community members and providers regarding pre-exposure prophylaxis (PrEP), a pill that can be taken to prevent an HIV infection. Community members, called “navigators,” will help those most at risk -- largely black gay men, especially in Oakland -- get access to PrEP.
Meanwhile, in Los Angeles County, the nonprofit AIDS Project Los Angeles is refocusing its efforts to adapt to the changing face of the AIDS patient. The project recently opened clinics in traditionally African-American and Latino neighborhoods that focus on increasing the use of PrEP.
Nick Moss, director of the HIV/STD unit at the Alameda County Public Health Department, acknowledges that there has to be a change in how public health entities approach HIV prevention and care in more urban areas. “We’re a government entity, so it’s important that we’re not barging in and telling people what to do,” he says. “We really want to make prevention efforts community-focused so we can best understand needs and challenges.”
One bright spot is that the CDC study could bring much-needed attention to the issue from public officials who dole out money and resources to health agencies. Officials at AIDS Project Los Angeles say they’ve heard that the CDC report has been circulating in Sacramento, so they’re hoping that state legislators will act soon to fund efforts like theirs. “We have an opportunity to address HIV in these communities in ways we haven’t before,” says Moss. “We know we can do a better job testing people; we know we can do a better job keeping people on treatment.”
The impact of the CDC report is good news to Wilson of the Black AIDS Institute. “I was diagnosed with HIV when I was 26, and my doctor told me to get my will in order because I wasn’t going to live to my 27th birthday,” says Wilson. “I’m about to celebrate my 60th birthday. So I’m always optimistic that something will lead to a breakthrough within our population.”