It’s World AIDS Day and I’m going to make you uncomfortable. It seems as if everyone is pissing each other off intentionally these days and I promise you that is not my goal. But as you’ve come to expect, on Ask the NP I keep it 100 and do my best not to sugarcoat. Especially with something this important.
I am no nationalist. In fact, quite the opposite. But on this World AIDS Day, I must bring awareness to the AIDS crisis in America—a crisis many aren’t even aware exists.
Recent data suggests that 50% of all gay and bisexual black men in the United States will contract HIV in their lifetime. 50 fucking percent.
“If gay and bisexual African-American men made up a country, its rate [of HIV] would surpass that of…all other nations.” Truth bomb courtesy of Linda Villarosa from her exceptional The New York Times Magazine piece “America’s Hidden H.I.V Epidemic.”
One in five American black men with HIV don’t know they have it until it has progressed to full-blown AIDS. These men often arrive at the hospital near death, requiring long stays in the intensive care unit and heroic measures to save their lives. Heroic measures that often don’t work.
I know this first-hand. I’ve seen these men die under my watch in the ICU. A 26-year-old should not die a horrible, painful, messy death from a disease that is 99% preventable. But he and others continue to die simply because they are poor, gay, and black.
Yes, I went there. And yes, this is a race issue. And a class issue. And a sexuality issue. It’s easy for us to ignore poor, gay, black men. That’s what we’ve done historically as a country, right? Oh, wait, my bad… Remember reading about all those gay black men in your school history books?
Yeah, me neither.
While rates of HIV diagnoses have plummeted among gay white men, heterosexual white men, and even heterosexual black women in the U.S.—along with many previously devastated countries all over the world—they continue to rise at an astronomical rate in the community of gay and bisexual black men.
The coordinated efforts of well-meaning U.S. and international health organizations focus on the global crisis while one of the worst AIDS crises’ on the planet is essentially ignored. The one right here in ‘Murica. The one in our own backyard.
Actually, it’s in our front yard. In our living rooms. In our churches and our boardrooms. In our emergency rooms. On our dating apps and in our clubs. In our bedrooms. Because gay and bisexual men of color are everywhere…everywhere except the broader historical discourse about HIV prevention and treatment.
This is not to say that there aren’t a ton of local and national organizations doing amazing grassroots work and making a huge difference. But these groups, particularly local organizations, are often strapped for resources and significantly (and intentionally?) underfunded by conservative state and federal agencies. This changed for the better during the Obama administration, but you can imagine how quickly the tide has turned under Trump.
HIV and AIDS in the U.S. is no longer an urban gay white male issue, but a Southern rural/small town poor gay black issue. Most new HIV diagnoses among gay black men occur in the South and in smaller urban or rural areas.
My friends with HIV (including the black men) generally have at least middle-class income, access to decent healthcare, good support systems, easy access to affordable PrEp, and live in communities where the stigma of HIV/AIDS is a fraction of what it used to be. Because of this, we’ve been lulled into thinking “the crisis is over.”
But that couldn’t be further from the truth. Just because the AIDS crisis isn’t impacting privileged gay white men in Los Angeles the way it did in the 90s doesn’t mean the fight is over for the LGBTQ community.
An AIDS-free generation is possible globally. But to do our part in making that a reality, we must change the discourse, initiate a renewed commitment to vulnerable communities right here in the U.S., and shake off our ridiculous, internalized racist and classist bullshit to save American lives.
“America’s Hidden H.I.V. Epidemic.” The New York Times Magazine, June, 6, 2017. Linda Villarosa. https://www.nytimes.com/2017/06/06/magazine/americas-hidden-hiv-epidemic.html
“Black Americans and HIV/AIDS: The Basics.” The Kaiser Family Foundation, February 7, 2017. https://www.kff.org/hivaids/fact-sheet/black-americans-and-hivaids-the-basics/
The Black Aids Institute. https://blackaids.org/
“Thousands Of Americans Still Die AIDS Every Year.” The Huffington Post, September 12, 2017. https://www.huffingtonpost.com/entry/hiv-aids-deaths-united-states_us_59b6bb38e4b06e4604a22f2c
Check out previous blogs and get in the know!