Black men who are gay or bisexual are "at the center" of the U.S. HIV/AIDS epidemic and should be a primary focus of testing, service and treatment efforts, a federal official and advocates said Wednesday.
Black men who have sex with men (MSM) account for one in four new HIV infections, even though they represent only one in 500 Americans, the Black AIDS Institute said in its new report, "Back of the Line: The State of AIDS Among Black Gay Men in America 2012."
This infection rate climbs quickly with age for these men: The odds of a black MSM becoming infected with HIV is about 8 percent at age 20 and nearly 60 percent by age 40.
Moreover, unless they receive treatment, black MSM "are significantly less likely to be alive three years after testing HIV-positive," when compared to white MSM, said the report.
Black MSM "continue to be first in line when it comes to need, but remain at the back of the line when it comes to assistance," said Phill Wilson, founder and executive director of the Black AIDS Institute.
"We need a new mindset," Dr. Kevin Fenton, director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at the Centers for Disease Control and Prevention, told a media briefing at the Kaiser Family Foundation in the District.
Black MSM "are not simply a fringe group in the fight against HIV/AIDS," said Dr. Fenton. "They are, in fact, at the center of the nation’s epidemic, and we cannot achieve an AIDS-free generation, or the end of AIDS in the United States, unless we make major inroads in the fight against HIV among black gay men."
Panelists talked about stigma, homophobia and other heightened risk factors for black MSM.
Research indicates that black MSM "are no more likely to engage in HIV-related risk behaviors than other MSM," said Ernest Hopkins, chairman of the National Black Gay Men’s Advocacy Coalition and director of legislative affairs at the San Franciso AIDS Foundation.
But they are associated with risk factors such as early sexual experience, having older sex partners, being molested as a child, being incarcerated, growing up in poverty, homelessness and suffering discrimination, said Mr. Hopkins.
There’s a feeling "that it’s not safe [for us] to come out … to live our lives authentically," said Wade Davis, a former National Football League player who now works with sexual-minority youth at the Hetrick-Martin Institute in the District.
"I remember when I was playing with the NFL the shame that I felt about being a gay black man," said Mr. Davis, who played defensive back for the Tennessee Titans, Washington Redskins and Seattle Seahawks. "It really prevented me from having other black male role models for me to look up to."
Looking back, he added, it would have been good if there had been "someone there for me, to talk to me, to help me understand that being who I was was OK."
But growing up in the South, "I heard so often that being gay was never going to be accepted, so I pushed myself to the margins of society," where it was easier to engage in risky behaviors, he said.
The report calls for stepped-up HIV testing, prevention and treatment for black MSM populations, as well as campaigns about reducing sexually transmitted diseases.
"We are very, very excited" about the new Food and Drug Administration approval for Truvada, said Dr. Fenton, referring to a daily pill that prevents most HIV infections when used by HIV-negative persons who engage in high-risk behavior.
The Black AIDS Institute report also ranked 25 cities on their ability to address HIV/AIDS among black men. New York City; Washington, D.C.; and Los Angeles were ranked as the best, while Gary, Ind.; Memphis, Tenn.; and Richmond, were ranked the lowest.
The report is released days before the July 22-27 19th International AIDS Conference convenes in Washington, D.C.
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