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AIDS group calls for end of marginalization of the black gay population

“It is a national tragedy that the AIDS crisis has continued unabated in the African-American community for so many years.”

— Beny Primm, M.D., chair emeritus, National Minority AIDS Council

A new report released Thursday by the National Minority AIDS Council (NMAC), “African Americans, Health Disparities and HIV/AIDS: Recommendations for Confronting the Epidemic in Black America,” examines and makes recommendations on how to close the gap on the sorry statistics in the black community regarding HIV/AIDS.

Since the beginning of the HIV/AIDS epidemic 25 years ago, African Americans have been overrepresented among those living with and dying from AIDS. The disease continues to affect African Americans more than any other racial/ethnic group in the United States. Today, African Americans comprise only 13% of the U.S. population but account for over half of all new HIV/AIDS diagnoses. Over 200,000 African Americans have died of AIDS, half a million are now living with HIV and blacks are 10 times more likely than whites to have AIDS. Confronting this national health disparity is a paramount concern.

NMAC put out this document in advance of World AIDS Day, which is on December 1; it makes strong recommendations to tackle the problem, and some big names — 30 leaders in the black community — have signed on to this report. Their voices are sorely needed to address the silence — and outright homophobia — that is exacerbating the spread of HIV. The list includes:

* Delegate Donna Christensen, (D-U.S. Virgin Islands)
* Representative John Conyers, (D-MI)
* Robert E. Fullilove, Ed.D., report author, Columbia University
* Representative Barbara Lee, (D-CA)
* Representative Juanita Millender, (D-CA)
* Dr. Beny Primm, M.D., Chair Emeritus, NMAC
* Representative Maxine Waters, (D-CA)
* Phill Wilson, Founder and Executive Director, Black AIDS Institute

One of the five policy solutions targeting the disproportionate impact HIV/AIDS is having on the black community addresses the long-standing homophobia that drives black men deep in the closet about their often unsafe, same-sex encounters, while in relationships with women completely unaware that their health are placed at risk.

* Eliminate marginalization of, and stigma and discrimination against, black gay and other men who have sex with men (MSM). African-American MSM is the population hardest hit by HIV, with diagnosis rates twice that among white MSM. Yet currently there is only one HIV prevention program that has been specifically designed for black MSM. Investing in research to implement interventions for black MSM is essential to reversing the epidemic in this population. Promoting leadership among black MSM and sustained capacity-building investments in the organizations that serve them is critical. Efforts to address homophobia and related stigma, discrimination and violence – all of which increase HIV risk among black MSM – are also needed.

The other recommendations:

* Reduce impact of incarceration as driver of new HIV infections. – AIDS cases among incarcerated persons are more than three times that of the general population, and African Americans are disproportionately represented in U.S. prisons. Outdated and inconsistently implemented HIV prevention policies have failed to reduce risk behaviors among prisoners while incarcerated and after their release. Providing routine, voluntary HIV testing for prisoners upon entry and release; making condoms available in correctional facilities; expanding re-entry programs to help prisoners transition back into society; and ensuring that their HIV prevention, substance abuse, mental health and housing needs are met prior to release are key to stopping HIV’s spread in the African-American community.

* Reduce role of injection drug use in sustaining the AIDS epidemic. – Among blacks, one in five (19%) new HIV infections is attributed to the sharing of contaminated needles through injection drug use. Reducing the role of injection drug use in the spread of HIV will require an increased investment in education and substance abuse programs designed to prevent people from using injection drugs in the first place and help current users to quit, and establishing needle-exchange programs to minimize the risk of infection from sharing needles.

* Expand proven HIV prevention, diagnosis and care programs. – Far too many African Americans lack accurate information about how HIV is transmitted, prevented and treated. Approximately 250,000 Americans – many of them African American – are unaware that they have HIV. These individuals are not receiving life-saving medical care and may unknowingly transmit HIV to sex- and needle-sharing partners. In addition, African Americans are diagnosed at later stages in the disease more often than other racial/ethnic groups, diminishing medications’ effectiveness. Many African Americans also distrust the medical establishment, which only adds to the problem. Establishing and expanding corps of community health workers is a proven, effective and critical bridge between physicians and patients where mistrust of the health care system exists.

* Stabilize communities by increasing affordable housing. – The scarcity of affordable housing faced by many African Americans is at the center of a web of interconnected socioeconomic problems affecting the black community, such as residential segregation, school failure for children and a lack of access to health care, including HIV prevention, diagnosis and treatment services. Stabilizing black communities by expanding federal housing programs, such as Housing Opportunities for Persons with AIDS (HOPWA), is central to stemming the African-American AIDS epidemic.

The full report is here.

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Pam Spaulding

Pam Spaulding