Host genetic factors play an important role in the outcome of AIDS and are also known to regulate the rate of disease progression.
A genetic variation which evolved to protect people of African descent against malaria has now been shown to increase their susceptibility to HIV infection by up to 40 per cent.
It is one of the reasons HIV is prevalent in Africa and not in Europe. It stands to reason transmission rates would be higher in populations here, without direct relation to conduct.
Some commentators would just like to make it about conduct in a way they do not do when it involves eating, drinking, or smoking.
They don't denigrate heterosexual sex in Africa when that is how it is transmitted there.
HIV is a disease that can not only be managed, but the transmission can be stopped with PrEP in addition to condoms.
It makes a lot more sense to give at risk populations every protection available before marriage.
It is more cost effective than lifelong treatment, and will still cost a fraction of what we spend on all the diseases stemming from hedonistic smoking, drinking, and overeating (> $800 billion annually).
Society goes to great lengths to celebrate heterosexual marriage and, until very recently, refused to acknowledge same sex marriage or relationships between LBGT people.
Same sex marriage encourages fidelity, monogamy and stability.
Testing and PrEP gives young people a better chance to reach marriage HIV negative.
A genetic variation which evolved to protect people of African descent against malaria has now been shown to increase their susceptibility to HIV infection by up to 40 per cent.
It is one of the reasons HIV is prevalent in Africa and not in Europe. It stands to reason transmission rates would be higher in populations here, without direct relation to conduct.
Some commentators would just like to make it about conduct in a way they do not do when it involves eating, drinking, or smoking.
They don't denigrate heterosexual sex in Africa when that is how it is transmitted there.
HIV is a disease that can not only be managed, but the transmission can be stopped with PrEP in addition to condoms.
It makes a lot more sense to give at risk populations every protection available before marriage.
It is more cost effective than lifelong treatment, and will still cost a fraction of what we spend on all the diseases stemming from hedonistic smoking, drinking, and overeating (> $800 billion annually).
Society goes to great lengths to celebrate heterosexual marriage and, until very recently, refused to acknowledge same sex marriage or relationships between LBGT people.
Same sex marriage encourages fidelity, monogamy and stability.
Testing and PrEP gives young people a better chance to reach marriage HIV negative.
8
Disingenuous subtitle to the article. It's written to sound as if gay black men in the U.S. are more likely to have HIV than their counterparts in all other countries -- which is false, and misleading. The article is comparing a projected percentage of gay blacks in the U.S. who MAY one day contract HIV vs the actual percentage of those 15 years and older in Swaziland who currently have HIV.
I don't mean to downplay the seriousness of HIV in the U.S., but this kind of massaging-of-numbers is pretty annoying and distracting to the actual issue...
I don't mean to downplay the seriousness of HIV in the U.S., but this kind of massaging-of-numbers is pretty annoying and distracting to the actual issue...
3
"Why do America’s black gay and bisexual men have
a higher H.I.V. rate than any country in the world?"
Why do Linda Villarosa and her editors headline this fine article with a comparison that couldn't be more apples / oranges? A devastatingly afflicted subgroup, compared to the entire population of Swaziland !
A comparison so apparently mangled inevitably remains front of mind throughout the reading of this nevertheless strong and deeply felt work. And informative, although having got itself into the business of comparisons it doesn't give us much about other potentially comparable subgroups. That isn't really what it is about.
As usual, the comments section offers a fair amount of nightmarish thoughts and ideas. (smdh)
a higher H.I.V. rate than any country in the world?"
Why do Linda Villarosa and her editors headline this fine article with a comparison that couldn't be more apples / oranges? A devastatingly afflicted subgroup, compared to the entire population of Swaziland !
A comparison so apparently mangled inevitably remains front of mind throughout the reading of this nevertheless strong and deeply felt work. And informative, although having got itself into the business of comparisons it doesn't give us much about other potentially comparable subgroups. That isn't really what it is about.
As usual, the comments section offers a fair amount of nightmarish thoughts and ideas. (smdh)
3
The govts fault?
Go to any male on line hook up site and you will see two things. Requests for lots of high risk bare back anal sex. And little to mention of condoms.
There may be requests for you to be negative. UB2. But almost no mention that condoms are required.
In fact in the article No Latex No Love two gay men at an international pride event documented how many men said yes while on line to sex then no to sex once they found out that condoms were required. Virtually everyone declined.
In the late 1990s we were well on our way to virtually eliminating syphilis in the US. Rates of infections within the MSM communitywere dropping like large heavy rocks for the first time.
Then we found a way to Rx HIV so it did not become an automatic death sentence.
At that point the condoms came off and the syphilis rates started to skyrocket.
Go to any male on line hook up site and you will see two things. Requests for lots of high risk bare back anal sex. And little to mention of condoms.
There may be requests for you to be negative. UB2. But almost no mention that condoms are required.
In fact in the article No Latex No Love two gay men at an international pride event documented how many men said yes while on line to sex then no to sex once they found out that condoms were required. Virtually everyone declined.
In the late 1990s we were well on our way to virtually eliminating syphilis in the US. Rates of infections within the MSM communitywere dropping like large heavy rocks for the first time.
Then we found a way to Rx HIV so it did not become an automatic death sentence.
At that point the condoms came off and the syphilis rates started to skyrocket.
15
Transgender women? Does the author mean men who are adopting the feminine gender stereotype that feminists taught us was wrong and forced on girls by "traditional" or "repressive" upbringing? Women without female genitalia? These really men, once known as cross-dressers or drag queens, who hold appeal only to other gay men. Whatever "genitalia" they do acquire will be non-functioning plastic appendages.
Please stop using the term transgender. The only thing I can think of that's more aberrant is Michael Jackson's tragic attempts trying to become "White". These are conditions that should be addressed by limited psychotherapy, not surgery. And some psychological conditions are will be resistant to treatment. It is sad, but it is unworthy of the number of mentions it receives in this once-serious newspaper.
Please stop using the term transgender. The only thing I can think of that's more aberrant is Michael Jackson's tragic attempts trying to become "White". These are conditions that should be addressed by limited psychotherapy, not surgery. And some psychological conditions are will be resistant to treatment. It is sad, but it is unworthy of the number of mentions it receives in this once-serious newspaper.
13
I don't think you understand what being transgender means or is. But I'm glad you posted you opinion here because sometimes I forget what these people have to endure.
9
When the candidates were asked about AIDS among black women in the South..."Cheney replied that he was not aware of the numbers, while Edwards spent more than a minute discussing AIDS in Africa."
Translation: Cheney flubbed the gotcha question and Edwards, no slacker he, touts the progress of the Bush efforts in Africa (presumably) and otherwise doesn't answer the question.
Cheney is evil, right?
And Edwards is such a fine politician. Wasn't he the one who had an affair with his staffer during his wife's battle with cancer?
I still do not understand the failure of Obama to address this crisis during the years when he controlled the entire table.
One more example of Obama "good intentions".
Translation: Cheney flubbed the gotcha question and Edwards, no slacker he, touts the progress of the Bush efforts in Africa (presumably) and otherwise doesn't answer the question.
Cheney is evil, right?
And Edwards is such a fine politician. Wasn't he the one who had an affair with his staffer during his wife's battle with cancer?
I still do not understand the failure of Obama to address this crisis during the years when he controlled the entire table.
One more example of Obama "good intentions".
3
The use of anti-retrovirals has prolonged the lives of AIDS patients, exponentially. HOWEVER, as a medical professional who has been involved in AIDS treatment and management since 1982 in NYC and India, one needs to acknowledge that anti-retrovirals ALSO produce a cascade of co-morbidities, which AIDS patients, using them for more than 15 years, are inevitably facing. This is documented medically and such information is easily found by anyone interested enough in knowing it, and looking behind the artificial screen of "everything is ok with AIDS if you take anti-retrovirals."
In 2009, the NYT published an article entitled, "The Downside of Living Longer With Aids". It covers situations which were then newly seen, developing with AIDS patients who had been on anti-retroviral meds for 12-15 years. These findings have been increasing regularly in the USA, where anti-retrovirals have been used now for over 20 year. Look up " Premature Aging with AIDS", if you want to see how the AMA has characterized this newly evolved issue of AIDS treatment. It has only been recently stated that this multi-faceted syndrome of degeneration of most systems in the body is a secondary effect of anti-retroviral therapy. The author of this article is clearly ignorant about this as she states that AIDS patients live "long and healthy lives ", if on anti-retrovirals. Their lives may be long, but they are definitely not healthy after years on these drugs, in far too many cases.
In 2009, the NYT published an article entitled, "The Downside of Living Longer With Aids". It covers situations which were then newly seen, developing with AIDS patients who had been on anti-retroviral meds for 12-15 years. These findings have been increasing regularly in the USA, where anti-retrovirals have been used now for over 20 year. Look up " Premature Aging with AIDS", if you want to see how the AMA has characterized this newly evolved issue of AIDS treatment. It has only been recently stated that this multi-faceted syndrome of degeneration of most systems in the body is a secondary effect of anti-retroviral therapy. The author of this article is clearly ignorant about this as she states that AIDS patients live "long and healthy lives ", if on anti-retrovirals. Their lives may be long, but they are definitely not healthy after years on these drugs, in far too many cases.
8
I spent two years combating HIVAIDS stigma in rural South Africa as a Peace Corps volunteer and saw the difference PEPFAR was able to make. It is heartbreaking that black gay men in rural Mississippi are so profoundly abandoned and shunned. We should be ashamed of ourselves.
5
In ancient times, diseases commonly associated with hygiene or sanitation were treated separately and led to elaborate rituals with food or diet to ensure that slaughtering procedures or the type of animals were proscribed from diets. This was a logical conclusion that became enshrined in religious practice.
If one were to survey a gay, in particularly gay men, one would find dozens and perhaps hundreds of sexual partners over the course of a lifetime. In our concern for not appearing "homophobic" we diminish the role of hygiene and pivot to the more convenient discussion of religious repression's role in the spread of AIDS among gay men.
When AIDS first burst on the scene I remember feeling terrified: how do I ensure it does not cross my path? Then I sensed a certain relief for the wider population, particularly the risk that it could enter the donated blood supply or jump to females through, again, over-active "bisexual" men. When it was under control, I viewed it as a public health triumph of hygiene and education, not evidence that gay men had become abstinent en masse. Even George W. Bush's efforts in Africa, himself an Evangelical, were laudable and removed one containable blight on the otherwise struggling continent.
How is it that so many years on, we still see this as either an opportunity to treat the only source as racism or religious repression? When will Black men be held to any modest level of responsibility, gay or living in the South or otherwise?
When?
If one were to survey a gay, in particularly gay men, one would find dozens and perhaps hundreds of sexual partners over the course of a lifetime. In our concern for not appearing "homophobic" we diminish the role of hygiene and pivot to the more convenient discussion of religious repression's role in the spread of AIDS among gay men.
When AIDS first burst on the scene I remember feeling terrified: how do I ensure it does not cross my path? Then I sensed a certain relief for the wider population, particularly the risk that it could enter the donated blood supply or jump to females through, again, over-active "bisexual" men. When it was under control, I viewed it as a public health triumph of hygiene and education, not evidence that gay men had become abstinent en masse. Even George W. Bush's efforts in Africa, himself an Evangelical, were laudable and removed one containable blight on the otherwise struggling continent.
How is it that so many years on, we still see this as either an opportunity to treat the only source as racism or religious repression? When will Black men be held to any modest level of responsibility, gay or living in the South or otherwise?
When?
11
What a brave and beautiful soul on the cover of this week's magazine. Though the photo is taken from above, somewhat belittling the subject, Jermerious' prouder stance on page 44 was no less moving. Thank you for helping to un-invisible these people.
3
This article was very touching and interesting. I don't believe Tennessee and North Carolina are considered "the Deep South" though, North Carolina is part of the Old South. Lovely informative piece though.
This is very troubling in itself — it's terrible that our fellow citizens are suffering like this. Especially when both preventative and curative drugs are otherwise widely available.
It's also yet another crisis that affects Southern and rural areas disproportionately. Joblessness, opioid addictions, high suicide rates — in 2017 urban and rural dwellers face very different lives. And it's a marked reversal from the 80s, when crime, AIDS, and blight was concentrated in cities.
It's also yet another crisis that affects Southern and rural areas disproportionately. Joblessness, opioid addictions, high suicide rates — in 2017 urban and rural dwellers face very different lives. And it's a marked reversal from the 80s, when crime, AIDS, and blight was concentrated in cities.
3
Thank you for this very powerful and important article.
2
We continue to make gay black men invisible in our society. Gay black men are also afraid to make themselves more visible in their culture; the same way white gay men were afraid in the 60s and before. As a gay white man I am ashamed that we have closed the door behind us when we got our pride, our place at the table, our health back. Pride is black and white and every color of the rainbow. How do we reopen this door?
22
Why? Because you're combining two groups that for whatever complex reasons sociologists can write about in their journals simply have irresponsible and lackadaisical attitudes towards safe sex. Witness the unwed single mother pregnancy statistics in the black community. The gay community has always had higher rates of STDs than the hetero one. Does the repression by society lead to greater hedonism once the cats have gone and the mice can play? They have higher rates of many hedonistic behaviors.
I know because I was in medical school in Brooklyn at the height of the AIDS epidemic, graduating in 1995. This was before retrovirals, and it was a grim and scary scene. Kings County Hospital didn't have the celebrities or moneyed Manhattanites dying in private rooms in hospitals serving those fortunate enough to have good health insurance, nor did it have the resources. More than half the inpatient population was HIV positive. AIDS had been known for over a decade (even if Reagan dragged his feet), many if not most of the patients were infected after that.
Sorry to be trite but irresponsible people begets irresponsible behavior. All the rest is commentary by those who make their livelihood studying such phenomena. Forget about HIV, aren't they worried about herpes, syphilis, and gonorrhea (which is increasingly resistant to antibiotics)? Please don't dare say nobody told them.
I know because I was in medical school in Brooklyn at the height of the AIDS epidemic, graduating in 1995. This was before retrovirals, and it was a grim and scary scene. Kings County Hospital didn't have the celebrities or moneyed Manhattanites dying in private rooms in hospitals serving those fortunate enough to have good health insurance, nor did it have the resources. More than half the inpatient population was HIV positive. AIDS had been known for over a decade (even if Reagan dragged his feet), many if not most of the patients were infected after that.
Sorry to be trite but irresponsible people begets irresponsible behavior. All the rest is commentary by those who make their livelihood studying such phenomena. Forget about HIV, aren't they worried about herpes, syphilis, and gonorrhea (which is increasingly resistant to antibiotics)? Please don't dare say nobody told them.
21
Hard to imagine you graduated from med school without an understanding of the social determinants of health and how shame and social oppression compound health risks. Must be easier to just believe in personal responsibility and not have to work to change anything or acknowledge your advantages, since you are not affected.
27
There are some illnesses worse than HIV, and bigotry and ignorance are two of them.
HIV can be treated, while bigotry and ignorance linger despite all facts and education.
AIDS is prevalent through heterosexual transmission in Africa, but there are fewer simpletons that cast aspersions on character or blame all heterosexuals for their irresponsible sexual orientation.
People suffer illnesses for behavior all the time - heart disease, diabetes, lung cancer. But for the most part people aren't cruel enough to blame the victims for their lack of perfection in life.
Antiretroviral drugs reduce transmission rates, save lives and ultimately cut costs to the medical system.
Meanwhile, Carl's Jr. pushes their fat burgers on the populace, killing off family members early and increasing medical costs that we all pay.
You didn't mention the hedonistic behavior of gluttony.
So if you want to label people with illnesses as irresponsible Dr Deanster, write a longer list than gay people and unwed single mothers.
HIV can be treated, while bigotry and ignorance linger despite all facts and education.
AIDS is prevalent through heterosexual transmission in Africa, but there are fewer simpletons that cast aspersions on character or blame all heterosexuals for their irresponsible sexual orientation.
People suffer illnesses for behavior all the time - heart disease, diabetes, lung cancer. But for the most part people aren't cruel enough to blame the victims for their lack of perfection in life.
Antiretroviral drugs reduce transmission rates, save lives and ultimately cut costs to the medical system.
Meanwhile, Carl's Jr. pushes their fat burgers on the populace, killing off family members early and increasing medical costs that we all pay.
You didn't mention the hedonistic behavior of gluttony.
So if you want to label people with illnesses as irresponsible Dr Deanster, write a longer list than gay people and unwed single mothers.
25
@drdeanster
Thank you.
I look at the opioid crisis and I wonder what is the source, the vector of this new blight on poor communities? Is it related to over-prescribed pain killers serving as the gateway? Is it a private medical industry run amok and willing to let the short-term profits' liability fall on the greed-obsessed society that permits it? Or is it a decadent society that prefers drugs to confronting life?
Where AIDS is concerned I completely agree with your post. I have as much sympathy today for a sick gay man as I would for someone who chose to lick the toilet bowl rim in each movie theater restroom he visited or chose filthy hygiene around food. Do these cohorts still exist amidst affluence? Yes, unbelievably the do.
We have health warnings for reasons. When people cannot follow simple directions or curb their impulses, I prefer to call it what it is rather than invoking the terms "homophobia" or "religious repression". Some religious practices are actually practical advice if you don't mind hearing the admonition "No".
I smile when I hear a Liberal (libertine) individual say that nobody should be told whom they have sex with or what they do in their bedroom. So remind me, again, how that really plays out, this right to privacy, when the gay man staggers into the emergency room for treatment.
How is privacy working for our Liberal society now?
Thank you.
I look at the opioid crisis and I wonder what is the source, the vector of this new blight on poor communities? Is it related to over-prescribed pain killers serving as the gateway? Is it a private medical industry run amok and willing to let the short-term profits' liability fall on the greed-obsessed society that permits it? Or is it a decadent society that prefers drugs to confronting life?
Where AIDS is concerned I completely agree with your post. I have as much sympathy today for a sick gay man as I would for someone who chose to lick the toilet bowl rim in each movie theater restroom he visited or chose filthy hygiene around food. Do these cohorts still exist amidst affluence? Yes, unbelievably the do.
We have health warnings for reasons. When people cannot follow simple directions or curb their impulses, I prefer to call it what it is rather than invoking the terms "homophobia" or "religious repression". Some religious practices are actually practical advice if you don't mind hearing the admonition "No".
I smile when I hear a Liberal (libertine) individual say that nobody should be told whom they have sex with or what they do in their bedroom. So remind me, again, how that really plays out, this right to privacy, when the gay man staggers into the emergency room for treatment.
How is privacy working for our Liberal society now?
1
Remember the Tuskegee Experiments. . . . .
7
It does not look as if either the NYT or its readers understand the notion of personal responsibility. If I mess up my life it is the fault of the government.
And where is the government going to get this money from? From those who did not mess up their lives. Oh, well....
And where is the government going to get this money from? From those who did not mess up their lives. Oh, well....
16
Where did the government get the money to bail out the predators of Wall Street that wrecked our economy less than a decade ago? Be careful of how you dish out judgement; your own day of repentance might be nearer than you think to remind and humble you of your own indiscretions and mistakes. Who are you to judge anyone but human like the rest of us.
22
preach!
1
I am someone who has not messed up his life and feel only limited responsibility for those who HAVE messed up theirs. I do feel SOME but it is not a blank check - I have grandchildren to take care of.
And, it seems Michael, that you are pretty judgmental yourself, talking about "day of repentance" and all that nonsense. Do take your theology elsewhere, please?
And, it seems Michael, that you are pretty judgmental yourself, talking about "day of repentance" and all that nonsense. Do take your theology elsewhere, please?
1
Quote:The president’s proposed budget includes a $186 million cut in the C.D.C.’s funding for H.I.V./AIDS prevention, testing and support services.
There is always more money for the military and NSA. Trump's budget proposal was for over 55% of the total budget to go to the military.
Where is the compassion for people who are suffering? Where is the 'wonderful health care' at a price all can afford? The GOP House certainly didn't pass that. What hopes do we have in the Senate when they are working in secrecy and hope to pass a law that is also potentially worse than ACA?
There is always more money for the military and NSA. Trump's budget proposal was for over 55% of the total budget to go to the military.
Where is the compassion for people who are suffering? Where is the 'wonderful health care' at a price all can afford? The GOP House certainly didn't pass that. What hopes do we have in the Senate when they are working in secrecy and hope to pass a law that is also potentially worse than ACA?
12
"Trump's budget proposal was for over 55% of the total budget to go to the military"
No it isn't. Even under the Trump budget, far more goes to Medicare and Medicaid than to defense.
But Medicaid and Medicare fall under mandatory spending so many people who think "too much is spent on defense" do not COUNT the mandatory spending and then of course defense looks big.
https://www.nationalpriorities.org/budget-basics/federal-budget-101/spen...
No it isn't. Even under the Trump budget, far more goes to Medicare and Medicaid than to defense.
But Medicaid and Medicare fall under mandatory spending so many people who think "too much is spent on defense" do not COUNT the mandatory spending and then of course defense looks big.
https://www.nationalpriorities.org/budget-basics/federal-budget-101/spen...
6
As a gay southerner living in San Francisco, I feel compelled to express my point of view. We have vans parked on Castro Street almost every day of the week offering free HIV testing in 20
minutes. The volunteers working these vans have solicited me for a test more times than I can recall. I could even say it can be annoying at times to be approached so many times but I will not. In the many years I spent in Mississippi, I have never ever seen one van conducting HIV testing. There is a problem with the availability of this valuable service and I don't know why.
minutes. The volunteers working these vans have solicited me for a test more times than I can recall. I could even say it can be annoying at times to be approached so many times but I will not. In the many years I spent in Mississippi, I have never ever seen one van conducting HIV testing. There is a problem with the availability of this valuable service and I don't know why.
23
It's 2017. How is it a "public health failure" when the information has been available for decades and prevention measures have been obvious for decades?
16
Maybe because being black & gay is still hugely taboo in the community. their pov is often archaic & in denial
1
I am straight white mail from Arizona and HIV negative, but this story still touched my heart because it shows how the American medical crisis has failed a large group of citizens. ObamaCare was a step in the right direction but now that is threatened by Republican policy that just wants to make this problem die. The work that Cedric Sturdevant is doing deserves to be rewarded. Perhaps we can crowd fund a new vehicle with aircon to support his work. Ford should offer a Transit Connect van at very favorable price. AirCon to assist his work. If Ford will
14
Your idea smacks of voluntary giving by individuals and corporations who are moved to act. BRAVO!
4
First of all I wanted to thank Linda Villarosa for writing this and Cedric Sturdevant for your amazing work. Also wishing every one of the people who appeared in this article hope and good health. Reading through these comments, I feel that some people have not read through this article carefully enough. I read several comments that if only people would use condoms, this wouldn't happen. As Villarosa points out, the issue is that higher incidence of HIV in Black gay and trans communities makes transmission rates increase. Another issue was lack of access to treatment.. compare HIV rates mentioned in this article to current HIV rates in San Francisco which is using the test and treat model. In 2014 San Francisco only had 302 new HIV cases.. see this article for information about model being used there. https://www.nytimes.com/2015/10/06/health/san-francisco-hiv-aids-treatme... Please, don't blame Black gay men and transgender women living with HIV, this does not help stop this crisis
12
What a beautiful, well-written article. My heart is opened by Cedric Sturdevant's devotion and I love that this community is in the news so that the rest of us can offer our invisible support. May they feel the love.
12
Because of prison. Innocent black young men were incarcerated unjustly. Now, they come out of this system confused and suicidal. They should grab themselves by the boot strains and form, a coalition for the alliance of against the innocent. and sue the hell out of these states and attorneys who get the welfare check for doing nothing but standing and agreeing. If they could get into that frame of mind.
7
This is a very insightful piece about two worlds that are largely foreign to me: the HIV community and the Deep South. Sturdevant is an angel and his story is both facinsting and inspiring. After poring over this lengthy article there remains a mystery: How can the rate of infrction for any one group be so much higher than everyone else, controlling for gender, race, and domicile. The putative explanations were more descriptive than insightful and hence ultimately unsatisfactory. Are there difficult and deeper questions that need to be asked about this group to end this wicked cycle? It may be sociological, it may be anthropological, it may be I don't know what. But something is missing, and something is very sad.
8
Some groups in the US such as straight white females or lesbians of any color have extremely little HIV.
Straight non MSM White males have very little HIV.
MSM in general have a lot of HIV and that goes to the number of different sex partners, the type of sex i.e. Anal, party and play and poppers, and the high risk pool their sex partners come from.
The poor and MSM have always been high risk for STDs.
And that is what I saw working in Syphilis control in public clinics ,the poor and MSM.
That is what you will find for HIV and syphilis in each and every clinic in the country and most of the Dx being reported from any doctors practice----the poor and MSM no matter their income level.
Being poor and MSM is like a perfect storm for HIV and Syphilis.
That is not a knock on any one or any group that is public health epidemiology
Straight non MSM White males have very little HIV.
MSM in general have a lot of HIV and that goes to the number of different sex partners, the type of sex i.e. Anal, party and play and poppers, and the high risk pool their sex partners come from.
The poor and MSM have always been high risk for STDs.
And that is what I saw working in Syphilis control in public clinics ,the poor and MSM.
That is what you will find for HIV and syphilis in each and every clinic in the country and most of the Dx being reported from any doctors practice----the poor and MSM no matter their income level.
Being poor and MSM is like a perfect storm for HIV and Syphilis.
That is not a knock on any one or any group that is public health epidemiology
11
The deeper question is why people fail to understand that this is simply one more example of institutional racism and individual blindness. It is not accidental that GMHC neglected black and latino gay men. It is not accidental that Southern states provide inadequate funding and care. And so on and on - all the way to segregated schools in NYC that have their own rates of HIV infection that differ by race.
11
This is one more example of conservative dominated policies in regions where religious values take precedence over human life and secular values. While these populations are one example, and a truly saddening one to read about, this will only get worse if proposed policies are moved through. Very sad.
24
This is truly tragic. However speaking as a woman who has lived with 3 gay male roommates I've seen how many sex partners they can have in just two days and it's staggering. Absolutely unbelievable. And this is how the virus spreads so rampantly. I'm just telling you what I saw first hand. Not what I read in a book. I'm sure that this isn't the case for all gay men, especially those in committed relationships. Gay, straight or otherwise if you're having unprotected sex with multiple partners you're playing games with your life. We all know the drill on HIV by now. It's just a matter of some people being irresponsible & wreckless. Don't blame society blame yourself.
32
It's not the number of sex contacts that is the problem. It's the unsafe high risk BB sex that is.
5
What's BB sex?
1
Bareback
This is just so heartbreaking. Remember thinking when reading about victims of the Catholic priest scandals that those were compounded tragedies. Sexual molestation and a loss of faith. In this group, the loss of faith is equally tragic. It's a great source of hope, comfort, etc., when struggling and at rock bottom like that. My heart breaks for them.
5
That there are only 237 comments on this story is a reflection of the thesis itself. To many, especially upper middle class whites, gay and bisexual men of color are a group whose needs are just as much a priority as those physically located in Africa. How many comments would this article have if it focused on white men, white gay men. white women, etc?
13
Or Trump.
5
I'm a Southern woman. If I went out wearing red high heels and skimpy clothes to a club that was openly handing out condoms and lubricant, there's no telling what or whom I would pick up or get picked up by, or, what sort of diseases I would be exposed to in the course of the evening. I care about the sick people and those helping them who were mentioned in the article. I just don't understand how they form a special population outside of statistics. They are black. Even as a neighbor to Mississippi, I have diligently fought back against labeling people like that.
4
What a beautifully written, haunting portrait of people who need compassion and care. We human beings are complicated, all of us with the capacity for denial and confusion. Blessings to those who reach out.
12
What a biased piece of writing.
There is more beyond compassion and care. Read the part describing the evening spent in the dark, windowless deafening gay bar. Think about how long the fellow in the 5-inch red pumps and green contacts spent to look good for his evening in the sun. Think about the abject poverty of the life outside, surrounding that sinking ship.
Would you like your children to be there? Would you like to be there?
Liberals like the writer who gush about how "resplendent" the man looked should be ashamed to cover such a deadly serious topic without the chops to do so.
There is more beyond compassion and care. Read the part describing the evening spent in the dark, windowless deafening gay bar. Think about how long the fellow in the 5-inch red pumps and green contacts spent to look good for his evening in the sun. Think about the abject poverty of the life outside, surrounding that sinking ship.
Would you like your children to be there? Would you like to be there?
Liberals like the writer who gush about how "resplendent" the man looked should be ashamed to cover such a deadly serious topic without the chops to do so.
11
Blame it on the liberals. Sure. I'm not even going to try to be unbiased, but you have a different kind of sickness. Your kind doesn't poison the body. No, it goes far deeper than that, eating away at your very heart and soul and turning you into some sort of cruel vicious creature lacking in any semblance of human compassion or understanding. May God have mercy on your soul.
15
In mid 2016, I had the chance to work closely with a group of women in Tanzania, who met on a regular basis to talk, share business tricks and celebrate personal events; all of these women were HIV positive or had AIDS. In discussing their health, they sort of casually chattered amongst themselves, and to me, like, "Well, I go to the clinic on the second Wednesday of each month," then, someone else would pipe in, "Oh, I go to the other one, closer to the market, it's faster." The medicine was free.
They asked me how people handle their HIV/AIDS medicine in America. I was almost speechless. Not only did I not know anyone personally, but I was quite sure that getting the testing and the medicine would be tied up in a bunch of bureaucracy, forms and potentially denied funding.
I asked them why HIV is continuing to spread in TZ, since testing, condoms and treatment had all been made so readily available - and over the months, I asked many men the same question. The answer was always the same: You've gotta die of something anyway, what difference does it make?
It really makes me wonder, if the poverty and discrimination in the South against these men is creating a similar hopelessness.
This level of internalized despair in country with the poverty, disenfranchisement, and low life expectancy of Tanzania is not particularly shocking, but when we see it in the United States it is our responsibility to address it.
They asked me how people handle their HIV/AIDS medicine in America. I was almost speechless. Not only did I not know anyone personally, but I was quite sure that getting the testing and the medicine would be tied up in a bunch of bureaucracy, forms and potentially denied funding.
I asked them why HIV is continuing to spread in TZ, since testing, condoms and treatment had all been made so readily available - and over the months, I asked many men the same question. The answer was always the same: You've gotta die of something anyway, what difference does it make?
It really makes me wonder, if the poverty and discrimination in the South against these men is creating a similar hopelessness.
This level of internalized despair in country with the poverty, disenfranchisement, and low life expectancy of Tanzania is not particularly shocking, but when we see it in the United States it is our responsibility to address it.
25
In Africa, death is always very close and always around.
3
This piece is urgent and provides a nuanced and humanized perspective on the U.S. status of the epidemic. I was a bit disappointed to find latino men who have sex with men (MSM) missing, though. From 2005-2014, incidence (number of new infections) among black/African American MSM increased 22% and flatlined around 2010. However, for latino MSM, new infections increased 24% in that period. Among young (13-24) latino MSM, the increase was a shocking 87%! If we're discussing health disparity and where efforts need to be focused, latino MSM certainly make up the population of Americans who have been neglected by our HIV/AIDS public health policy.
10
I found this too much to digest . Having been POZ for over 40 years now, and knowing the science - as explained pretty well in Science Magazine recently, in 1981, for the volume of patients that were surfacing all over the nation, there were already 250,000 people infected and living with HIV when Dr.Gottlieb reported those first five cases. I am afraid the dice were rolled before the CDC, etc got their hands on the epidemic.
Still, when I see the major network news people say things like 'before the aids epidemic ended, as if it is over, I want them to read this article and take it to heart. It is but one piece of evidence that says our epidemic in America is way too alive and taking lives way faster than anyone wants to admit.
Thanks for doing this study, I only wish a shorter version was printed that more people will read. I know that it is a sad reality that Americans can't and wont read anything this long. Most Americans that is.
Still, when I see the major network news people say things like 'before the aids epidemic ended, as if it is over, I want them to read this article and take it to heart. It is but one piece of evidence that says our epidemic in America is way too alive and taking lives way faster than anyone wants to admit.
Thanks for doing this study, I only wish a shorter version was printed that more people will read. I know that it is a sad reality that Americans can't and wont read anything this long. Most Americans that is.
19
As someone who grew up in the Deep South during the height of the AIDS epidemic in America, this article is not surprising. Race, poverty and cultural stigmas about homosexuality are obviously a driving factor, but one area where more attention needs to be brought to is education. I attended one of the top public junior high & high schools in the state of MS in the mid-90s. Sex education in public schools is non-existent. Students are taught abstinence (if even that) and about the reproductive cycle. AIDS was never mentioned once at my school. We learned about it through Magic Johnson and the media. The fact that these poor, uneducated men seem to not fully comprehend the disease and what steps should be taken to prevent/treat is what one would expect due to these circumstances. Hopefully this article will bring much needed attention and help to this part of the country.
14
Unfortunately it seems a lot of people, especially in the black community, believe Magic Johnson was "cured" of HIV, so they think HIV is no longer a big deal. Dangerous line of thinking.
9
Superb journalism! Kudos to the author, & thanks to NYT for continuing to print writing of such high caliber.
10
Can't help but notice this article appears at the same time as an article on how people of the Deep South don't believe in climate change. Is there any part of science they respect? I blame our educational system.
5
What a gift this is to those committed to stay woke. A must read for every progressive American.
4
What, specifically can we do to help? Educate our children, remember this epidemic is far from over, and resources are not as widely available as we assume. My strength is not policy and program implementation, but taking care of roots which hopefully turn into healthy shoots and grow. What can we do at the most basic level to help? Mr. Cedric Sturdevant, thank you. Thank you for being someone we can all look up to. What do you need sir to do your work? We need to help you.
17
A heartbreaking story. Thank you for the expressive writing.
2
The reason is clear. Prejudice and stigma and poverty.
Guess what? Mississippi just started charging $25 to get an HIV Test!
SAD!
Guess what? Mississippi just started charging $25 to get an HIV Test!
SAD!
7
Don't worry their Medicaid will cover it
4
Thank you thank you shining a light on this hidden crisis. Shame on Mississippi's Governor Bryant for not having this at the top of his agenda.
4
Thank you for this deep, thoughtful article. We obviously need to inform more people about this shameful situation, here in the poorest state in the proud USA, where this kind of neglect should not exist.
Thanks Ms Villarosa and the NYT.
Thanks Ms Villarosa and the NYT.
3
35 years of neglect? How do you write -- and publish -- that without your screen exploding?
We've done nothing but throw money at endless AIDS education. We've neglected other diseases while handing out cash to countless activists whose work is really just other social work, duplicating services and enabling astonishing quantities of fraud.
People on your editorial board know this. Yet the lies spill out article after article after article, unchecked.
We've done nothing but throw money at endless AIDS education. We've neglected other diseases while handing out cash to countless activists whose work is really just other social work, duplicating services and enabling astonishing quantities of fraud.
People on your editorial board know this. Yet the lies spill out article after article after article, unchecked.
12
Absolutely. And all for a disease that every man in this article knew how to prevent. I don't believe in shaming patients, but the idea that this situation is driven by neglect by government is not backed up by the facts. This article barely addresses the pervasive homophobia in the black community - both in the South and elsewhere. It discredits the reality that far more straight black men have sex with men than their white counterparts. And it doesn't even bother to wander into genetics and immunology - which tend to suggest that blacks are more susceptible to contracting the HIV virus and to see their viral loads increase more rapidly. I'd also be curious to see what medication adherence rates are - I expect they are FAR lower, and it's consistent with the sort of depressed ability to delay gratification and avoid high risk behaviors that drives higher infection rates. This is not blame. This is actually compassion. Only by confronting the real issues will this situation be addressed.
10
I currently work as a researcher on HIV clinical trials in South Africa. We experience exactly the same problems here in largely heterosexual communities with shame, denial and HIV related stigma which leads to people not testing and not adhering to their medication regime. I am concerned that PrEP is often touted as a viable prevention method. The drug is hugely expensive and has a number of unpleasant side effects. If we can't get people who are already ill to adhere to their medication what makes us think that the same people will willingly take a strong drug every day to prevent themselves from becoming ill?
14
Maybe if gay black American men weren't reduced to a fraction of the fraction of the population to get the physical human love that they need this situation wouldn't exist.
4
Counter--- Maybe if they were monogamous they'd have plenty of safe partners. Hey even at 21in College on Ice Hockey team I didn't have sex with multiple young ladies a day let alone a week or month or semester. Call me normal, wait normal is now abnormal.
7
Interesting point- how does that work?
Im a transgender woman who is polyamorous. Im also white and live in Colorado, so there are very few black people here.
In the LGBT community I know and am part of in Denver is obsessive about condoms, protection, PreP, all that. I could not imagine having unprotected sex with a persom unless both of us had been tested and had no other partners since the last testing.
I dont know, when you are queer HIV is more in your face, and so we in CO stay smart and stay protected.
I also bought hormones from India for 3 years and just recently got insurance and am now going to a doctor to get my hormones. And Im white. LGBT people have it tough. Being a POC and LGBT makes it just that much more difficult. I hope more is done to make medical care a right for all in this nation.
In the LGBT community I know and am part of in Denver is obsessive about condoms, protection, PreP, all that. I could not imagine having unprotected sex with a persom unless both of us had been tested and had no other partners since the last testing.
I dont know, when you are queer HIV is more in your face, and so we in CO stay smart and stay protected.
I also bought hormones from India for 3 years and just recently got insurance and am now going to a doctor to get my hormones. And Im white. LGBT people have it tough. Being a POC and LGBT makes it just that much more difficult. I hope more is done to make medical care a right for all in this nation.
5
Why is it harder for people of color to have safe sex than it is for you? Just trying to understand...
8
"Sex makes you do crazy things" a quote from a movie I saw about 15 years ago, I am not making excuses for the HIV afflicted however I want to implore everyone to not be judgmental of the afflicted. Yes safe sex is a great idea but circumstance where people find themselves sometimes can encourage them to make highly risky decisions which might be costly, and most especially when we are referring to the excluded members of our society, and I mean the LGBQ.
3
I am always disturbed when advocates promote PrEP as if HIV/AIDS is the only STD which one should avoid. It's great that PrEP allows gay men to enjoy unprotected without fear of contracting HIV.
Now tell me what PrEP does for: syphilis, chlamydia, gonorrhea, warts, hepatitis, herpes, and HPV. Last I checked, PrEP does nothing for any of them.
Now tell me what PrEP does for: syphilis, chlamydia, gonorrhea, warts, hepatitis, herpes, and HPV. Last I checked, PrEP does nothing for any of them.
7
Educate yourself then. Individuals on PrEP are carefully screened for STDs at least every 3 months as well as counseled on safer sex practices.
A recent report from Kaiser Healthcare in San Francisco documents NO new HIV infections in their 2000+ patients on PrEP over the 3+ year time frame.
In addition, we know that the risk of HIV transmission from HIV+ individuals whose viral loads are adequately suppressed is zero, or close to it.
Yes, PrEP is expensive, but unlike HIV treatment, is not a lifetime commitment. In addition, the more people are on it, the lower the price should be.
A recent report from Kaiser Healthcare in San Francisco documents NO new HIV infections in their 2000+ patients on PrEP over the 3+ year time frame.
In addition, we know that the risk of HIV transmission from HIV+ individuals whose viral loads are adequately suppressed is zero, or close to it.
Yes, PrEP is expensive, but unlike HIV treatment, is not a lifetime commitment. In addition, the more people are on it, the lower the price should be.
1
as you go thru life you make your decisions you live your decisions. I made the decision to take care of my own nobody gave me anything. Now in my battle against cancer no one is giving me anything I take care of myself now why should i be forced to give my resources that i need to people that chose to have fun instead of working.
5
The key to stopping HIV infection and AIDS is to be tested.
If one is positive, antiretrovirals will bring the viral load to undetectable with adherence. This will stop or severely diminish new infections.
If one is not tested, yet is positive, the virus can easily spread.
AIDS or HIV is not God's punishment of gay people. It is commonly spread though heterosexual sex in Africa.
People's actions can affect the chance of catching the disease, just like heart disease, diabetes and many types of cancer.
Most people who are truly spiritual would follow the example of Jesus Christ and emphasize with those who suffer, rather than use it as a cudgel to further inflict pain.
In a sad article overall, the quote “Growing up, I was taught that God was not fixing to forgive a person who was homosexual” was particularly unfortunate.
When you are taught through ignorance words that don't exist in the Bible, it can encourage people to follow a path of hopelessness and destruction.
Marriage equality was an extraordinary step in the right direction, encouraging people to form loving committed monogamous relationships that reduce the chance of sexually acquired disease and raise the spirits of those born of equal worth to all.
It is unfortunate that some take glee in natural tragedies like floods and earthquakes and disease and use it to blame the victim.
Tragedy can strike anyone, and God is not usually the assailant.
If one is positive, antiretrovirals will bring the viral load to undetectable with adherence. This will stop or severely diminish new infections.
If one is not tested, yet is positive, the virus can easily spread.
AIDS or HIV is not God's punishment of gay people. It is commonly spread though heterosexual sex in Africa.
People's actions can affect the chance of catching the disease, just like heart disease, diabetes and many types of cancer.
Most people who are truly spiritual would follow the example of Jesus Christ and emphasize with those who suffer, rather than use it as a cudgel to further inflict pain.
In a sad article overall, the quote “Growing up, I was taught that God was not fixing to forgive a person who was homosexual” was particularly unfortunate.
When you are taught through ignorance words that don't exist in the Bible, it can encourage people to follow a path of hopelessness and destruction.
Marriage equality was an extraordinary step in the right direction, encouraging people to form loving committed monogamous relationships that reduce the chance of sexually acquired disease and raise the spirits of those born of equal worth to all.
It is unfortunate that some take glee in natural tragedies like floods and earthquakes and disease and use it to blame the victim.
Tragedy can strike anyone, and God is not usually the assailant.
6
Maybe because 1 in 4 African-American men go to prison sometime in their lives?
5
The disease doesn't care about being PC, or cool, or sympathetic or progressive. If you have unprotected sex with high risk partners, multiple partners, do drugs, share needles, smoke, don't take your meds, don't follow the regimen, you will get HIV, it will progress rapidly, you will spread it, and you and your partners will die. The disease will continue to kill members of groups that engage in risky behavior until they are either gone or until they learn and apply behaviors that halt the course of the disease.
Railing about discrimination, conspiracy theories, on and on, makes no difference. It comes down to this - Learn or Die. Is there anything about that you don't understand?
Railing about discrimination, conspiracy theories, on and on, makes no difference. It comes down to this - Learn or Die. Is there anything about that you don't understand?
17
Thank you Linda Villarosa for illuminating yet another way racism and homophobia are destroying us. This article is overdue, but better late than never.
2
Several comments state that religion is to blame? Really? Religion?
I thought not using protection contributed to STDs.
But it's religion's fault? I didn't know.
By the way, how many more carved out specialty groups are we going to get?
I thought not using protection contributed to STDs.
But it's religion's fault? I didn't know.
By the way, how many more carved out specialty groups are we going to get?
8
Some of the comments on this article are so very, very heartless and cruel. Everyone commenting most likely has had unprotected sex with someone at some point in their life. In other words, these are people living in Glass Houses throwing stones at other people. My grandmother always used to say to "There but for the grace of God go I". Good words for anybody to remember--Any one of us reading this could have unfortunately contracted this terrible disease. That we didn't means we were lucky.
Those who are blaming these people who have been infected with the HIV virus, I say to you, there but for the grace of God go you. It could have been you, and you should thank the stars that it wasn't. And then look inside yourself and think what you might be able to do to help other people who weren't so lucky. We're All in This Together.
Those who are blaming these people who have been infected with the HIV virus, I say to you, there but for the grace of God go you. It could have been you, and you should thank the stars that it wasn't. And then look inside yourself and think what you might be able to do to help other people who weren't so lucky. We're All in This Together.
5
The mechanism of HIV transmission has been known for decades, and the groups with by far the highest rates of infection—gay and bisexual men, (particularly blacks), and IV drug users—remain unchanged. Yet these groups are apparently regarded by the NYT and most of its readers as victims, devoid of personal responsibility and somehow blameless for their condition. Thousands of heavy smokers die every year of lung cancer. Are they also victims?
14
When AIDS became a plague white gay activists encouraged safe sex and many vocally supported shutting down the bathhouses which was helping to transmit it at an alarming rate. White activists who encouraged otherwise were condemned. Black activists encouraged the black community to think that the government had created AIDS to kill blacks. This view was openly supported by the most respected and promienent blacks in this country from Will Smith to Jerimiah Wright to Louis Farrakhan. A few NAACP Presidents made the same suggestion and Jesse Jackson and Al Sharpton did too.
So blacks believed that AIDS was something that was being done to them, and they remained passive. Whites took a pro-active approach. How dare anyone attempt to guilt white America or white gays because of the irresponsible rhetoric of the black community. They should direct their anger at the homophobic anti-white conspiracy theorists who encouraged blacks not to be pro active in their own health. Black activists got millions in tax payer funds to "help" the black community. They pocketed it and let their people suffer for self serving reasons and now (like always) want to directed their anger at whites and demand more money for "community leaders". The anger over the suffering should be squarely on their shoulder. Don't say the solution is for more services directed towards the black community. I live in a city that is 6% black and blacks get more than the 94% of non-black pop. combined.
So blacks believed that AIDS was something that was being done to them, and they remained passive. Whites took a pro-active approach. How dare anyone attempt to guilt white America or white gays because of the irresponsible rhetoric of the black community. They should direct their anger at the homophobic anti-white conspiracy theorists who encouraged blacks not to be pro active in their own health. Black activists got millions in tax payer funds to "help" the black community. They pocketed it and let their people suffer for self serving reasons and now (like always) want to directed their anger at whites and demand more money for "community leaders". The anger over the suffering should be squarely on their shoulder. Don't say the solution is for more services directed towards the black community. I live in a city that is 6% black and blacks get more than the 94% of non-black pop. combined.
13
I wonder if every person who is advocating "safe sex every time" has had safe sex every time.
5
No but the smart ones did.
4
Lots of people on this thread advocating safe sex and condoms are not themselves in a high risk group as far as HIV, syphilis, etc.
What they can do and not get infected has little in common with MSM.
What they can do and not get infected has little in common with MSM.
3
I hope all of these "why don't you wear a condom" or stop being so promiscuous" crowd in this comment stream were virgins until they were married. It's easy to judge and throw stones, but if you have ever engaged in any form of premarital sex, then you are no different than these men. You took a risk, but you were fortunate enough to not be a member of a marginalized group with a high HIV positive population- so don't judge.
I read these comments, and is very clear why people don't want to get tested or openly admit their sexuality. The judgement and ignorance is real and harsh. Food for thought, leave your comfortable ivory and show some compassion.
Thank you New York Times- special thank you to Villarosa and Sturdevant for shedding light on this story. I pray these men receive the education, services, and medial treatment needed to address this growing epidemic.
I read these comments, and is very clear why people don't want to get tested or openly admit their sexuality. The judgement and ignorance is real and harsh. Food for thought, leave your comfortable ivory and show some compassion.
Thank you New York Times- special thank you to Villarosa and Sturdevant for shedding light on this story. I pray these men receive the education, services, and medial treatment needed to address this growing epidemic.
5
This article, to no surprise, glosses over the rampant homophobia that exists in african- american communities. Bullied, shamed, harassed, insulted, assaulted, and worse - these men continuously get the message from the community, family and friends that their black lives don't matter at all. Shocked that oppressed people can be aggressive oppressors? Get real. The left will always ignore actually useful identity politics anytime the truth becomes inconvenient.
12
And of course white gay and bisexual men with HIV don't matter.
7
I worked 25 years ago under my black gay male hero, Reggie Williams, of San Francisco's National Task Force on AIDS Prevention--the first gay-male-of-color nonprofit funded by the CDC. I directed programs targeting Black gay males (BGMs). I can attest to how inadequate funding was for programs like ours.
Today, the struggle remains. We must get BGMs life saving one-dose daily meds that are more tolerable and easier to remember to take. Yet, such meds are more expensive. With BGMs largely in areas with lawmakers hostile to Obamacare or Medicaid funding, there looms an even larger death crisis.
Unacceptably high Black male unemployment, limited self empowerment options for queer Black men, and unchecked (often Church-based) African-African heterosexism signify a lethal triple cocktail of consequence that can devastate the psyches of even those BGMs who try to do the right thing. With lives torn asunder, basic survival with AIDS becomes too arduous.
Part of the struggle, my own, was burnout, writhing in public health systems redolent with corruption. Back room deals once favored entities focused largely on white gay men. Too, greed and hubris haunted some early Black-run AIDS organizations.
Many culprits exist vis-à-vis BGMs who walk a lonely path. We fall, like hollowed trees in a forest where the ghosts of indifference, of outright hostility, and of abject apathy mean no one dare hear our withered bodies fall into graves few will dare to visit or even remember exist.
Today, the struggle remains. We must get BGMs life saving one-dose daily meds that are more tolerable and easier to remember to take. Yet, such meds are more expensive. With BGMs largely in areas with lawmakers hostile to Obamacare or Medicaid funding, there looms an even larger death crisis.
Unacceptably high Black male unemployment, limited self empowerment options for queer Black men, and unchecked (often Church-based) African-African heterosexism signify a lethal triple cocktail of consequence that can devastate the psyches of even those BGMs who try to do the right thing. With lives torn asunder, basic survival with AIDS becomes too arduous.
Part of the struggle, my own, was burnout, writhing in public health systems redolent with corruption. Back room deals once favored entities focused largely on white gay men. Too, greed and hubris haunted some early Black-run AIDS organizations.
Many culprits exist vis-à-vis BGMs who walk a lonely path. We fall, like hollowed trees in a forest where the ghosts of indifference, of outright hostility, and of abject apathy mean no one dare hear our withered bodies fall into graves few will dare to visit or even remember exist.
9
trump's elimination of Aids programs is further proof (as if I needed any) that he is a stupid, bigoted little man who cares only for money and himself and family, certainly not people of color or whose sexual preferences differ from his.
2
“Why do America’s black gay and bisexual men have a higher H.I.V. rate than any country in the world?”
For the same reason that Black people writ large, and Black males particularly, are at the bottom of the socio-economic totem pole, whether it is health, employment, or education—institutional racism along with the Black male being the most despised and devalued individual in racist America, whether he be gay or straight. It is all connected to the same basic structure of institutional racism.
As Dr. King stated, “…We are all tied together in a single garment of destiny; what affects one directly, affects all indirectly.”
For the same reason that Black people writ large, and Black males particularly, are at the bottom of the socio-economic totem pole, whether it is health, employment, or education—institutional racism along with the Black male being the most despised and devalued individual in racist America, whether he be gay or straight. It is all connected to the same basic structure of institutional racism.
As Dr. King stated, “…We are all tied together in a single garment of destiny; what affects one directly, affects all indirectly.”
5
Nothing is more amusing than the Liberal MSM asking questions on which the answer is blatantly obvious to anyone whose brain has not been fried by Political Correctness.
8
It's almost as if the Liberal MSM is denying science.
This infection process is not that gay African American males are simply engaging in unprotected sex. The issue is the men getting infected are likely to be under the influence of alcohol or other drugs when they engage in unsafe sex. It is naive to assume these men have sex without condoms when they are stone cold sober. They are high or drunk when they have unprotected sex.
So let's talk about drugs-alcohol-sex as the real crisis here. Condoms don't get used properly when the sexual partners are drunk or high. When drug or alcohol use begins the whole thing...who even thinks about protection....getting high or drunk drives the moment.
So let's talk about drugs-alcohol-sex as the real crisis here. Condoms don't get used properly when the sexual partners are drunk or high. When drug or alcohol use begins the whole thing...who even thinks about protection....getting high or drunk drives the moment.
4
Of course it's the southern states, where health care is for the rich and white, sex education is either nonexistent or abstinence only, and racism rampant. it's embarrassing that they are still part of the US.
1
There's nothing hidden about this at all. The medical community is acutely aware of this demographic. This is way there's a blanket ban on blood donations for men who have sex with men.
I do not want to minimize the severity of the situation. It is an unfortunate quirk of happenstance that a far more virulent strain of HIV came to the North American continent. To make progress in this battle, some fundamental changes in the national dialogue have got to occur.
It is important to acknowledge the route of transmission for this virus (blood and sex). It is unfortunate, but pointing out the sexual aspect is likely to raise the hackles of much of the nytimes.com readership, but this is cold. hard. unforgiving. fact.
Unprotected sex (oral sex included) and shared needles are the reason this epidemic persists. This is not a condemnation of who these people are. The fact that I must make this statement is telling of how off course the dialogue on this topic has gotten.
If we don't accept how it is happening, nothing will change. These unfortunate men will continue to suffer and die prematurely in this country. As long as the progressive of this country continue to pretend it is the long dead religious spirit of this country that is the cause of gay and bisexual men's HIV infections, this community is doomed. This is truly heartbreaking.
I do not want to minimize the severity of the situation. It is an unfortunate quirk of happenstance that a far more virulent strain of HIV came to the North American continent. To make progress in this battle, some fundamental changes in the national dialogue have got to occur.
It is important to acknowledge the route of transmission for this virus (blood and sex). It is unfortunate, but pointing out the sexual aspect is likely to raise the hackles of much of the nytimes.com readership, but this is cold. hard. unforgiving. fact.
Unprotected sex (oral sex included) and shared needles are the reason this epidemic persists. This is not a condemnation of who these people are. The fact that I must make this statement is telling of how off course the dialogue on this topic has gotten.
If we don't accept how it is happening, nothing will change. These unfortunate men will continue to suffer and die prematurely in this country. As long as the progressive of this country continue to pretend it is the long dead religious spirit of this country that is the cause of gay and bisexual men's HIV infections, this community is doomed. This is truly heartbreaking.
10
Ahem, you need to educate yourself.
The risk of HIV transmission from unprotected oral sex is negligible.
The risk of HIV transmission from an HIV+ individual who has undetectable viral RNA in the blood is also negligible.
THAT is why testing, knowing ones status, and treatment is so important.
We can break the cycle of HIV transmission but access to diagnosis and treatment is paramount.
The risk of HIV transmission from unprotected oral sex is negligible.
The risk of HIV transmission from an HIV+ individual who has undetectable viral RNA in the blood is also negligible.
THAT is why testing, knowing ones status, and treatment is so important.
We can break the cycle of HIV transmission but access to diagnosis and treatment is paramount.
You realize that you're correct only if the mucosal membranes are intact? Right? Any cut, scratch, puncture, ulcer, etc. dramatically increases the risk. How often have you bitten your lip? Cold sores? Chapped lips
Oh dear.
You also realize that a sizable number of people contract HIV asymptomatically, right? There's a latency between positive tests which creates a window period of infectivity, you know this right?
I think you need to look up what is meant by "negligible". While you are, indeed, correct regarding the marked reduction in transmissibility of HIV if the RNA is undetectable, this does not mitigate the need for vigilance. How often does someone's viral load get measured? If it is undetectable today, great, but what happens if it begins to rise a week later?
Lastly, yes, you're right, we can break the transmission of HIV, but diagnosis and treatment alone are not enough. Look at the epidemiological history of chlamydia and gonorrhea as an object lesion for relying on diagnosis and treatment alone.
Expecting a modicum of self-control from people, is, I agree, a ridiculous thing to ask. It is, however, time for folks to sober up and realize that those of us who contract HIV bear some responsibility in as far as our actions are involved.
I should have to make this caveat, but, please, this doesn't apply to rape victims, or blood recipients, or anyone else that didn't chose high risk behavior, stick a needle in their arm, or engage in unprotected sex.
Oh dear.
You also realize that a sizable number of people contract HIV asymptomatically, right? There's a latency between positive tests which creates a window period of infectivity, you know this right?
I think you need to look up what is meant by "negligible". While you are, indeed, correct regarding the marked reduction in transmissibility of HIV if the RNA is undetectable, this does not mitigate the need for vigilance. How often does someone's viral load get measured? If it is undetectable today, great, but what happens if it begins to rise a week later?
Lastly, yes, you're right, we can break the transmission of HIV, but diagnosis and treatment alone are not enough. Look at the epidemiological history of chlamydia and gonorrhea as an object lesion for relying on diagnosis and treatment alone.
Expecting a modicum of self-control from people, is, I agree, a ridiculous thing to ask. It is, however, time for folks to sober up and realize that those of us who contract HIV bear some responsibility in as far as our actions are involved.
I should have to make this caveat, but, please, this doesn't apply to rape victims, or blood recipients, or anyone else that didn't chose high risk behavior, stick a needle in their arm, or engage in unprotected sex.
1
Stories like these are so important to write about and to read. Everyday heroes like Cedric Sturdevant grace those around him with his love and concern, and make a remarkable difference in people's lives. God Bless him and those he serves.
2
As much as I want to feel compassion for these individuals, I admit that I can't. Not practicing safe sex in the 21st century and ending up HIV positive is similar to smoking and being shocked at having developed lung cancer. We don't live under a rock in this country. We all know what we have to do to protect ourselves and our partners.
On the other hand, lack of access to proper treatments for HIV-positive people is a disgrace for a wealthy country that refuses to provide modern healthcare. I'm all for rectifying that.
On the other hand, lack of access to proper treatments for HIV-positive people is a disgrace for a wealthy country that refuses to provide modern healthcare. I'm all for rectifying that.
8
What I find disturbing is that H.I.V. is still being spread so easily. In 2017 people should know how to have safe sex and understand the necessity of limiting sexual partners. People should also know that nothing good comes from sharing needles. I hope this article will serve as a wake call. It will be a sad state of affairs if we are reading about the same topic in another article in five years.
5
Thank you, Linda Villarosa, for this article and all that it examines. The level of focus is why we need journalists like yourself.
It is important to keep things in perspective.
Approximately 6% of the US population is black men.
Depending on the studies you choose to believe, no more than 1 in 10 black men are gay. So gay black men are at most 0.6% of the US population.
Of those, about 1 in 4 live in the South. or 0.15% of the US population.
So this entire article is about no more than 0.15% of our population. The headline and the author are attempting to hype this as a "national epidemic" and "worse than sub-Saharan Africa".
No wonder progress can't be made. They are not even capable of talking about the issue without in a proportional and reasonable manner, based on the actual data in context.
Approximately 6% of the US population is black men.
Depending on the studies you choose to believe, no more than 1 in 10 black men are gay. So gay black men are at most 0.6% of the US population.
Of those, about 1 in 4 live in the South. or 0.15% of the US population.
So this entire article is about no more than 0.15% of our population. The headline and the author are attempting to hype this as a "national epidemic" and "worse than sub-Saharan Africa".
No wonder progress can't be made. They are not even capable of talking about the issue without in a proportional and reasonable manner, based on the actual data in context.
13
Not to be cruel, but the Black/gay/bisexual community has no one to blame but themselves. It is not racism, not religion, and not the South. Certainly poverty is a problem, but as the article likes to point out, this is not Africa. Education is not an issue and neither is how to protect oneself. and your partner. We all have to take responsibility for our own health.
9
The epidemic is not hidden. It is right there in front of our eyes, as well as many other ''epidemics '' regarding health care. This particular problem just so happens to affect a subsection of a subsection that is marginalized in so many other ways.
Sexual education works. It works well and especially works well when implemented from a young age @school. ( and home ) Aye, it is not particularly fun to stop what you are doing and put on a condom, nor does it give the same pleasure as without one, but it may just save your life to be careful.
That is knowledge and education. ( not necessarily promotion as many on the extreme right extol in the same breath as religious mumbo-jumbo )
Sexual education works. It works well and especially works well when implemented from a young age @school. ( and home ) Aye, it is not particularly fun to stop what you are doing and put on a condom, nor does it give the same pleasure as without one, but it may just save your life to be careful.
That is knowledge and education. ( not necessarily promotion as many on the extreme right extol in the same breath as religious mumbo-jumbo )
5
What I'd like to know is why I'm seeing more and more bad grammar, typos, etc. in the Times, often in headlines or on the front page. Have they fired all the copy editors and proofers? You'd think they could get the subhed right in a lead story for the magazine: "Why do America's black gay and bisexual men have a higher H.I.V. rate than any country in the world?" That sentence compares American men's H.I.V. rate with...countries. The sentence should say something like, "Why do black gay and bisexual men have a higher H.I.V. rate in America than in other countries?" I see writing like this in the Times every day lately. I was going to write to the Public Editor about the declining quality of the writing but I see that she's been canned and her position has been eliminated. Too bad.
9
Everyone in this day and age knows that unprotected sex, especially outside a monogamous relationship, is risky behavior for STDs, period. That has been the message communicated everywhere for the last 30 years, at least.
Whether it is riskier among some demographics than others, as the article here suggests, it is still risky behavior. On the other hand, protected sex drastically reduces the risk of HIV.
All the navel gazing and hand wringing (Racism! religion! poverty! homophobia! Trump! the tooth fairy!) in this article does not change the simple fact that anyone having unprotected sex (outside of a relationship with someone they know and trust) is a fool and need only look in the mirror for someone to blame if they contract the disease.
Whether it is riskier among some demographics than others, as the article here suggests, it is still risky behavior. On the other hand, protected sex drastically reduces the risk of HIV.
All the navel gazing and hand wringing (Racism! religion! poverty! homophobia! Trump! the tooth fairy!) in this article does not change the simple fact that anyone having unprotected sex (outside of a relationship with someone they know and trust) is a fool and need only look in the mirror for someone to blame if they contract the disease.
12
Being black in America is to be condemned to being diseased.
The morbidity rate of blacks is staggeringly high in all categories of diseases, not just HIV, not just sexually transmitted infections, not just chronic diseases, not just metabolic diseases, but also environmental and social health diseases.
For too many, blacks have access to better health care and living conditions in prison than in the communities they live.
The morbidity rate of blacks is staggeringly high in all categories of diseases, not just HIV, not just sexually transmitted infections, not just chronic diseases, not just metabolic diseases, but also environmental and social health diseases.
For too many, blacks have access to better health care and living conditions in prison than in the communities they live.
1
It's no coincidence that these high rates are within the Bible Belt.
2
This white, straight, promiscuous, liberal,urban, reader is shocked. Please tell me how I can help.
Homophobia within the black community is one of the biggest cause. Most black men who are openly gay are shunned and run the real risk of physical violence within the black community. It is not a myth that many black men are having sex with men secretly, and then having relationships with women to cover up. Most do it so well that most black women will have sex with them convinced there is no way they could be gay.
The one way to end this is for all blacks to accept gays for who they are. It will save lives. Lives of the black gay men, lives of the women they infect and lives of the straight black men who get infected from the infected women. It is a vicious circle.
The one way to end this is for all blacks to accept gays for who they are. It will save lives. Lives of the black gay men, lives of the women they infect and lives of the straight black men who get infected from the infected women. It is a vicious circle.
10
So you're saying Black people are discriminating against others. No only whites discriminate!
2
The takeaway seems to be that Gay Black men suffer from higher rates of HIV and AIDS due to a lack of testing and postponing treatment after contracting the disease.
The rest of the article, although interesting, seems to deflect and obscure this conclusion. The tautological definition of "viral load" which dances around this, is unforgivable.
The rest of the article, although interesting, seems to deflect and obscure this conclusion. The tautological definition of "viral load" which dances around this, is unforgivable.
4
Why do America’s black gay and bisexual men have a higher H.I.V. rate than any country in the world?
Because church, shame, the closet.
Because church, shame, the closet.
1
My immediate strong response to this questions pops out as - Why would you expect otherwise.
Black men are the poorest therefore they eat less nutritious food and have weaker immune systems in place.
And then again, black men receive less of less optimal health care therefore their ailments have more time to become established in their bodies.
...and again, black men have less financial resources to pay for testing and the means to have safe sex.
Why would they not suffer the most of all????
Black men are the poorest therefore they eat less nutritious food and have weaker immune systems in place.
And then again, black men receive less of less optimal health care therefore their ailments have more time to become established in their bodies.
...and again, black men have less financial resources to pay for testing and the means to have safe sex.
Why would they not suffer the most of all????
So let's examine that... Are they employed? If not I'm betting Medicaid which poor workers have no insurance so I'm better wrong. HIV will get them SSDI ( if they ever worked ) or SSI if not Welfare. Try again
4
HELPING Men of color practice safer sex and get treatment if diagnosed with HIV or other STDs is of vital importance to all Americans. Living in poverty and in communities that would reject them, these men are isolated from help and support. That's why the new cases of HIV are so high.
3
A sad and heartwrenching story. But it warms me to know that we have another saint walking among us and his name is St. Cedric. May heavenly light shine upon him, and may the radiance and love from beyondand above bless and keep him.
2
To your sub-titular question I suggest 2 answers: hatred and blacks and hatred of gays. They are both complicated, and in the Deep South more so. Here we have the Black Belt (named after the soil) and the even larger Bible Belt (named after the Bible). But that Bible in the Belt is not one of love and compassion, but one of hatred. Don’t forget that white Christian churches stood in the forefront of segregation and preachers prayed at KKK rallies and lynchings. Sturdevant believes “that many black gay and bisexual men have been rejected and discarded.” and he is correct Here in the South (and in the nation at large) you could shorten that to “many black men have been rejected and discarded.” But the problem is exacerbated by being gay or bi-sexual. And unfortunately, there does seem to be a high level of antipathy toward them in the black community.
Why more black men do not seek medical intervention and stick to their meds is also complicated. Perhaps they see no reason to live. But I have noticed general distrust among blacks of the medical establishment, including such things as advance directives and hospice care (those, I sense, they think gives to others the power to kill them). My sense is that the infamous Tuskegee Experiment has a lot to do with this distrust. Why would black folks trust the establishment? Would you? (And yes, I’m “white,” and that’s why I have labeled some of my thoughts as speculative.)
Why more black men do not seek medical intervention and stick to their meds is also complicated. Perhaps they see no reason to live. But I have noticed general distrust among blacks of the medical establishment, including such things as advance directives and hospice care (those, I sense, they think gives to others the power to kill them). My sense is that the infamous Tuskegee Experiment has a lot to do with this distrust. Why would black folks trust the establishment? Would you? (And yes, I’m “white,” and that’s why I have labeled some of my thoughts as speculative.)
1
[[Marq barely said goodbye as he jumped out of the car in front of a convenience store on an avenue scattered with a pawnshop, a liquor store and several Baptist churches, and he all but admitted he was planning to spend the afternoon smoking weed and looking at Instagram.]]
But, of course, it's the fault of very, very overt institutional racism.
Right?
Very very.
But, of course, it's the fault of very, very overt institutional racism.
Right?
Very very.
7
Once this virus migrates from homosexual or bisexual to strictly heterosexuals then it's pretty much game over from a public health perspective; the primary cause for aggression by real traditional African groups toward homosexual culture and an explanation of why many real African Protestants are not - on board - with Western liberal appeasement to homosexual conduct.
3
You should be aware that in Africa, HIV is spread overwhelming through heterosexual contact and has been for decades.
Your comment is utter nonsense.
Your comment is utter nonsense.
1
Racism contributes to the self-defeating behaviors and attitudes that strangely mark the boundaries of self-help, either before or after the disease is contracted. And before a rush to criticism, in saying racism, I don't mean white people; they are not to blame, and are irrelevant to the sustained presence of HIV among black men.
I mean racism as a system! One complex with layers of norms, barriers, tales, values, material opportunities, beliefs, group attitudes, a system living in time and space, its effects within the black community. Racism goes beyond prejudice or bias or name calling; it goes beyond discrimination. It has components exposed in this article: the weakness of community support and of rejection, perhaps in fear of perpetuating stereotypes about black sexuality and permissiveness—a denial system within racism that induces an imposed blindness about the presence of HIV. In religion, the training of black preachers in the rigidness of scriptural message and an unwillingness of congregations to reexamine their sense of charity and mercy. In resources, the lack of money allocated to the basic needs of patients, for drugs and counseling.
Racism doesn't have to use race in its process: the elements of its process are often race-neutral in appearance, but result in outcomes described by race. Race shows up in the final content of the process. (Voting restrictions are another example of how race appears in the final result but not the in process.)
I mean racism as a system! One complex with layers of norms, barriers, tales, values, material opportunities, beliefs, group attitudes, a system living in time and space, its effects within the black community. Racism goes beyond prejudice or bias or name calling; it goes beyond discrimination. It has components exposed in this article: the weakness of community support and of rejection, perhaps in fear of perpetuating stereotypes about black sexuality and permissiveness—a denial system within racism that induces an imposed blindness about the presence of HIV. In religion, the training of black preachers in the rigidness of scriptural message and an unwillingness of congregations to reexamine their sense of charity and mercy. In resources, the lack of money allocated to the basic needs of patients, for drugs and counseling.
Racism doesn't have to use race in its process: the elements of its process are often race-neutral in appearance, but result in outcomes described by race. Race shows up in the final content of the process. (Voting restrictions are another example of how race appears in the final result but not the in process.)
30
Spot on!
The racist system you mention was built by white people and has been sustained by white people for hundreds of years either through direct action or complacency and comfort. So please don't let white people off the hook.
Very well put.
There is no doubt this is a worthwhile and necessary article.
However, the headline comparison of a highly vulnerable population, "black gay and bisexual men", to an entire country is foolish. We know gay men are especially vulnerable to HIV infection. There was never any reason to compare the rate of infection in a vulnerable population to the rate in another population not selected for vulnerability. That holds for every infection.
However, the headline comparison of a highly vulnerable population, "black gay and bisexual men", to an entire country is foolish. We know gay men are especially vulnerable to HIV infection. There was never any reason to compare the rate of infection in a vulnerable population to the rate in another population not selected for vulnerability. That holds for every infection.
11
Not if you care whether the people survive or no.
1
That's one reading of the headline. Another reading is with the emphasis on the modifier, "black," as it is specifically applied to a discrete group, "America's...gay and bisexual men." Gay white Americans do not suffer HIV infection (and morbidity/mortality) in the same numbers as this minority within a minority. The fact that the numbers of this group (granted, skewed by overall populations) dwarf those out of even sub-Saharan Africa, still considered a "hotspot" for emergent infection and inadequate or absent life-saving intervention, is not only attention-grabbing (as I am sure was the intent), but is both sobering and relevant.
1
I disagree. The majority of the population is familiar with the presence of HIV/AIDS in their own communities, and therefore believes that the crisis is now effectively and compassionately managed. They no longer feel it is either a public health nor a human rights crisis that needs continued aggressive attention. Comparing the rates of infection in particular populations to the rate in the overall population makes us face the contrast and ask ourselves what that means to us.
That has human rights implications, but even if you don't care about those, it has public health implications. The article discusses how the men affected aren't taking fewer precautions than the overall population, but infection is at a critical mass where even occasional mistakes have gravely compounding implications. Well, guess what? That sub-population is part of our greater population. If we cannot control it there, it will eventually affect us all.
That has human rights implications, but even if you don't care about those, it has public health implications. The article discusses how the men affected aren't taking fewer precautions than the overall population, but infection is at a critical mass where even occasional mistakes have gravely compounding implications. Well, guess what? That sub-population is part of our greater population. If we cannot control it there, it will eventually affect us all.
1
Yet more good reasons to work diligently on a cure!
8
For the last over 30 years, the whole of America has heard about H.I.V. and aids, how it is acquired from namely: 1. blood transfusions before blood donations were tested 2. Sexual contact 3. dirty needles and or sharing needles 4. health care professionals contact with the patient when it comes to open sores, bodily fluids, etc. Having lived in New York city before the aids epidemic in 1968, the gay community had lots of indiscriminate sexual contacts without protecting themselves. Now, because of injecting crushable opiates, those in the black community are using that method, and have a higher rate of aids for their numbers at almost 44% of new cases. Sexual contact without protection, and using intravenous drugs is probably the source of most H.I.V, in the black and gay community. Mostly, people are indifferent to aids because of the high rate of stabilizing the disease as chronic, and not deadly. However, depending each individual and racial genetic makeup, the disease can be more deadly by the nature of the disease.
12
Wow. This is an ill-informed post.
2
I guess you did not read the whole article. Starting with George W Bush, all the money on sex education and how HIV is transmitted was spent on abstinence policies.
Please read before making ignorant comments.
Please read before making ignorant comments.
2
The age of television and digital has made most information not only readily available but put out by the media, on all the television for the last 40 years, and internet for the last 20 years. Besides, adults are responsible for self educating themselves in relation to all of this, as my two kids who are now 44 and 45 received all of this in their 7th. grade biology class in our small school.
1
I know these statistics are not made up but I am a 70 year old black woman who has lived in Detroit, New York, Atlanta, Houston, and San Francisco but have never personally known an African American male or female die of AIDS. I've known white AIDS patients who have died. Cancer, Diabetes, Cardiovascular Disease you name it I've seen it. But not H.I.V. It could be the cause of death was kept secret but I know the face of AIDS. Maybe the people I know who are gay and bisexual who might be H.I.V. positive are taking their medications and receiving the correct medical treatment. Something I wish was the case for all who have this horrible disease.
11
Unfortunately, there is still a lot of stigma as well as personal trauma leftover from past stigma. People are reluctant to wear their conditions on their sleeves. Even without stigma, talking about our health conditions is awkward. Statistically many of my friends and coworkers must be affected by heart disease, diabetes, digestive issues, autoimmune issues, and HIV/AIDS. I can name a few of them, but very few.
Is it necessary to talk about these things openly? Yes, if we want build a culture of compassion and understanding and develop a society driven to support the study and control of these diseases. We will not abolish the stigma by keeping quiet as a society.
But how do we talk about them? Standing around at the water cooler at 9:08 am, do we greet our coworkers with, "Mornin', Bill. Did you bring in those Munchkins? Thanks, I had a couple of chocolate ones already! I was diagnosed with in 2008. By the way, I have a conference call with that new client in 12 minutes. Are you free to join us? Do you have any illnesses?" Like I said, awkward.
The risks of being open are still so great. We can't look at people and tell them, "it's your own fault there is still a stigma, because you don't talk about your disease." They risk job termination, social ostricization, etc by choosing openness. We need to be the ones to create a new, open and safe playing field.
Is it necessary to talk about these things openly? Yes, if we want build a culture of compassion and understanding and develop a society driven to support the study and control of these diseases. We will not abolish the stigma by keeping quiet as a society.
But how do we talk about them? Standing around at the water cooler at 9:08 am, do we greet our coworkers with, "Mornin', Bill. Did you bring in those Munchkins? Thanks, I had a couple of chocolate ones already! I was diagnosed with in 2008. By the way, I have a conference call with that new client in 12 minutes. Are you free to join us? Do you have any illnesses?" Like I said, awkward.
The risks of being open are still so great. We can't look at people and tell them, "it's your own fault there is still a stigma, because you don't talk about your disease." They risk job termination, social ostricization, etc by choosing openness. We need to be the ones to create a new, open and safe playing field.
1
I was a public health nurse and then worked in Corrections for many years. Denial is rampant in this population. If you cannot feel it, it is not real, so the theory goes. The educated White man who hates them deep down inside, tells them a bunch of "lies".
Poor education, poverty, present orientation and racism conspire to condemn this population.
Poor education, poverty, present orientation and racism conspire to condemn this population.
16
Spot on, I know of an inmate of "this population" who was immediately transported out of prison to ICU after being diagnosed with full blown AIDS. For a few days his fellow inmates formed a long queue outside the lab for HIV blood testing...years of contacts. I now understand the implications more completely.
1
The history of HIV in the US is the history noble lies. Before, it was HIV affected everyone: heterosexuals and homosexuals alike. I'm glad the NYTimes is publishing the real statistics now: that it overwhelming affects gay men, and in particular, gay black men. Not giving people the facts saves them from the pain of stigmatization the short run, but dooms them to a near death sentence in the long run.
19
Gay or straight, black or white, HIV infection affects everyone in essentially the same way (absent treatment). You weren't lied to, you merely did not understand what was being said.
4
If the author wanted to draw attention away from the "down low" myth, why feature a guy with an ex wife and kids? It's counterproductive in that respect, even though he is a deserving and engaging subject.
4
He's not lying or pretending he's straight. So he's not DL.
One can read a lot from tea leaves, or none at all. Would you ultra-high rate of HIV among this pocket of gay/bisexual black men have been just an oversight of early neglect (that resulted in delayed outreach)? Would leaving out the case in the early reports have contributed to that? Certainly the writer wants us to believe that. But I highly doubt it.
Afterall this has been 35 years in the making. No one - and I truly mean no one these days - in US could have claimed total innocence of what HIV is. Would these American gay men have been less informed that those in rural African countries like Swaziland? I highly doubt it.
And why would there be such high rate of HIV infection here in US deep south of both gay and bisexual men? What's up with these men? We cannot just blame this rate of infection on poverty because, poor as they are, they would not have been poorer than those in Swaziland. Is that an issue with lifestyle choice? It just doesn't square away that neatly.
Afterall this has been 35 years in the making. No one - and I truly mean no one these days - in US could have claimed total innocence of what HIV is. Would these American gay men have been less informed that those in rural African countries like Swaziland? I highly doubt it.
And why would there be such high rate of HIV infection here in US deep south of both gay and bisexual men? What's up with these men? We cannot just blame this rate of infection on poverty because, poor as they are, they would not have been poorer than those in Swaziland. Is that an issue with lifestyle choice? It just doesn't square away that neatly.
25
For everyone who commented that HIV is a preventable disease & it's their own fault for not wearing a condom, I ask you to stop & take a moment to consider if you have ever in your life had unprotected sex. Be honest. If yes, do you think that you deserved to die for it?
31
I think the question is why this is higher in the black community. Even if you accept that blame game of "it's your own darn fault", it's key to know WHY these bad decisions either occur more frequently or carry more risk in the black community.
2
I am glad someone chose to highlight this important topic, and that it appeared on the top of your website this afternoon. This is what we are seeing in Long Island - a constant number of new HIV infections in a population that is disproportionately Black/Latino MSM, and no strategy seems to be working to reduce the number of these new infections due to the same issues that Ms. Villarosa highlighted in her article. Very frustrating.
3
Stunning piece of investigative journalism. Kudos to reporter and NY Times. This is what high quality journalism is all about.
18
I am saddened by the number of comments that dismiss this article and its subject as just more evidence of the moral failings of Black people. I'm also saddened by the comments that basically ask "why should we care? This is the lifestyle they chose." This inability to have compassion for anyone "other" will ultimately be the cause of our collective demise. Remember when the crack/heroin epidemic was the fault of moral failings of Black people? Remember when it was dismissed as something only "they" did, because they were poor, uneducated, etc.? Fast forward a few decades and witness how drugs have ravaged many white communities and now there is much hand wringing and grasping for understanding.
The damage from AIDS/HIV may no longer be as high a priority for hetero communities or gay whites, but look beyond the current disease. Any mutated, drug-resistant strain of this or some new disease could set us all right back to the 80s if people find a way to view it in terms of moral failing instead of lack of resources/education.
The damage from AIDS/HIV may no longer be as high a priority for hetero communities or gay whites, but look beyond the current disease. Any mutated, drug-resistant strain of this or some new disease could set us all right back to the 80s if people find a way to view it in terms of moral failing instead of lack of resources/education.
32
You need to look at the CDC data
The single largest risk group for new HIV Dx in the US each and every year are white men who have sex with men.
1-MSM white
2-MSM black
3-MSM Hispanic
4-Black woman
That is the ranking every year for new HIV Dx.
I Idon't know how you came to the conclusion that hiv is no longer an issue for white MSM. The actual DXs tell a different story.
The single largest risk group for new HIV Dx in the US each and every year are white men who have sex with men.
1-MSM white
2-MSM black
3-MSM Hispanic
4-Black woman
That is the ranking every year for new HIV Dx.
I Idon't know how you came to the conclusion that hiv is no longer an issue for white MSM. The actual DXs tell a different story.
5
I nominate this for the Pulitzer Prize. Great, devastating reporting.
15
Yes!!
Why?
Well, it's certainly not due to any choice forced on them by old white men.
These men need information to assess the implications of the choices they make.
Best wishes for a long and healthy life.
Well, it's certainly not due to any choice forced on them by old white men.
These men need information to assess the implications of the choices they make.
Best wishes for a long and healthy life.
7
Old white men decide their chances of being in prison, their social services, their employment opportunities, their health insurance or lack thereof. Old white men decide what drugs will enter the country, and to what populations they will be disseminated. Old white men like the Monster in Chief just proposed a decrease in the funding for AIDS prevention. One would think that part of that prevention would be the very information you feel these men need. Why did you have to bring up old white men?
1
Au contraire. Old white men forced a number of choices on these people by legislating away any number of opportunities this group might otherwise have had for educational, medical, and economic support. Yes, everyone makes choices, and those choices have consequences, but some people are afforded considerably fewer choices than others.
1
All this unnecessary suffering and lack of love and support is heartbreaking. And for what? Some misinterpreted words in a fantasy book? Humans can look others in the eyes and deny their value simply because they don't like who they love? How sad. My heart aches for all those who not only are in pain because they feel they must hide who they are, but are also in pain due to an illness we have medicines for. I am so thankful for those who do offer their love and support, like Cedric Sturdevant. Were religion real, people like him would be its saints.
10
I'm amazed by people who can work their hatred of religion into any topic. No one's forcing you to attend a mosque, temple, or church, yet you (and many others like you) feel a need to show up in almost every news story on New York Times and dump on people of faith.
Reinhold Niebuhr once said, "Excessive orthodoxy is never rooted in faith: it is rooted in doubt." This statement could also apply to the aggressive atheists as well as the religious.
Reinhold Niebuhr once said, "Excessive orthodoxy is never rooted in faith: it is rooted in doubt." This statement could also apply to the aggressive atheists as well as the religious.
3
God bless him for the work he does
11
The average Black household in the USA has $100,000 less financial wealth than the average White household in the USA. Federal, state, and local laws, banking and insurance rules and regulations systematically combined to prevent Black Americans from owning homes in the suburbs from the end of WW2 through the 1970's -- that's the major source of middle class financial wealth in the USA.
To the commenters and readers who think the moral failings of Black Gay men in the South caused their illness and pain, consider that if their parents and grandparents and great grandparents were encouraged and supported to accumulate substantial real estate equity by investing in a fine suburban home that could be to be converted into financial wealth when sold to be passed down to those Black Gay men, nearly all of those young men's families would have sufficient funds to provide them decent medical care.
The lack of wealth in the Black community to provide for their most destitute is the result of political decisions by the White majority of the USA from the time of "Birth of A Nation" until Nixon's administration began enforcing the Fair Housing Act after he was reelected in 1972. The lack of medical care for Gay Black men in 2017 is also a political decision by the White majority of the USA.
To the commenters and readers who think the moral failings of Black Gay men in the South caused their illness and pain, consider that if their parents and grandparents and great grandparents were encouraged and supported to accumulate substantial real estate equity by investing in a fine suburban home that could be to be converted into financial wealth when sold to be passed down to those Black Gay men, nearly all of those young men's families would have sufficient funds to provide them decent medical care.
The lack of wealth in the Black community to provide for their most destitute is the result of political decisions by the White majority of the USA from the time of "Birth of A Nation" until Nixon's administration began enforcing the Fair Housing Act after he was reelected in 1972. The lack of medical care for Gay Black men in 2017 is also a political decision by the White majority of the USA.
6
The huge philanthropic resources are directed by liberals to white men.
The vast majority of Americans recognize that African-Americans, in particular, have been treated unfairly in this country over the decades. That said, I never understand comments like this that infantilize grown men and remove from them responsibility for their decisions. We don't do this for poor White, Asian, Hispanic or Native adults. Why must some on the left insist that Black Americans can't run their own lives? It's insulting.
3
I think you're missing the point. The article repeatedly points out how the disease is handled differently by its victims by race, from avoidance and prevention, through realization and diagnosis, to treatment and restriction on spreading, even with equal, even focused, access to information, treatment, and support resources.
The question is "WHY is the uptake/acceptance rate so much lower by race?" Blaming racism, either historical or current, is easy but incomplete at best and dangerously inaccurate at worst.
The question is "WHY is the uptake/acceptance rate so much lower by race?" Blaming racism, either historical or current, is easy but incomplete at best and dangerously inaccurate at worst.
2
This is all very sad and should be remedied. Howevre, the writer is pushing forward the case that this situation occurs because of racism, and could have been avoided if 2 black men were included in the initial report. I had just started my medical education when AIDS was first reported. For a brief period it was known as GRID, gay related immunodeficiency. Training in NYC I was a first hand witness to the epidemic. I treated gay black men. The situation described here has more to do with the fact that the small town poor rural south is dysfunctional.
9
This is not the fault of the "poor rural south." The same thing is happening in the rest of the country, that gay black men on Long Island are having the same experience.
The bulk of treatment and drugs is funded by Medicaid and philanthropic organizations, many of whom provide for people who are not poor enough to qualify for Medicaid, but need assistance. There are long waiting lists. The philanthropists directed their money to white men who are in less need than some of the black men.
The LGBT organization focused on same sex marriage. It provides tax benefits to white men and women who are middle class. The key SCOTUS case dealt with an 80+ year old, wealthy woman who objected to paying $350,000 in estate tax when her wife died leaving her $4 million. The amount of money: lobbying for changes in the law, bringing the cases to SCOTUS, suing because a baker or a florist won't bake a cake or make bouquet for a wedding. Really. Why is the community spending money on weddings when others are in need.
It is shameful that the community got all focused on the problems and micro-aggressions against wealthy white people while ignoring the black men and women in their community.
The bulk of treatment and drugs is funded by Medicaid and philanthropic organizations, many of whom provide for people who are not poor enough to qualify for Medicaid, but need assistance. There are long waiting lists. The philanthropists directed their money to white men who are in less need than some of the black men.
The LGBT organization focused on same sex marriage. It provides tax benefits to white men and women who are middle class. The key SCOTUS case dealt with an 80+ year old, wealthy woman who objected to paying $350,000 in estate tax when her wife died leaving her $4 million. The amount of money: lobbying for changes in the law, bringing the cases to SCOTUS, suing because a baker or a florist won't bake a cake or make bouquet for a wedding. Really. Why is the community spending money on weddings when others are in need.
It is shameful that the community got all focused on the problems and micro-aggressions against wealthy white people while ignoring the black men and women in their community.
Sadly this problem is self-limiting.
5
That was a deeply cynical comment.
I agree it comes across that way - I truly hope for my own character I don't mean it that way. It would have been better for me to mind my own matters and not butt-in on this.
Nevertheless I feel empathy for these men - but I don't want to pick between being honest or dumb if reality is the context. I am certainly all for platitudes and respect for fellow human beings, but that doesn't change the self-limiting situation the science of disease transmission reckons.
Probably what I meant - and probably more technically correct - is the problem is sadly contained. Virulent diseases make us all appreciate our vulnerability as humans. It is the case here that the traditionally virtuous are not vulnerable to this one.
Even though my problems are altogether different from the gay community's, I still feel empathy to these, my fellow humans. But it is from the outside. And I do need to exercise especial care in discussing a problem I am neither privy nor vulnerable.
Nevertheless I feel empathy for these men - but I don't want to pick between being honest or dumb if reality is the context. I am certainly all for platitudes and respect for fellow human beings, but that doesn't change the self-limiting situation the science of disease transmission reckons.
Probably what I meant - and probably more technically correct - is the problem is sadly contained. Virulent diseases make us all appreciate our vulnerability as humans. It is the case here that the traditionally virtuous are not vulnerable to this one.
Even though my problems are altogether different from the gay community's, I still feel empathy to these, my fellow humans. But it is from the outside. And I do need to exercise especial care in discussing a problem I am neither privy nor vulnerable.
1
As I read this article, I knew the author had to be a writer. This piece was so eloquently written, one could just place herself in the space/time/view as the writer captured everything that was emphasized. The story also has motivated me to do more to reach out to young, gay black men in this community, many of whom may not have hope because of different reasons. I implore each of us to use our blessings, skills and abilities to show love and do what we can to help communities like this throughout our country!
6
In more rural areas, those minorities who are gay or bisexual lack both proximity to tertiary treatment centers (often University medical centers) and also must keep their sexual orientation secret in a small community. They often go untested, and that can be fatal: one friend went 7 years without testing. By the time his HIV was discovered, he was already too sick. If we had a national health system, even the most remote areas would have clinics to address health needs. But in the current atmosphere of "health is not a right but a privilege" the problems of minority patients in rural areas will continue to go unaddressed.
12
Even with funded local clinics, the staff is local and the same stigmas apply. More money alone is not the answer.
1
Last week I signed an opt-in for my 5th grader to attend "About Blood and HIV" program in health class at her public school. 5th grade. 10 years old.
Mississippi should properly educate ALL of her children.
Mississippi should properly educate ALL of her children.
12
They do, regardless of the redundant, mythical claims made here.
3
Statistical note: the numbers presented for black American MSM vs. anyone living in Swaziland are not comparable. The former is lifetime risk; the latter is prevalence, a snapshot a particular time. Lifetime risk is always going to be higher than the snapshot. Not that this makes black American MSM risk less serious.
5
thank you for your comment. Complete data has been hard to come by, but according to government statistics, an estimated one third of all Black gay men in major U.S. cities are HIV-positive. (This isn't lifetime risk, which is 1 in 2). This is higher than 28.8 prevalence in Swaziland. Look at Figure 4 here, and see citation at the bottom of the charts. http://www.amfar.org/uploadedFiles/_amfarorg/Articles/On_The_Hill/2016/B...
As a former GMHC and ACT UP volunteer, I found the descriptions and examples of societal abandonment in this article to be eerily similar to that suffered by mostly young white HIV gay men in the 80s through early 90s. Today most HIV gay white men, certainly in urban areas, are hidden in another way altogether; they have the means, knowledge, and reasonable hope to tap into every resource available to them. No longer skeletal, full of hope for the future, they blend in if they choose to, have no need to reveal their status if they choose not to. That this population thrives alongside poor African-American HIV men who struggle on all the levels they once did is heartbreaking. A second swell of powerful activism is called for. Thank you for this article, and for showcasing Mr. Sturdevant and what can be done where there is the essential will.
13
This is such an excellent article. It is simply mind boggling that in 2017, in the United States of America, people are needlessly suffering from HIV/AIDS. If this helps to save the life of just one extra person, I would be forever grateful.
3
As an HIV care provider for children and youth and a native of Jackson, MS, I thank you so much for sharing this article. It is a huge public health emergency that gets far too little attention. What is even sadder it that we have all the medical tools to treat individuals with HIV as well as to successfully prevent HIV with PrEP but we have not provided the infrastructure and support these young people need to be successful with treatment.
God bless Cedric Sturdevant.
God bless Cedric Sturdevant.
7
Thank you for this important article. I spent a decade working in Miami in the RW program, and worked extensively with black MSMs and Black churches. Most didn't get it but a few did. Miami was fortunate to have Title 1 funds and great outreach. Unfortunately, the Deep South doesn't have the advantage of these funds. But even in in Miami we see hight rates of infection. It will just get worse under this administration. We must elect the right people to keep our population healthy.
5
The article intentionally avoids mentioning the single thing that will prevent the epidemic: change in behavior. Why is that? People don't contract the disease by walking down the street but through risky behavior. Why is society instead to blame for not making treatments universally available when treatments would not be needed if the persons at risk changed their behaviors? Stated differently, why should society act as a guarantor for risky behavior?
20
I started reading this article today at lunch and just finished it now at 9:30 p.m.
Lindale Villarosa, thank you for writing such an interesting, compelling and humanizing article.
"I just don't know how everything got so bad." Jordan, Community College student.
Oh my goodness, I could not stop thinking of him all afternoon. I read that and I was nearly crying. I have 2 sons and I could see my own child in this young man. Hugs Jordan.
We need to take care of people here too.
Keep writing Linda. God bless all the men.
Lindale Villarosa, thank you for writing such an interesting, compelling and humanizing article.
"I just don't know how everything got so bad." Jordan, Community College student.
Oh my goodness, I could not stop thinking of him all afternoon. I read that and I was nearly crying. I have 2 sons and I could see my own child in this young man. Hugs Jordan.
We need to take care of people here too.
Keep writing Linda. God bless all the men.
9
Ben Carson, this is only a state of mnd. What is remarkable : he has peace of mind. That American continue to elect persons of equal peace of mind, who appoint such spokepersons with real power, means American are getting what they deserve for failure to vote their true best interest.
34
What are the drugs of choice in the gay "black" community in the South?
I remember reading that Amyl Nitrate played a role in a flare up of HIV in communities of urban "white" gays.
Are people walking out of Club Metro at 4AM sober as a judge or do drugs play a role in people's judgement regarding sex partners and condom use? Is there meth? Coke? Xanax?
Details, please.
I remember reading that Amyl Nitrate played a role in a flare up of HIV in communities of urban "white" gays.
Are people walking out of Club Metro at 4AM sober as a judge or do drugs play a role in people's judgement regarding sex partners and condom use? Is there meth? Coke? Xanax?
Details, please.
1
Several years ago, the Washington Post did a fascinating story on African-American males who were gay or bisexual called Double Life on the Down Low. It was illuminating and depressing and I am not surprised that the rate of HIV is so high, as hiding who you are still seems to be ingrained into the bible thumping belt.
30
"Double Lives on the Down Low" was a pioneering piece of journalism. Use it for one of my college courses on health care. But it was the same New York Times Magazine that ran the article. "Just for the record."
3
White men engage in the same behaviors.
Family doc here, 28 years in the game.
It's mainly the socioeconomic situation. Many poor people lead disorganized lives, lurching from one crisis to the next. Add to that the fact that these folks don't have wives or girlfriends to stabilize their behavior to some extent and you get chaos. Young straight males are not known for their decision-making abilities, either. But their sexual activities are limited by women.
Poverty + young + male = crazy stuff
I have a few gay pts on Truvada. I tell them how risky unprotected sex is. I assume (hope?) that this info is also readily available among gays. None has come up positive yet. I don't know what they do in private, but they seem to get what I'm saying. They are older and are of higher SE status than these folks.
It's mainly the socioeconomic situation. Many poor people lead disorganized lives, lurching from one crisis to the next. Add to that the fact that these folks don't have wives or girlfriends to stabilize their behavior to some extent and you get chaos. Young straight males are not known for their decision-making abilities, either. But their sexual activities are limited by women.
Poverty + young + male = crazy stuff
I have a few gay pts on Truvada. I tell them how risky unprotected sex is. I assume (hope?) that this info is also readily available among gays. None has come up positive yet. I don't know what they do in private, but they seem to get what I'm saying. They are older and are of higher SE status than these folks.
107
Thank you doctor, for your clear statement of the problem. As an active leader in the State of Minnesota in the fight against HIV/AIDS, I can also attest to socio-economic status and equity disparities in general--money, access to comprehensive healthcare, education, etc.--being key roots of the problem.
6
As a physician, you should be asking your patients about their sexual practices.
3
How much are taxpayers coughing up for Truvada so that others can have unsafe sex?
2
The article states: "the risk of contracting HIV boils down to a numbers game rather than a blame game." That's only partly right.
The numbers show that the more people you have unprotected sex with, the more likely it is you will contract HIV/AIDS. That is the case whether you're black, white, gay, straight or anything else.
Promiscuity has always been anathema to judeo/christian culture, and the blame for being promiscuous applies to everyone--black, white, gay, straight or anything else.
So it's both a numbers game and, in large chunks of America, a blame game. Numbers: if you are promiscuous, you are more likely to contract HIV/AIDS. Blame: it's your own fault if you do.
The numbers show that the more people you have unprotected sex with, the more likely it is you will contract HIV/AIDS. That is the case whether you're black, white, gay, straight or anything else.
Promiscuity has always been anathema to judeo/christian culture, and the blame for being promiscuous applies to everyone--black, white, gay, straight or anything else.
So it's both a numbers game and, in large chunks of America, a blame game. Numbers: if you are promiscuous, you are more likely to contract HIV/AIDS. Blame: it's your own fault if you do.
1
The larger question is, why is HIV still being spread so liberally? Why aren't people using safe sex techniques and limiting partners?
80
They can't afford it and Republicans don't want to subsidize it. Religious freedom and all that.
People do what makes them feel good. Most do what makes them feel in the moment, some plan for next week, and a very few plan for their whole lives. This is behavior is amplified in children and adolescents, unfortunately it only takes one mistake to ruin the rest of your life.
5
Sadly, this is because most men (gay or straight) prefer and enjoy "condom free sex" because it feels better -- and they are so short-sighted, they do not care if this leads to HIV or AIDS in themselves or their partners.
You don't need to be a genius to figure out that this dark hole of neglect and dispair is venerated in it's larger locale. What better way to strengthen the hands of the pastor's , decons and other manifestations of sothern religiosity than to have your own band of lepers nearby to warn your flock and your potential new accolates of the dangers of sin.
10
Interesting that Mrf can turn principles of a religious life chastity, marriage, monogamy against the practitioners. STDs have always been lethal...prior to the age of modern medicine and the bugs are developing resistance. Subtract religion and being careful with your body is important to your survival no matter who you are. This isn't something that is new but go ahead and express your hostility to those that have different ideals.
1
As a society, we have decided that sex has no consequences, and sexually transmitted diseases (STD) are no biggy, as they are treatable. This article shows the devastation from a virulent virus, but easily preventable one, that devastates a person and his entourage.
If we accept sodomy, serial monogamy, one night stands, swinging etc. than we, as a society, have to take responsibility for treatment of these individuals.
If we accept sodomy, serial monogamy, one night stands, swinging etc. than we, as a society, have to take responsibility for treatment of these individuals.
26
Look at the whole concept behind "PrEP" -- that you can take a little pill, and then go out and have unprotected anal sex with multiple partners who are strangers to you and there is no risk.
It's a MINDSET. The mindset of the 60s and 70s was "if it feels good, do it" and it led DIRECTLY and unambiguously to the AIDS crisis.
How long until "PrEP resistant" forms of AIDS develop?
It's a MINDSET. The mindset of the 60s and 70s was "if it feels good, do it" and it led DIRECTLY and unambiguously to the AIDS crisis.
How long until "PrEP resistant" forms of AIDS develop?
4
What is baffling about the HIV discussion, especially to young gay men--like me--is what the messaging should be about other forms of safe sex. Unprotected sex is Russian roulette: that's been discussed for years. But I think there are people who adopt a throw-up-you-hands attitude when, for instance, we can't get straightforward, reliable data about something like oral sex. When more gay men elected, in casual encounters, to only engage in unprotected oral sex and protected anal sex, HIV rates declined. But even today we have the CDC saying "little to no risk," or "theoretical risk," and there is a sense of there's-no-escaping-this-risk. The gay experience of seeking and receiving medical advice we can trust is something the straight community hasn't gone through. Imagine if women were told oral sex might, maybe, possibly, result in pregnancy. Whether that would change your behavior or not, it would be confusing, give reason for alarm, and make you feel like every sexual encounter is a landmine. And your life suddenly feels very constricted and temporal. And I think that messes people up.
40
The connection between cause and effect may not be as obscure as you suppose.
2
Information regarding risk has been crystal-clear for over 25 years. If you're in New York, there is no shortage of information available to you, and the fact that some of the medical information cannot give you 100% guarantees is just the way life is. In 1981, when I was your age, it's true that we didn't have straightforward, reliable information. We all certainly have access to it now. If there is not a local Gay and Lesbian Center near you, please review the information on the GMHC website.
1
Oral sex can indeed lead to HIV and AIDS.
ANY unprotected sex can lead to STDS, AIDS and HIV.
ANY unprotected sex can lead to STDS, AIDS and HIV.
Thanks New York Times--yet another institution that is participating in race politics and division. Who cares what color people are? You love to divide and codify and pretend you are being intellectual about it--it is pathetic. We are all the same. We all have red blood. I call on non-racist (non Trump deplorables--who are akin to brainwashed Nazi youths--minus the brains) Americans to boycott answering truthfully what race, sex, age, you are for ANY questionnaire, or census. Hard to gerrymander if they don't know these details. Grow up New York Times.
28
The mentioning of race was essential in this piece because of the demographics impacted by HIV currently. The numbers in that community far outpace those in others who have access to adequate health infrastructure and the current regiment of medications and structural support. So yes, it was necessary to mention race because that's whose most impacted.
8
The NYT is acknowledging a demographic with a serious health issue. That acknowledgement leads to awareness which leads to solutions. You're world of pretend will only exacerbate such problems.
10
I'm sorry, but your idea will just sweep issues under the rug. I call on all Americans to find it in their hearts to support all people including people who don't look like yourselves. If the White Mississippi establishment would expand Medicaid and ensure adequate funding for HIV services for all people including focusing on people of color where there is such a serious issue, then we'd make progress.
5
This is a battle we are not going to win until we have a small pox like vaccine.
With a one shot vaccine we could send teams of public health advisors into the field like we did in Africa and India and around the world for small'pox some decades ago.
A disease we eliminated.
Two things really scare me.
One is the number of sexually active people taking meds to Rx or prevent who are on now and then dosages. People in general often are bad at taking oral meds. For any number of reasons people as stated in this article take the meds don't take the meds take the meds don't .....
A mutated resistant HIV is a death sentence for millions.
And it scares me how many co-infections these high risk groups are showing. Not just HIV but a lot of others including a run away syphilis epidemic. And a syphilis infection coupled with HIV has lead to syphilis related brain issues we normally see after many decades of syphilis infection. Now we can see them after months.
Gay Men with HIV dying of a very deadly and quick acting form of meningitis in periodic spurts.
In time this can get a lot worse
Read any male on line hook up site you want. Talk to men that are actively cruising strangers. What is most often on the menu----BB anal.
What is often never on the menu----condoms.
How many different sex partners can many of these high risk have in a year----- several 100s.
This battle will be won in the labs at CDC or NIH or similar. Or it's never going to be won.
With a one shot vaccine we could send teams of public health advisors into the field like we did in Africa and India and around the world for small'pox some decades ago.
A disease we eliminated.
Two things really scare me.
One is the number of sexually active people taking meds to Rx or prevent who are on now and then dosages. People in general often are bad at taking oral meds. For any number of reasons people as stated in this article take the meds don't take the meds take the meds don't .....
A mutated resistant HIV is a death sentence for millions.
And it scares me how many co-infections these high risk groups are showing. Not just HIV but a lot of others including a run away syphilis epidemic. And a syphilis infection coupled with HIV has lead to syphilis related brain issues we normally see after many decades of syphilis infection. Now we can see them after months.
Gay Men with HIV dying of a very deadly and quick acting form of meningitis in periodic spurts.
In time this can get a lot worse
Read any male on line hook up site you want. Talk to men that are actively cruising strangers. What is most often on the menu----BB anal.
What is often never on the menu----condoms.
How many different sex partners can many of these high risk have in a year----- several 100s.
This battle will be won in the labs at CDC or NIH or similar. Or it's never going to be won.
19
But with 45 leaving most science based positions unfilled, then slashing budgets by as much as 28%, we will not produce the outcome you envision.
3
I am guessing you don't know about HIV pre exposure prophylaxis. https://www.hiv.gov/hiv-basics/hiv-prevention/using-hiv-medication-to-re... . And pills just don't hope down people's throats on their own.
Thank you for a reasoned, scientific comment. The crisis of the '80s may be over be the reality of the present is frightening.
2
Thank you for exposing the lip service exhibited by Mr. Obama and his administration who came woefully unprepared to address drug addiction and were enabled by the media to hide the AIDS plaque in the South. As a gay Southerner who spent time visiting my friends at drag shows in Mississippi, Louisiana, Georgia, and Florida, I was not surprised that anal intercourse was the preferred sex act among us instead of oral sex. What I did find unique to my experience was the high use of cooking cheap drugs so as to make them injectable and sharing those needles. What I saw was the my friends not only injected but they would draw blood back into the syringe so as to pick up any drug residue. It was a hellish scene and one that I wish I could forget. It is also one that I wish I could forgive Mr. Obama, who dashed the hope and lost the potential of so many young gay men of African descent as well those of every color across the South. This brings us to the present day "what do we have to lose" Trump administration. The DNC wants to destroy the GOP with a fake Russian collusion narrative and waste valuable time with the help of elite rich liberals; instead of rolling up their sleeves and doing the collaborative hard work of addressing the war on drugs, AIDS, and other social ills in America; then the NYT and the media is part of the problem and not the solution. Let's put America first and address the destruction of our friends and family now. Mrs. Gates can you hear me?
27
Sorry, but your blame game doesn't add up. Take responsibility for your own health and your own life, gay, straight, bi, black, white, brown, etc. It's called adulthood.
10
What does Mr. Obama have to do with any of this? Huge non-sequitur.
3
The sad irony is that fundamentalists of the Christian Church conveniently forget that "their Jesus" healed a man with leprosy in Matthew Chapter 8; similarly the Church in the South should take the lead in "loving others as I have loved you," John 13:34. Acknowledging the humanity in black gay and bisexual men would start the dialogue needed to encourage safe sex, access to healthcare providers and conversations to nourish souls as opposed to damning such bretheren to Hell!
17
Sometimes it's up to the community not the federal government to do something. I have known several people (black and white) who believe that they are AIDS resistant or immune. And I have been told that like Bill Clinton who did not have sex with that woman -- do not consider doing the down-low sex. I worry about black women who have sex with these "straight" men and their potential babies.
Why not have an AIDS crusade? Where is the preacher who will shout prevention from the pulpit. (All a bunch of wusses??!!)
Why not have an AIDS crusade? Where is the preacher who will shout prevention from the pulpit. (All a bunch of wusses??!!)
9
Living near a Deep South county which has one of the highest rates of AIDS cases in the state, I say "Amen" to the suggestion that word come form the pulpit.
Of course, that would take judgement, and offending both the "go forth and multiply" dictate as well the business model that says getting a full plate back is a good thing.
Of course, that would take judgement, and offending both the "go forth and multiply" dictate as well the business model that says getting a full plate back is a good thing.
4
I find it irresponsible for the NY Times to identify the location of the gay nightclub. This is not only mean but dangerous to all the homophobes who love to kill LGBT folks. Shame on you NY Times!
15
I would think that the NYT would have requested permission before posting the information of anyone or anyplace involved in this article.
The "gay nightclub" is on twitter and facebook, is listed in local "best of" roundups and the local paper, and pops right up when you google it.
Thank you for this brilliant piece. It's to our shame that a preventable plague has been allowed to run rampant because of racial blind spots, if that phrase is not too gracious. My daughter is in Uganda working at an AIDS research clinic. Is there one in Mississippi?
33
We need the Peace Corps in our own country.
8
A few years ago, a family member came out of the closet. While some extended family members shunned him, many of us rose to his defense and refused to participate in religious intolerance. While those family members did not modify their views, they are well aware that their intolerance will not be tolerated at family functions.
Reading this article makes me ashamed to be Christian because I believe that Jesus would minister to HIV+ individuals, not shun them. Shame on all of us!
Reading this article makes me ashamed to be Christian because I believe that Jesus would minister to HIV+ individuals, not shun them. Shame on all of us!
49
i was naively thinking that aids was no longer a serious threat to anyone in the US. it's terrible that this disease is still killing people and that race is playing a factor.
19
It needn't be this way. No one can be this uninformed to not know that sex without protection can have tragic consequences. Everyone should take responsibility for their own behavior.
2
Why? - I would imagine its for the same reason that 2/3 of black children are born out of wedlock - black men just don't take precautions to the same degree as other men.
59
How then, John, do you explain the fact that this issue is largely regional?
4
Adding to your comment, it's more than that. Because they are not held responsible -- a single mother gets government help -- they can father child after child without ever having to support even one. It's tragic, leads to disadvantaged children, and is the fault of the government for enabling this practice.
1
Dubious claims John, care to cite a source?
2
I'm disappointed but not surprised by this piece.
Absolutely, HIV/AIDS disproportionately affects black men who have sex with men (MSM). But, without a shred of evidence, the author repeats the pernicious, borderline-homophobic myth that it's a consequence of racist neglect by bourgeois northern white gay men. She purposefully ignores the resources that institutions and philanthropic organizations have continued to pour into HIV/AIDS; she implies that same-sex marriage is little more than a wedding party, as if legal union doesn't confer vital benefits to same gay couples (health insurance and social security benefits, for example) or normalizes homosexuality in historically hostile populations.
That leads me to my second point: She dismisses down low culture and black homophobia out of hand, probably because it complicates her intersectional narrative. In fact, black MSM face significant discrimination within the black community. See the graph on acceptance by religious denomination:
http://www.pewforum.org/2016/05/12/changing-attitudes-on-gay-marriage/
Only white evangelical Christians are more homophobic than black Protestants.
Unfortunately, I have neither the time nor the space to parse the rest of the article. And let me be clear: HIV/AIDS among black MSM is an alarming phenomenon that deserves public attention. But the author hurts rather than helps the cause by framing the issues in exclusively racialized terms and refusing to engage in a good faith discussion.
Absolutely, HIV/AIDS disproportionately affects black men who have sex with men (MSM). But, without a shred of evidence, the author repeats the pernicious, borderline-homophobic myth that it's a consequence of racist neglect by bourgeois northern white gay men. She purposefully ignores the resources that institutions and philanthropic organizations have continued to pour into HIV/AIDS; she implies that same-sex marriage is little more than a wedding party, as if legal union doesn't confer vital benefits to same gay couples (health insurance and social security benefits, for example) or normalizes homosexuality in historically hostile populations.
That leads me to my second point: She dismisses down low culture and black homophobia out of hand, probably because it complicates her intersectional narrative. In fact, black MSM face significant discrimination within the black community. See the graph on acceptance by religious denomination:
http://www.pewforum.org/2016/05/12/changing-attitudes-on-gay-marriage/
Only white evangelical Christians are more homophobic than black Protestants.
Unfortunately, I have neither the time nor the space to parse the rest of the article. And let me be clear: HIV/AIDS among black MSM is an alarming phenomenon that deserves public attention. But the author hurts rather than helps the cause by framing the issues in exclusively racialized terms and refusing to engage in a good faith discussion.
68
Thank you for the humanist view on this.
Glad you ran out of parsing space. The author covers homophobia in the black community, in black churches, and in the lives of many, though not all, of the young men affected--thrown out and abandoned by their families. These problems also exist in the white and Latino communities, particularly in fundamentalist families and churches. Her comment about gay marriage was merely a statement of fact. Resources were diverted and the community reduced the amount of time spent talking about AIDS, as did the entire American public and the media. Before I read this article, I knew this problem existed, but I didn't realize how bad it is. It seems that insufficient resources have been devoted to it by every group, including, of course, our politicians. AIDS/HIV remains a difficult problem to discuss-- because most infections come from voluntary sex acts. Many people don't want to pay into a healthcare system that pays for care for diseases that are caused by voluntary acts -- including smoking, drinking, and STDs. One only has to read the comments here.
7
Amen.
Gay, black men may have one of the highest number rates of HIV but the rates among black women have risen by the highest percentage in the past decade or so. They are also seriously affected by this disease.
15
Actually, the rate of HIV infection has significantly decreased and continues to decline for black women. I imagine that as the currently infected group of black women dies off, the HIV prevalence rate among black women will be even lower.
I personally know plenty of young black educated women who are gladly abstaining from sex altogether.
I personally know plenty of young black educated women who are gladly abstaining from sex altogether.
2
All the more vigilant with whom you sleep and to protect yourself properly.
2
New HIV infections for black women have dropped fairly dramatically in recent years, 42 percent between 2005 and 20014. Still, it's not over for black women whose rates are high compared to women of other races. Here's the citation for the stats: https://www.cdc.gov/hiv/group/racialethnic/africanamericans/index.html
1
Thank you.
4
What an awful failure of public health policy.
The fact that PrEP (Truvada) has been available for a number of years as a preventative, and while the drug is expensive, the manufacturer and nonprofit organizations have teamed up to make it available for little or no cost to many (at least that's the case in Austin).
Clearly, the public health community needs to step up. At the same time, primary care physicians, many of whom seem to practice a purposeful ignorance when it comes to PrEP, need to get on the ball, learn about PrEP and actively encourage its use in all populations. If they did that, we truly could be looking at an HIV-free generation in a couple of decades.
The fact that PrEP (Truvada) has been available for a number of years as a preventative, and while the drug is expensive, the manufacturer and nonprofit organizations have teamed up to make it available for little or no cost to many (at least that's the case in Austin).
Clearly, the public health community needs to step up. At the same time, primary care physicians, many of whom seem to practice a purposeful ignorance when it comes to PrEP, need to get on the ball, learn about PrEP and actively encourage its use in all populations. If they did that, we truly could be looking at an HIV-free generation in a couple of decades.
12
Failure of public health policy? How failure of the individuals accept some degree of responsibility for their own conduct? This "epidemic" is not the fault of society, it is theirs...
5
Thats a bit of exaggeration about little to no cost Truvada for HIV PrEP in the US. Much more needs to be done along those lines, even in Austin.
Correlates with religion
12
"50% of african-americans will be hiv positive?"
this is statistical error and statistical nonsense . it is extrapolating from a small number.
it will never happen or even come close.
this is statistical error and statistical nonsense . it is extrapolating from a small number.
it will never happen or even come close.
12
If you read the article more carefully, what the author said was that fifty percent of African-American gay men are expected to get HIV during their lifetime not fifty percent of African Americans.
The article says 50% of African-American gay men, not 50% of all African-Americans. Still, a sobering number.
I agree, Charles, and attempting to equate this hypothetical prevalence with Swaziland's actual prevalence is at best a reflection of the author's naivete, at worst an intentional effort at sensationalism.
How about reporting the actual prevalence among gay and bisexual black men? And the five year trend? It is ridiculous to report the "estimated lifetime risk" without providing the standard measurement - in this case prevalence. And it is particularly bad reporting to then compare the somewhat contrived figure - the estimated lifetime risk - to prevalence measured in Swaziland.
The NYT should do better than this.
How about reporting the actual prevalence among gay and bisexual black men? And the five year trend? It is ridiculous to report the "estimated lifetime risk" without providing the standard measurement - in this case prevalence. And it is particularly bad reporting to then compare the somewhat contrived figure - the estimated lifetime risk - to prevalence measured in Swaziland.
The NYT should do better than this.
The story fails to answer the basic question:
If you are black and at risk, or already infected, are there resources available, if you seek them out, to either obtain Truvada or HIV treatment if already infected? The closest we come to answering that question is something about 9,000 folks on a waiting list, nationwide, for HIV medication in 2011. That's six years ago, and we're not told how long folks had to wait, or exactly how many of these were "poor black and brown men in Southern states," although the author asserts that most of the folks who were waiting fit this demographic.
The headline says "Why do America's black gay and bisexual men have a higher HIV rate than any country in the world?" but the story doesn't come close to answering the question. Based on what is published, my takeaway is, it's in large part an absence of personal responsibility, people who play ostrich for whatever reason--there are several examples provided of people who should know better not going to doctors or not taking medication even when it is offered. After reading this, I googled and found several articles about obtaining Truvada for free or at reduced cost:
http://www.advocate.com/commentary/2017/3/08/getting-prep-cheap
Beyond Truvada, let's be frank. I'm not gay, yet the need for condoms and the basics of HIV have been drilled into my head for the past quarter century. The author somehow seems to want to blame "the system." At some point, you have to look in the mirror.
If you are black and at risk, or already infected, are there resources available, if you seek them out, to either obtain Truvada or HIV treatment if already infected? The closest we come to answering that question is something about 9,000 folks on a waiting list, nationwide, for HIV medication in 2011. That's six years ago, and we're not told how long folks had to wait, or exactly how many of these were "poor black and brown men in Southern states," although the author asserts that most of the folks who were waiting fit this demographic.
The headline says "Why do America's black gay and bisexual men have a higher HIV rate than any country in the world?" but the story doesn't come close to answering the question. Based on what is published, my takeaway is, it's in large part an absence of personal responsibility, people who play ostrich for whatever reason--there are several examples provided of people who should know better not going to doctors or not taking medication even when it is offered. After reading this, I googled and found several articles about obtaining Truvada for free or at reduced cost:
http://www.advocate.com/commentary/2017/3/08/getting-prep-cheap
Beyond Truvada, let's be frank. I'm not gay, yet the need for condoms and the basics of HIV have been drilled into my head for the past quarter century. The author somehow seems to want to blame "the system." At some point, you have to look in the mirror.
39
That Advocate article says it is "possible" to get Truvada cheap. Getting Truvada cheap for HIV pre exposure prophylaxis is a very rare occurrence.
Well thanks, black churches; you've sure done your part here.
Racism certainly plays its part here, but any honest examination of the circumstances in which blacks who are not heterosexual or exclusively so live must also look at Africa, which is not exactly a safe or welcoming continent for those who do not follow rigidly-prescribed social and cultural roles.
Perhaps instead of hurling hysterical abuse at invited speakers on East coast and West coast campuses, BLM activists and their friends might shake themselves out of their indignations and do some meaningful social justice work. Fifty years ago, young men and women like them were risking their lives in the Deep South. Shouting loudly in the halls of academe ain't quite the same level of courage. Put up or, you know...
Racism certainly plays its part here, but any honest examination of the circumstances in which blacks who are not heterosexual or exclusively so live must also look at Africa, which is not exactly a safe or welcoming continent for those who do not follow rigidly-prescribed social and cultural roles.
Perhaps instead of hurling hysterical abuse at invited speakers on East coast and West coast campuses, BLM activists and their friends might shake themselves out of their indignations and do some meaningful social justice work. Fifty years ago, young men and women like them were risking their lives in the Deep South. Shouting loudly in the halls of academe ain't quite the same level of courage. Put up or, you know...
22
If gay black men are waiting for the black churches and other black institutions to come around, they will be waiting forever. If they want acceptance, they will have to demand it just as white gays did with ACT UP. Interrupt church services, confront the pastors, chant slogans, lie down in the aisles. Remember "we're here, we're queer, get used to it" ? It won't be easy, it won't be pretty, but if you want change, you have to go out and take it instead of waiting passively for it to come to you.
1
Wow, as if it is not difficult enough just to be black or gay , but to be black and gay and now have 50% chance of getting infected by HIV!
Great NYT journalism for many reasons, and here's one: it critically points out this epidemic is not simply because this population has more unprotected sex than other population.
Great NYT journalism for many reasons, and here's one: it critically points out this epidemic is not simply because this population has more unprotected sex than other population.
4
You may thank Millet for that. I agree that journalism should pay strong attention to reporting scientific data as this article does more than is usually the case.
The South is a Third-Word country on almost every measurable aspect of life; with an abundance of institutionalized ignorance and racism. Expecting a better outcome to a chronic but survivable disease- is wishful thinking.
18
But Third World countries don't have this kind of infection rate.
Maybe I'm missing something, but I'm having trouble understanding how stigmatization and discrimination, which is surely present in the South for gay men on a level that doesn't exist elsewhere, is driving this infection rate. Are these folks so beaten down by society that they're, perhaps subconsciously, trying to kill themselves?
Lots of people face discrimination but still address their health concerns to the best of their abilities. As the article shows, this is not happening among black men in the South. Condoms are available. Truvada is available, and at free or reduced cost in many cases. Certainly, medication is available for those already infected. But black men just aren't doing any of these things. That's what I took away from this story.
Maybe I'm missing something, but I'm having trouble understanding how stigmatization and discrimination, which is surely present in the South for gay men on a level that doesn't exist elsewhere, is driving this infection rate. Are these folks so beaten down by society that they're, perhaps subconsciously, trying to kill themselves?
Lots of people face discrimination but still address their health concerns to the best of their abilities. As the article shows, this is not happening among black men in the South. Condoms are available. Truvada is available, and at free or reduced cost in many cases. Certainly, medication is available for those already infected. But black men just aren't doing any of these things. That's what I took away from this story.
2
As an older gay man, I am not surprised that many younger gay and bisexual men are coming down with HIV in 2017. The British newspaper The Guardian reports today (on its front page) that the UK has attained the highest rates of syphilis since 1949. The reason: unprotected sexual encounters among young gay men. The Syracuse, New York, health department reported last year a surge in sexually transmitted diseases -- again mostly due to casual sex among gay/bisexual men. There is a large gay subculture devoted to casual sexual encounters, all facilitated and hastened by the internet and social media. Add to that the popular rejection of condoms and the total dismissal of quaint concepts such as getting to know someone before you have sex. This milieu -- whether it is white, black, or Hispanic -- is cynical, feels entitled, and knows very well of the risks. It is simply a philosophy of life for some.
44
It is a philosophy -- aided and abetted by lefty liberalism that says pleasure today matter more than anything else..."if it feels good...DO IT!"....it's always somebody else's responsibility if you screw up .... "You can't tell ME what to do!" (i.e., wear a condom every time).
You reap what you sow.
You reap what you sow.
1
Thank you!
For several years now, I have taught a college-level course on the politics and history of HIV/AIDS. Nearly all of my students report receiving only one message about HIV (and that, only once in their education): use a condom. None of them have ever heard about PEP or PrEP, most of them have not been tested, all of them believe HIV/AIDS is a thing of the past. Some of them report receiving only abstinence-only education in public schools here in liberal Massachusetts. There is no mandated sex ed curriculum in Mass.
This is what sex education looks like in a relatively affluent and liberal state, among students who have done well enough to get to college. If that's the best we in the US have to offer our kids, the epidemic will continue to ravage the least privileged among them.
Those of us who lived through the 80s owe it to the succeeding generations to transmit the history, to change our antiquated, ignorant systems of public education and public health, and to take care that history not repeat itself. As it already is.
Thank you to Linda Villarosa for this compelling article, bringing so many of the strands of the current epidemic together, and placing them in the context of the history you (and I) have lived through. You are a role model for all of us who bear the moral obligation to bring this history forward.
This is what sex education looks like in a relatively affluent and liberal state, among students who have done well enough to get to college. If that's the best we in the US have to offer our kids, the epidemic will continue to ravage the least privileged among them.
Those of us who lived through the 80s owe it to the succeeding generations to transmit the history, to change our antiquated, ignorant systems of public education and public health, and to take care that history not repeat itself. As it already is.
Thank you to Linda Villarosa for this compelling article, bringing so many of the strands of the current epidemic together, and placing them in the context of the history you (and I) have lived through. You are a role model for all of us who bear the moral obligation to bring this history forward.
178
Id hope that the LGBTQ people in ur class knew what PreP was....Im 29 and a gay trans-woman, and every queer person I know knows about PreP and uses protection.
Thank God I live in Colorado I guess. Maybe my scene is just more informed, but being safe just seems like a cultural norm to my friends and I.
Thank God I live in Colorado I guess. Maybe my scene is just more informed, but being safe just seems like a cultural norm to my friends and I.
By focusing on the politics and education of HIV/AIDS you are missing the key theological root in the black community behind this epidemic-the black church. Along with the problem of mass black incarceration. Neither a dearth of sex education nor a lack of political or socioeconomic power are the key roots to the black male HIV epidemic.
The black 'Christian' church is an enduring reservoir of duplicitous diabolical homophobic delusional denial. The church has been the longest surviving black controlled institution supported primarily by black women and led by black preachers. Being gay or bi-sexual black male is seen as the penultimate sin. Beyond all redemption except for 'choosing' another gendered ordered life-style or being 'cured' or abstinence. The black 'gay' choir director and the black 'gay' beautician are claimed to be sophisticates. There are black male gay churches.
About 40% of the 2.3 million Americans in prison are black. And sex between men in prison is not considered to be gay. Blacks are only 13.2 % of Americans. This is another HIV route into the black gay and bisexual community.
The black 'Christian' church is an enduring reservoir of duplicitous diabolical homophobic delusional denial. The church has been the longest surviving black controlled institution supported primarily by black women and led by black preachers. Being gay or bi-sexual black male is seen as the penultimate sin. Beyond all redemption except for 'choosing' another gendered ordered life-style or being 'cured' or abstinence. The black 'gay' choir director and the black 'gay' beautician are claimed to be sophisticates. There are black male gay churches.
About 40% of the 2.3 million Americans in prison are black. And sex between men in prison is not considered to be gay. Blacks are only 13.2 % of Americans. This is another HIV route into the black gay and bisexual community.
1
Condom or mulit-million dollar HIV drugs? Why is sex education recommending condom use a problem exactly?
I see a number of HIV in practice and govt.distributes ARV drugs free, does CD 4 counts regularly and the risk of associated TB is high.X rays are freely available.Longevity has improved greatly but compliance to medication is still difficult.Need to motivate them all the time, encourage them when viral counts dip,their condition improves. But it is taxing
3
Life is hard. We've have got to work hard at it. Keep it up!
Why is this surprising? Poor and ethnically homogeneous populations often isolate themselves from the dominant culture and its sources of information. Between limited education and rejecting or ignoring concerns regarded as
'white', these communities have poor outcomes in most measures of wellbeing - health, diet, obesity, education, employment, incarceration, etc. 'Systemic racism' is the fallback explanation for all dysfunction, but it does not explain rejection of basic information on health and personal behavior. That dysfunction will persist until society finds a way to reach marginal populations with the messages that the rest of us absorb from constant exposure in the media.
'white', these communities have poor outcomes in most measures of wellbeing - health, diet, obesity, education, employment, incarceration, etc. 'Systemic racism' is the fallback explanation for all dysfunction, but it does not explain rejection of basic information on health and personal behavior. That dysfunction will persist until society finds a way to reach marginal populations with the messages that the rest of us absorb from constant exposure in the media.
22
Excellent response, though I hardly blame the kids for not being taught--and they didn't live through the earlier crisis. But yes, what do we as a society do about people who actively reject factual and helpful information, whether it be about HIV/AIDS or the Trump Administration.
This hidden HIV epidemic in the current times is a very sad situation that defeats my optimism expressed in the beginning of this century. that by 2050, HIV will be eradicated using a multi pronged approach, which I had predicted in my editorial in the Journal of the Royal society of Medicine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1079254/
We have highly active and effective anti HIV/AIDS therapy to treat HIV infected persons and most governments provide such treatment free of cost, we know how HIV is transmitted and how to effectively prevent transmission using physical barriers and not exchanging infected needles and billions of dollars have been spent on vaccine research by the US government over the past 30 years. What seems to be failing is the education about HIV prevention and compliance with practices to prevent HIV infection. It is disheartening that the knowledge of this real rascal termed HIV is not as infectious and wide spread, as the morbidity and mortality caused by the highly infectious HIV.
We have highly active and effective anti HIV/AIDS therapy to treat HIV infected persons and most governments provide such treatment free of cost, we know how HIV is transmitted and how to effectively prevent transmission using physical barriers and not exchanging infected needles and billions of dollars have been spent on vaccine research by the US government over the past 30 years. What seems to be failing is the education about HIV prevention and compliance with practices to prevent HIV infection. It is disheartening that the knowledge of this real rascal termed HIV is not as infectious and wide spread, as the morbidity and mortality caused by the highly infectious HIV.
5
The etiology of this problem is not hard to figure out.
Lack of real education, too much time, and the ability to find multiple partners quickly with smart phones.
Lack of real education, too much time, and the ability to find multiple partners quickly with smart phones.
16
Maybe because they are not protecting themselves and others?
14
Possibly they are not being careful enough?
13
If public support for AIDS/HIV treatment and prevention in the United States has diminished, one reason is that the news media these days rarely, if ever, mention in an obituary that the deceased had AIDS or HIV. In the 1980s and 90s, obituaries frequently mentioned that the deceased HIV or AIDS. Today, I rarely, if ever, see it in an obituary. It is no surprise that public support of HIV/AID treatment and prevention has diminished. The news media, with the notable exception of this article in the NYT today, hardly ever mention that someone has HIV or AIDS anymore. This causes the general public to believe that AIDS/HIV is no longer a problem in the United States.
5
Most obituaries of people who died of AIDS In the 1980s and 1990s used euphemisms such as "after a short illness" or "pneumonia" or "cancer" and did not mention HIV/AIDS.
And of course, the obituaries of all the people who died in the 1970s while the epidemic was gaining steam didn't mention the disease either, for obvious reasons.
And of course, the obituaries of all the people who died in the 1970s while the epidemic was gaining steam didn't mention the disease either, for obvious reasons.
The U.S. has nearly 40 years of HIV epidemiological and public health research and the resulting knowledge to deal with HIV disease. But it obviously takes financial and human resources beyond what is currently available from both governments and private agencies. In the Trump era, I doubt that this tragedy will get additional funding to combat it. Worse, funds are likely to diminish.
This is an important article. There are caring, empathic theater artists dealing with this issue in an imaginative way. I speak of Playwrights Sanctuary which is helping underprivileged playwriting hopefuls put their cares & convictions into words and action - new plays. This program is helping those in California, Florida & NYC. One way to confront this silence is through stage poetry,
2
So happy engaged dramatists are getting the word out on how dramatic arts can help others. Service & volunteerism is intrinsic to this special program - the roots of which were ignited by a t John s University project. Today in our damaged democracy younger threatened populations must find reassurance. The theater has always been an inclusive art form. I don't speak of mainstream entertainment -- the worst parts exhibited in a Reality TV star President. I'm talking about about experimental even underground alternative theater arts. This is not the star struck name recognition theater for the elite & privileged. There are theater experts who spend retirement years as activists. They contribute an informed sensibility to this energetic. compassionate project.
It is only a matter of time before many of those infected with HIV will learn that they are also infected with hepatitis C, which is still crushingly expensive to cure with meds. This needs to be taken into consideration in formulating state and nationwide public health plans and budgets. Early detection and treatment for hepatitis C matters as it reduces the number of people who are able to transmit the disease.
3
You are missing key information on transmission of HCV and "many of those" if you mean MSM, non PWID is likely inaccurate.
What an amazingly informative and important article. I just hope Americans will read it with an open heart and critical mind. Already, it seems like there's a fair amount of misreading--the 50 percent of HIV infection refers to gay and bisexual black men, not ALL blacks. This sort of misreading, fueled by stereotypes and general lack of statistical sense, will create more problems.
In the short run, with Trump in the White House (who would most likely misread this article in so many troubling ways), the federal government will be out of the picture for coming up with innovative solutions to this problem. Can anyone imagine Trump holding a press conference in the White House lawn to address the HIV crisis among gay and bisexual black men in Southern states? I would purchase a "Make American Great America" cap and eat it. In this vacuum, private foundations must step in and make this a major priority. After decades of intervention in sub-Saharan Africa, it turns out that the rate of infection is higher in an American sub-group.
In the long run, we need to fundamentally disrupt the entrenched pattern of social and economic inequality in the American South. Ever since the founding of this nation, the gross oppression and poverty in the South have been left to fester like an open sore on the body of this nation. The fate of this nation depends on addressing this fundamental problem that distorts our national politics, race relations, economic potential, and social fabric.
In the short run, with Trump in the White House (who would most likely misread this article in so many troubling ways), the federal government will be out of the picture for coming up with innovative solutions to this problem. Can anyone imagine Trump holding a press conference in the White House lawn to address the HIV crisis among gay and bisexual black men in Southern states? I would purchase a "Make American Great America" cap and eat it. In this vacuum, private foundations must step in and make this a major priority. After decades of intervention in sub-Saharan Africa, it turns out that the rate of infection is higher in an American sub-group.
In the long run, we need to fundamentally disrupt the entrenched pattern of social and economic inequality in the American South. Ever since the founding of this nation, the gross oppression and poverty in the South have been left to fester like an open sore on the body of this nation. The fate of this nation depends on addressing this fundamental problem that distorts our national politics, race relations, economic potential, and social fabric.
8
The New York Times Magazine article, "Double Lives on the Down Low," by Benolt Denizet-Lewis, published August 3, 2003, may provide some clues.
9
Prefer that my taxes paid support Somali orphans. Their unfortunate misery is not voluntary and will respond more readily to sustained care.
10
Living in ignorance, I thought the worst of the epidemic was over - that usually, AIDS had become a chronic disease - frightening, but no longer a death sentence, with a hellish decline. And the percentage of African America men expected to get HIV is outrageous: how can a country refuse to act if 50% of a group is expected to get a disease which can be prevented??
Linda Villarosa has managed to both individualize the people she interviewed, and to analyze a long list of the barriers to change, which run from federal inaction through state neglect and chronic poverty and racism, and to personal behaviors.
If this many people were, say, suddenly getting polio, there would be demands for action.
One specific question on an ambiguous sentence: if the CDC reported that "only 48% of black gay and bisexual men effectively suppress the virus with consistent medication." does that mean that the virus is not suppressed despite consistently taking the meds, or that the men are inconsistent in taking them?
Linda Villarosa has managed to both individualize the people she interviewed, and to analyze a long list of the barriers to change, which run from federal inaction through state neglect and chronic poverty and racism, and to personal behaviors.
If this many people were, say, suddenly getting polio, there would be demands for action.
One specific question on an ambiguous sentence: if the CDC reported that "only 48% of black gay and bisexual men effectively suppress the virus with consistent medication." does that mean that the virus is not suppressed despite consistently taking the meds, or that the men are inconsistent in taking them?
10
Yes, that sentence is highly ambiguous. Careful editing should have corrected it. A correction might have required an extra paragraph, however.
Both interpretations are correct and should be viewed in tandem.
All studies show that adherence to a complex medication regimen over a long period is never 100 percent, actually much less. And that occurs even if circumstances are optimum. Where there is a lack of healthcare resources, a lack of financial resources, a lack of education, a lack of public transportation (all effects of poverty) outcomes are always worse. When those factors are combined with immense social stigma, internalization of such stigma, and relatively young age, outcomes are even worse.
Actual medical factors also come into play. Different persons and different groups of persons can have different reactions to standard doses of various medications. Much has to do with individual metabolism and the health of the organs where metabolism occurs. Ideally, each patient's reaction to each drug would be evaluated. Unfortunately, time, cost and sometimes physician knowledge make such evaluation difficult or impossible in many cases. With HIV/AIDS, the problem is increased if the disease has progressed to opportunistic infections. It may then be very difficult for the patient or for the physician to be sure whether a reaction is an effect of a medication or of disease progression.
Both interpretations are correct and should be viewed in tandem.
All studies show that adherence to a complex medication regimen over a long period is never 100 percent, actually much less. And that occurs even if circumstances are optimum. Where there is a lack of healthcare resources, a lack of financial resources, a lack of education, a lack of public transportation (all effects of poverty) outcomes are always worse. When those factors are combined with immense social stigma, internalization of such stigma, and relatively young age, outcomes are even worse.
Actual medical factors also come into play. Different persons and different groups of persons can have different reactions to standard doses of various medications. Much has to do with individual metabolism and the health of the organs where metabolism occurs. Ideally, each patient's reaction to each drug would be evaluated. Unfortunately, time, cost and sometimes physician knowledge make such evaluation difficult or impossible in many cases. With HIV/AIDS, the problem is increased if the disease has progressed to opportunistic infections. It may then be very difficult for the patient or for the physician to be sure whether a reaction is an effect of a medication or of disease progression.
2
I read that to mean that 52 percent of that population either don't take meds, or don't take them consistently enough to be effective.
Inconsistent in taking them.
I am a 60 year old HIV-positive gay white man. I was ravaged by full blown AIDS 20 years ago but was fortunately able to move out of the AIDS category and back into the HIV positive category because of the new medications. I have been thriving for two decades now and fully expect to die from something that is not AIDS related. I also could not have had better support all around. I came from a liberal family with financial means and had their full support, as I also had from the liberal community in New York City. My father was a renowned pharmaceutical chemist with connections to all the newest treatments and physicians involved with them. My current physician is in the forefront of this field. I experienced very little rejection or scorn; the norm for me was kindness and sympathy from everyone in the hospitals or anywhere. I cannot begin to tell you the benefit such generosity lent to my healing process. And in the midst of all of this support, my path to recovery was still very, very arduous. When I had recovered I felt as though I had gotten a PhD in AIDS survival I participated in outreach in the new growing demographics of infections in the black community. I can testify to all here that I did not begin to appreciate the support that I had, and how that support was key to my recovery, until I witnessed the lack of support these new patients have and how that jeopardizes their health.
330
There is nothing more unhealthful and dangerous than being born and bred colored black in America. No amount of education nor power nor wealth can make you white.
Humanity denying African enslavement and equality defying separate and unequal Jim Crow are the historical physically identifiable caste class weight. But an even heavier burden is carried by black gay and bisexual men who are doubly bedeviled by their color and their sexual orientation.
Being colored white in America is to be privileged and 'relaxed' in a nation where normal and natural is always colored white.
'I am an invisible man' unnamed protagonist in "Invisible Man' by Ralph Ellison
See the poetry of Langston Hughes and Countee Cullen along with the fiction and non-fiction of James Baldwin. See the life of Bayard Rustin.
Humanity denying African enslavement and equality defying separate and unequal Jim Crow are the historical physically identifiable caste class weight. But an even heavier burden is carried by black gay and bisexual men who are doubly bedeviled by their color and their sexual orientation.
Being colored white in America is to be privileged and 'relaxed' in a nation where normal and natural is always colored white.
'I am an invisible man' unnamed protagonist in "Invisible Man' by Ralph Ellison
See the poetry of Langston Hughes and Countee Cullen along with the fiction and non-fiction of James Baldwin. See the life of Bayard Rustin.
4
Solution: Safe Sex all times! ;-)
58
Or just say no, and don't have sex. It won't kill you.
9
Too simplistic. It is like asking a drug addict to stop taking drug, or a smoker to cut it out.
10
@KadoSante, how is practicing safe sex simplistic? Abstinence would indeed be a simplistic proposal but I don't understand how using condoms is.
2
HIV is now miraculously a largely preventable disease. What's stopping these men from putting on a condom or using clean needles if that's the issue?
Is it access? Education? Stigma? Culture?
Any program must be honest and get to the root of why these men have not gotten the message that they do not have to get AIDS to begin with.
Is it access? Education? Stigma? Culture?
Any program must be honest and get to the root of why these men have not gotten the message that they do not have to get AIDS to begin with.
97
Apparently the reasons are all those you state, plus the obstacles of cost - and the cultural and religious stigmatization that leads to denial.
17
These men have similar practices with respect to other comparable communities (i.e. rates of protection or clean needle use is not necessarily higher elsewhere), but their background prior of getting infected are higher due to the 50% prevalence of disease. In many places you end up with teenage pregnancy, whereas here it's HIV. There is a high amount of stigma in some regions of USA, further reducing availability of testing, advice, community support. Overall healthcare is worse in Southern USA for blacks, with black women dying from breast cancer at unacceptable rates. In conclusion, multiple factors at work.
8
Did you read the article? I thought it explained this very well.
6
Sad.
My take-away is that the overwhelming key is that unprotected sex equals a high probability outcome of infection. Therefore, either protected sex or no sex. You can't ignore the 500 pound gorilla in the room.
Juan
My take-away is that the overwhelming key is that unprotected sex equals a high probability outcome of infection. Therefore, either protected sex or no sex. You can't ignore the 500 pound gorilla in the room.
Juan
72
Education about the transmission of HIV would go a long way. Pervasive misconceptions about the virus are still a problem in 2017, largely a result of the government's opposition to sex education. For example: Among sexual activities, receptive anal intercourse with internal ejaculation carries the greatest risk of infection; it creates microscopic tears in the rectum which provide the virus with a direct path to the bloodstream. The simple act of "pulling out" significantly reduces that risk. Ditto generous application of lubricant.
Moreover, as the author notes, there is another preventative option: PrEP (Pre-Exposure Prophylaxis). It reduces transmission by 99%. Currently, there is one drug on the market, Truvada: a small blue pill taken daily by members of at-risk populations. Two other drugs are in clinical trials, including another pill and, IIRC, a quarterly injection.
Activists like the author are (undoubtedly) working to increase access to these resources for black MSM.
However, HIV infection rates are a symptom of the broader plight of black Americans. Meaningful improvement is incidental to much broader institutional reform (criminal justice, healthcare, economic policy, etc.). Contrary to what the author seems to imply, LGBT advocacy groups have nowhere near the necessary clout or resources to effect that kind of change. Inasmuch as the author means to indict their agenda... well, suffice it to say that her blame is misplaced.
Moreover, as the author notes, there is another preventative option: PrEP (Pre-Exposure Prophylaxis). It reduces transmission by 99%. Currently, there is one drug on the market, Truvada: a small blue pill taken daily by members of at-risk populations. Two other drugs are in clinical trials, including another pill and, IIRC, a quarterly injection.
Activists like the author are (undoubtedly) working to increase access to these resources for black MSM.
However, HIV infection rates are a symptom of the broader plight of black Americans. Meaningful improvement is incidental to much broader institutional reform (criminal justice, healthcare, economic policy, etc.). Contrary to what the author seems to imply, LGBT advocacy groups have nowhere near the necessary clout or resources to effect that kind of change. Inasmuch as the author means to indict their agenda... well, suffice it to say that her blame is misplaced.
2
Well thanks for that tidbit,J.Fillio. How much sex-education and sexual health is being funded in MO. primary and secondary schools,or even state supported colleges.? Even in KCMO I don't see much in the way of publically funded education,resources,needle exchanges and outreach to this community. It has all been dumped on NPO's, and underfunded "charity clinics" like Kansas City Care Clinic. It's not that 500lb gorilla in the room you are sensing-it's a decade of partisan politics piled up in large heaps that you smell.
1
I recently returned to Gulf Coast area of Texas where my family lived for 2 years. I had not been in touch with these 8th grade friends since the mid-1950's.
Unless you visit the Deep South you cannot appreciate what life is like for people of color there. It is like it is still Jim Crow times there. Get nostalgic for the "Happy Days" 1950's? Visit the small/medium sized towns like Jackson, MS, and you'll see a world unknown in the Bi-Coastal US or Great Lakes states. The southern culture of poor uneducated Caucasian people has changed very little since 1955. The "N" word flies around like the last 65 years never happened.
In the south, LGTBQ people must hide their sexual orientation...in all but the big cities. Homosexual people are regarded with great disdain by the majority southern culture. That is southern people who did not grow up in families where children were educated to accept all people as worthwhile. Much of that intolerance stems from fundamentalist Christian doctrine which focuses on the differences between the races rather than the things all races share in common. Not ministers. Average churchgoers. Just go to a small town church on Sunday morning....the races worship in separate buildings.
Besides all these HIV positive people who suffer...think of how many children in the Deep South go to bed hungry every night. How few are Domestic Violence shelters in the Deep South. It is another world down there.
Unless you visit the Deep South you cannot appreciate what life is like for people of color there. It is like it is still Jim Crow times there. Get nostalgic for the "Happy Days" 1950's? Visit the small/medium sized towns like Jackson, MS, and you'll see a world unknown in the Bi-Coastal US or Great Lakes states. The southern culture of poor uneducated Caucasian people has changed very little since 1955. The "N" word flies around like the last 65 years never happened.
In the south, LGTBQ people must hide their sexual orientation...in all but the big cities. Homosexual people are regarded with great disdain by the majority southern culture. That is southern people who did not grow up in families where children were educated to accept all people as worthwhile. Much of that intolerance stems from fundamentalist Christian doctrine which focuses on the differences between the races rather than the things all races share in common. Not ministers. Average churchgoers. Just go to a small town church on Sunday morning....the races worship in separate buildings.
Besides all these HIV positive people who suffer...think of how many children in the Deep South go to bed hungry every night. How few are Domestic Violence shelters in the Deep South. It is another world down there.
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[[In the south, LGTBQ people must hide their sexual orientation...in all but the big cities. Homosexual people are regarded with great disdain by the majority southern culture. That is southern people who did not grow up in families where children were educated to accept all people as worthwhile. Much of that intolerance stems from fundamentalist Christian doctrine which focuses on the differences between the races rather than the things all races share in common. Not ministers. Average churchgoers. Just go to a small town church on Sunday morning....the races worship in separate buildings. ]]
Let's say all of that is accurate and true.
Wear a condom, especially when having anal sex. Get tested. Get your partner tested.
When driving, there is an axiom, if you're waiting to make a left turn but can't see the oncoming traffic, you wait. The axiom is "If you don't know, don't go."
This applies to gay men in a community with a high rate of HIV...if you don't know your partner's status (or your own), don't have sex with that person.
Since, as the author points out, these men are not hypersexual Mandingos, they certainly can control their urges until they've either gotten tested or made a run to Walgreens for a box of condoms.
Safe sex is hot sex.
Let's say all of that is accurate and true.
Wear a condom, especially when having anal sex. Get tested. Get your partner tested.
When driving, there is an axiom, if you're waiting to make a left turn but can't see the oncoming traffic, you wait. The axiom is "If you don't know, don't go."
This applies to gay men in a community with a high rate of HIV...if you don't know your partner's status (or your own), don't have sex with that person.
Since, as the author points out, these men are not hypersexual Mandingos, they certainly can control their urges until they've either gotten tested or made a run to Walgreens for a box of condoms.
Safe sex is hot sex.
5
Even liberal elites like Maher on HBO gets to use the "N" word without any real consequences! Grow up!
3
I don't understand why there are not vast migrations of people to the cities if not to the blue states at this point. Been down so long it seems like up to me?
2
I kept thinking to myself, who could have written this? It's comprehensive from the White House to the corner, from L.A. to Jackson, from research presentations to club conversations, from the eighties to today. It carries the right emphasis on family and church, and on humanity rather than tropes. Most of all: "But at this point now, I feel like I can't lose another young man to this disease". You're speaking for all of us, Mr. Sturdevant, whether we know it or not.
34
Thank you 45 once again for erasing the hope of the people that voted for you. Poor Black and white southerners have few chances to even stay alive with this huge mistake of a president. So very sad
20
how is this 45's fault. what did the last president do the past 8 years? did this problem just arise in the last 100 days or so?
13
Central Park Five was stellar performance by your 45- just for big starters, and that was even more than 8 years ago.
1
A national tragedy!
9
Obamacare has failed these people. We need to ask why.
9
Please get outside of politics and think about the reality of the people's lives described here. This is a deep, well-written article about an important problem and group of people. Thank goodness for people like Mr. Sturdevant and the others who are working in this area and showing people a more positive way to deal with this illness. Our political leaders aren't providing the means necessary to address the problem.
33
Stated in the article, Mississippi refused to expand Medicaid.
41
and what did 8 years of Obama the president do to help alleviate this problem?
AIDS is a totally preventable disease, unless you have been unfortunate enough to be born with it or forcibly in contact with a carrier. Why isn't the message of prevention getting to those who need it?
70
Seems like the author covered that thoroughly.
Hidden? No, it is clear as blue sky. But few with power look.
15
Part of the answer is stigma.
17
Homophobia, Racism and " religion ". A cruel, deadly combination. This piece was outstanding. I'm saving and sharing this. Thank you.
47
The USA is such a place of extremes: extreme ignorance, beauty, grace, cruelty ... This article encompasses it all. But it's becoming too much now; the extremes are expanding; it's fraying, we are fraying, coming undone.
The only way forward as I see it is a new federalism, a decentralization, where the states with potential become their own nations, and welcome in the name of human rights and opportunity a round of internal migrants.
The only way forward as I see it is a new federalism, a decentralization, where the states with potential become their own nations, and welcome in the name of human rights and opportunity a round of internal migrants.
5
and what about those states that don't have that potential? just leave them behind to fend for themselves?
1
First, gay and transgender men should get away from the black "community" that is virulently anti-black gay (while being supportive of white LGBTQ people). Move to a white or integrated area, and ask for help and support. And when they get that support, go back and work against gender bias in the black churches, civic groups, and organizations. A lot of folks screaming racism need to look in the mirror and realize they harbor anti gay bias.
35
Yes , they should just pick up and move to New Hampshire where you live. Should we assume there is affordable housing and appropriate jobs for them in the Live Free or Die state not to mention the health care services they need?
23
Hi! How do you suppose these people can afford to move? There is also intense racism within the gay community against black men, so I don't think your "move to a white area" solution is tenable.
12
Move to a white or integrated area - Then they would have to deal with racism from Whites! Most of the gay Black men I know would rather stay nestled in the Black community despite homophobia, than deal with racist LGBT Whites.
2
A little factoid. In Africa, 2/3 of people living with HIV are of medications (which cost $84 a year). In America, 1/3 of infected people are on meds, which cost about $35k a year.
I know how hard it used to be to be able to get insurance/ meds before Obamacare. You had to have good insurance before the diagnosis and then never leave that job. If the company you worked for went out of business, like mine did, there are no options except to hope you live in a state that funded the Ryan White program.
One reason guys used to not get tested was because of preexisting insurance conditions. They were waiting until they had better insurance before getting tested. CRaZy system of health care we had- and will soon have again.
That being said, I have a hard time finding sympathy for people who don't take the meds they are able to get.
When I first started my medications 17 years ago, it was 18 pills a day, 2 of which had to be refrigerated, and also a liquid shot. All with horrible side effects - one formed a crystalline structure in my stomach before it was taken off the market. But I took them every day and was glad for them. And I've lived healthily without infecting anyone else ever since. Today, I take 3 pills a day with no side effects. No excuse not to take your mess, folks.
I know how hard it used to be to be able to get insurance/ meds before Obamacare. You had to have good insurance before the diagnosis and then never leave that job. If the company you worked for went out of business, like mine did, there are no options except to hope you live in a state that funded the Ryan White program.
One reason guys used to not get tested was because of preexisting insurance conditions. They were waiting until they had better insurance before getting tested. CRaZy system of health care we had- and will soon have again.
That being said, I have a hard time finding sympathy for people who don't take the meds they are able to get.
When I first started my medications 17 years ago, it was 18 pills a day, 2 of which had to be refrigerated, and also a liquid shot. All with horrible side effects - one formed a crystalline structure in my stomach before it was taken off the market. But I took them every day and was glad for them. And I've lived healthily without infecting anyone else ever since. Today, I take 3 pills a day with no side effects. No excuse not to take your mess, folks.
As an A Fro-American, I must ask why the white medical establishment has failed to incorporate the ground-breaking research of Dr Thabo Mbeki that proved the African treatment for HIV?
This research has led to thousands of lives being restored in South Africa.
This research has led to thousands of lives being restored in South Africa.
50% of african-americans will be hiv positive? this number seems apocalyptic. forget about racism and homophobia, you would think even donald trump would see this as the public health emergency it is. the social support mr sturdevant provides would be ridiculously inexpensive to scale and subsidize.
15
Sadly, tragically, I don't think Trump would care at all about these people. He may even celebrate their deaths.
3
I think you mean to quote " one in two African American gay and bisexual men" not 50% of African American Men!!!
10
The thing is though, you don't have to frame the problem as a competition for resources between global and domestic AIDS programs. There should be enough to go around.
7
I did not see this as a competition for resources, more of a denial of the fact that there are populations infected with HIV in our country that were not being recognized or treated. Instead, our country was looking at HIV as being mostly effectively treated in our country and that our population was no longer at such risk. This article makes it clear that their is still much to do in our country.
Wonderful, well-researched comprehensive piece. Reminds us in the liberal, white community that HIV/AIDS remains a public health and race issue in the US.
14
As is Trump has nothing to do with health care policy in the US.
The gay community reflects the wider society in which it is located. Gay men and women can be as bigoted, racist, etc. as those living in the wider community. The sad thing is that as gay people we might not have integrated the experience of being a victim of racism or bigotry. The fight is not over because there is Prep and people are living longer with AIDS. Not all of us are lucky to be born privileged.
11
Thank you, Thank you, THANK YOU, Linda for this wonderfully researched and brilliantly written article. How important its message is!
24
A friend of mine once observed that the bane of the black America is organized religion and organized sports. Both homophobic institutions.
32
That may be true, but what does that have to do with the practice of safe sex?
5
Both vibrant.
The EXACT same thing can be said about White America.
1
Yet another article that provides evidence of the great divide in this country. whether it be HIV, Alzheimers, Cancer, the Education system, another example of how people of color and the poor suffer so much more greatly in our country, due to racism and poverty. If you look at the funding and the research dollars devoted to the challenges that face these groups, you will understand why the negative tolls and impact on their lives are far greater.
17
Having lived in the deep South for fourteen years as a gay white man I humbly appreciate this article. However well-written, there are unspeakable issues I have found here in the South that are not present in other parts of the United States. First, black and white gay or bi-men here still are largely segregated here. A concrete example is that Atlanta has a Black Gay Pride in September, and its "Pride" celebration in early October. The second is that even in Atlanta, natives who are gay or bisexual men have all grown up with significantly more ill will on the part of immediate families and institutions in which they live, study, worship, and work. Although this is subtle, it still exists today. And, if it is somewhat obvious in Atlanta, it becomes magnified in smaller cities like Jackson, MS. The third relates to the second: fundamentalist Christianity, and the Southern Baptists--for which a large segment of African-Americans are reared, view MSM with great consternation and severe condemnation even today. Gay and bi-men here know who they are, but it is better not to admit who they are. Lastly, the Southern States social contract with its constituents is less likely to provide marginalized citizens education, prevention, and effective treatment strategies. The sad outcome for African-American gay and bi-men is more than just social isolation. The stigma of being black and gay here is a heavy cross to carry made worse by social and economic barriers that persist here.
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Appreciate that there is a stigma in the South that doesn't exist elsewhere, but what does that have to do with these absurdly high infection rates?
It's not a failure of Obamacare. It's not stigmatization, and, most certainly, with this rate of infection so many years after HIV reached national consciousness, it is not ignorance. I don't know what it is, but I'm seeing no easy answers as to why people aren't looking after their own health.
It's not a failure of Obamacare. It's not stigmatization, and, most certainly, with this rate of infection so many years after HIV reached national consciousness, it is not ignorance. I don't know what it is, but I'm seeing no easy answers as to why people aren't looking after their own health.
6
Very well stated!
1
The poverty and burdens that African Americans carry in the south I have come to believe are hard for all whites in this nation to fathom. The juxtaposition of what Christianity is supposed to be... "good news, and fear not" is instead a shredder for steep racial and class divides here.
1
Low impulse control
21
Seriously? How could we drop the ball so badly?
Yet another way we fail our Black Men... more than any other nation. Absolutely criminal in a developed nation!
Yet another way we fail our Black Men... more than any other nation. Absolutely criminal in a developed nation!
13
Society does not fail them. They fail themselves for not using proper protection. Wear a condom and be safe. Stop blaming others.
11
Victim blaming is not a solution.
1
Every thing negative in America from socioeconomics to politics to education to housing to health crashes and burns along the historically colored humanity personhood denying African enslavement in America and the American equality defying separate and unequal African Jim Crow inhumane line. African Americans inextricably intertwine caste and class in a physically identifiable minority.
7
The neighborhood I live in, in Brooklyn is one of the few areas in NYC with rising cases of HIV. The causes seem varied but it mainly affects gay men of color.
Local churches have actively squashed attempts to help LGBT people in the neighborhood especially when it came to opening clinics for people with HIV.
I see bus stop advertising which proclaims "love your gay child" which seems out of place in NYC, but it's necessary for my neck of the woods where religion reigns.
Brooklyn's federal aid for young HIV/AIDS patients has dropped from $2 million a year to $350,000 (according to a 2013 Daily News Article). Yet, every church in my area is enjoying tax-free benefits and perpetuating the problem.
It's criminal.
Local churches have actively squashed attempts to help LGBT people in the neighborhood especially when it came to opening clinics for people with HIV.
I see bus stop advertising which proclaims "love your gay child" which seems out of place in NYC, but it's necessary for my neck of the woods where religion reigns.
Brooklyn's federal aid for young HIV/AIDS patients has dropped from $2 million a year to $350,000 (according to a 2013 Daily News Article). Yet, every church in my area is enjoying tax-free benefits and perpetuating the problem.
It's criminal.
38
Why are you waiting for churches to stem the tide of HIV? What don't these "gay men of color" understand about how HIV is transmitted and what can YOU do to help them understand and then modify their behavior?
Are these "gay men of color" immigrants, sex workers, closeted?
And I'm going to need links to articles showing that churches fought to keep clinics out of Brooklyn.
Are these "gay men of color" immigrants, sex workers, closeted?
And I'm going to need links to articles showing that churches fought to keep clinics out of Brooklyn.
6
Re: "On Saturday nights, men of color in and around Jackson make their way to the gay club Metro. The windowless building with royal blue paint peeling off aluminum siding stands on Highway 80 next to a run-down car shop and has no sign out front; you just have to know."
Well, now we all know. You just added to the danger facing these people. It was completely unnecessary to provide a detailed description of the location. Do you know how many people must go by that place every day who had no idea. Now they do.
Well, now we all know. You just added to the danger facing these people. It was completely unnecessary to provide a detailed description of the location. Do you know how many people must go by that place every day who had no idea. Now they do.
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I get the feeling that Ms. Villarosa is looking to publish the next great American social expose, without too much regard for how publishing this article is going to further stigmatize black, gay and bisexual men, many of whom, including myself, are NOT infected with any disease-- though non-black gay people certainly think so, and who can blame them when they see headlines like this!
16
In a small town, do you really think that this was a secret? It may be studiously ignored; it wouldn't be unknown.
21
Everyone already knew. Now you do too.
6
I hate to say it but one of the answers is racism which is alive and doing quite well in America. The truth is that many programs that are set up to help people in America are not aimed at the right people or, if they are targeted at people who are poor, phase out too soon. Programs aimed solely at poor people are often poor programs, subject to cuts because others don't know about them or resent them, and can fail to address the real needs.
The other thing that leaps out here is the ignorance and that ought to be remedied with public service announcements and education in school. There is no reason for any person who contracts AIDS to feel ashamed of their sexuality, their skin color, etc. And there is no good public health reason to cut or limit programs that keep a person with AIDS healthy enough to stay out of nursing homes, hospitals, and at work.
The other thing that leaps out here is the ignorance and that ought to be remedied with public service announcements and education in school. There is no reason for any person who contracts AIDS to feel ashamed of their sexuality, their skin color, etc. And there is no good public health reason to cut or limit programs that keep a person with AIDS healthy enough to stay out of nursing homes, hospitals, and at work.
84
I would add that racism, particularly among the LGBT community is alive an well. Many of the strides the white LGBT community have gained are slow to come for LGBT members of color.
6
You seem to hold everyone and everything accountable other than the individuals. That can be the difference between taking action and not.
3
hen3ry, it's much too easy to cry "racism." Truth be known, there's a great deal of homophobia in the black community. The upshot of this is that, if you're gay/bi/trans, you keep it on the "down low (DL." When you have that scenario, you have rapid increases in HIV because people are reluctant to seek treatment. They're aware it's a surefire way to be the target of the haters in the community.
Great work. This feature article is one of the reasons I subscribe to The New York Times. Linda Villarosa tells a great story, and Rudy Rove's photos reveal the vulnerability of his subjects.
92
Linda thank you for not forgetting how the plague continues live and kill in America. The so much contributes to the hidden epidemic.
Yes, poverty and race certainly. Yet the prime number is the hateful dialogue and history of the church in shaming, blaming and building the walls that act as a deadly closet to living life honestly. With the recent AIDS Memorial coming to to life just yards from St Vincent's Hospital - the epicenter of those early plague years - I'm reminded how the Catholic Church (then the largest healthcare provider in NY state) treated the desperate and dying with care or disdain depending most often on the religious strain the nun giving direct care was herself infected by.
Self awareness coupled with truth, even in the darkest locations go so far in extending life and reducing despair for those living with HIV. It's a tough recipe to come by when secrets decide.
Yes, poverty and race certainly. Yet the prime number is the hateful dialogue and history of the church in shaming, blaming and building the walls that act as a deadly closet to living life honestly. With the recent AIDS Memorial coming to to life just yards from St Vincent's Hospital - the epicenter of those early plague years - I'm reminded how the Catholic Church (then the largest healthcare provider in NY state) treated the desperate and dying with care or disdain depending most often on the religious strain the nun giving direct care was herself infected by.
Self awareness coupled with truth, even in the darkest locations go so far in extending life and reducing despair for those living with HIV. It's a tough recipe to come by when secrets decide.
29
Yet it was the Catholic Church, its hospitals - such as St. Vincent's, St. Clare's, Mother Cabrini, and others in NYC alone - and its religious orders - that were the first and largest providers of health care to HIV/AIDS patients in much of this country, often providing very loving care to people who had been abandoned by everyone else, even family and close friends - and regardless of their ability to pay.
The "church" as described in this article are Southern Evangelical churches that continue to condemn and stigmatize people even for their LGBTQ orientation.
The "church" as described in this article are Southern Evangelical churches that continue to condemn and stigmatize people even for their LGBTQ orientation.
43
If you know anything about the AIDS crisis of the 1980s, you would know that the Catholic medical centers performed heroically.
17
Such a sad, poignantly written article. In Canada, British Columbia led the country in providing free drugs to AIDS sufferers.Other meds are generally not free...people on welfare disability can receive prescriptions from a restricted list and there is a similar subsidized list for seniors. Currently seniors get no subsidy unless they are poverty level.
Unfortunately systemic racism exists here too. Toronto and Montreal it involves the black community. In Canada generally it involves aboriginals and Metis and they similarly have a higher incidence of HIV AIDS than the general.population.
Unfortunately systemic racism exists here too. Toronto and Montreal it involves the black community. In Canada generally it involves aboriginals and Metis and they similarly have a higher incidence of HIV AIDS than the general.population.
42
Since we know HIV/AIDS is a completely avoidable infection, aside from accidental cases, the only thing we can do is continue to educate and warn. I suspect that those who do not take known precautions don't care what happens to them, for a variety of reasons, that may include self hatred resulting from homophobia and racism. This might explain the basis for this story.
There is no room whatsoever for complacency, in the immediate circumstances because of the immense cost of treatment to community who are paying for it, and in the future, where a new sexually transmissible disease will likely one day appear. At one time, syphilis was untreatable, now we have HIV/AIDS, but what future plague might befall us if we do not curtail unsafe sexual behaviour?
There is no room whatsoever for complacency, in the immediate circumstances because of the immense cost of treatment to community who are paying for it, and in the future, where a new sexually transmissible disease will likely one day appear. At one time, syphilis was untreatable, now we have HIV/AIDS, but what future plague might befall us if we do not curtail unsafe sexual behaviour?
54
This is a stigmatizing response. I imagine that people very much care what happens to them, but don't actually consider themselves to be at risk. It's a common issue -- you know this could be a problem, but find yourself to be above it (very common among adolescents). And yes, internalized racism and homophobia might make them feel less worthy and less intentional about using condoms or reducing the number of partners, but of course they care.
Also, the emphasis shouldn't be on curtailing unsafe sexual behavior. In some cases, perhaps even many, people living with or at risk for HIV might have multiple sex partners, but their sex is typically an expression of love, intimacy, and pleasure. Unsafe sexual behavior is a part of ending the epidemic, but that's not a systemic, sustainable response in the way that improving trust of medical providers within black communities or increasing access to care would be. Assuming that people are just promiscuous without condoms continues to make everything worse.
Also, the emphasis shouldn't be on curtailing unsafe sexual behavior. In some cases, perhaps even many, people living with or at risk for HIV might have multiple sex partners, but their sex is typically an expression of love, intimacy, and pleasure. Unsafe sexual behavior is a part of ending the epidemic, but that's not a systemic, sustainable response in the way that improving trust of medical providers within black communities or increasing access to care would be. Assuming that people are just promiscuous without condoms continues to make everything worse.
7
This is a crucial, remarkable, and brilliant work of reporting and social analysis. I remember Linda Villarosa's ground-breaking series on Black women and HIV on the front page of the Times decades ago, and her commitment and knowledge make her the most important voice for understanding the real nature of the American racial divide. No one reading this piece could ever claim that we have "survived the plague", not if the "we" means ALL Americans. Blistering!
42
It seems to me that most of these afflicted people have no one to blame but themselves for the negligent conduct which they engaged in that yielded an inevitable result.
51
And it strikes me that it's just this attitude that helped create this crisis.
16
Blame themselves and then what?
7
And you believe that blame fixes any problems? We have created an environment where being in stable gay relationships isn't accepted or allowed to be practiced. Don't you dare bring your same sex partner home, to school dances or show public affection. Uncaring and callous people, like you, are part of the problem. Wake up.
11
Great reporting. Thanks so much.
16
One has only to look at the ongoing stigmatization of Gay and Trans individuals in the parts of this country where conservative political and religious views reign supreme to understand why many people resist asking for medical help assuming they can access it in the first place. A case in point - the bill passed recently in the Texas Legislature that allows open discrimination on the grounds of sexual orientation and religion in the foster care system.
36
Back in the 1980's I was losing finds to a mysterious illness that appeared to grow out of the shadows of big cities with large gay populations. Elizabeth Taylor organized the first public meeting to raise awareness of this dark cloud that was taking the life's of her friends. I vividly remember that evening as Miss Taylor openly wept that her recent trip to Washington DC was in vain. President Ronald Reagan not only ignored her pleas for help but refused to acknowledge this horrifically devastating disease even existed. First Lady Nancy Reagan had lost friends to this illness and yet she choose to remain silent. President Ronald Reagan allowed an epidemic to grow out of his own backyard to global proportions. AND once again we have a conservative backed Presidency taking a destructive stance on humanity and our planet.
97
That was 30 years ago. Blaming Reagan for today's AIDS/HIV rates is absurd. Neglecting to address the issue in the 1980's resulted in more dead people then and into the 90's. It has nothing to do with today's rates. Most of the newly infected today weren't even born then. Their entire lives have been lived with presidents Clinton, Bush II, and Obama. Think about it. A 30 year old today was born in 1987. He was five when Clinton assumed office, 13 when Bush II was sworn in, and 21 when Obama became president. (*)
It's like the story that all of the mentally ill homeless today are the fault of Reagan.
How can we find solutions when our biases twist our thinking so profoundly?
* I skip Bush I in this example, but if you want to include the pre-K years, fine.
It's like the story that all of the mentally ill homeless today are the fault of Reagan.
How can we find solutions when our biases twist our thinking so profoundly?
* I skip Bush I in this example, but if you want to include the pre-K years, fine.
19
Seems to me, article is somewhat misleading; whereas rates of Black males are based upon predictions - "that if current rates continue," figures for white males, which are also on the rise, relies upon today's numbers.
15
What a moving and infuriating piece, so beautifully written and thoroughly researched that I am still reeling from all the outrageous facts contained within it. The layers of shame/stigma/institutionalized racism and more at the base of the epidemic, the commitment and loyalty of the organizations committed to saving these men, the men themselves, for sharing their stories. I want to hug Sturdevant for his dedication to these lost and dying men and trans women, and applaud Linda Villarosa for her impeccable reporting, her heartfelt storytelling and her fierce commitment over the decades since the epidemic first began to share its impact on African Americans. Also, huge props to the New York Times Magazine for publishing this story, especially now, where we need these stories and people like Sturdevant more than ever.
80
Excellent reportage. Thank you for taking the time and effort to cover this important story comprehensively and compassionately. It occurred to me while reading this that the Americans most affected by HIV at this time - black gay men and trans women, live in states where Republican governors did not expand Medicaid under the Affordable Care Act.
Great article. Thank you.
7
Ms. Villarosa does an excellent job of presenting the challenge and complexities of this epidemic. Some other dimensions to the problem include the reluctance of men to engage with the healthcare system and an historic lack of quality care in the urban and rural south...Black Americans in the South routinely die at higher rates of almost every measured chronic condition. The very areas and populations she focuses on have been known for decades as America's "Stroke Belt " Another contributing factor has been a lack of leadership on health system reform from national patient groups such as the National Minority AIDS Council (more focused on urban rather than rural issues and small non-profits rather than hospital systems) and the Black AIDS Institute focused more on media efforts.
23
Two numbers leaped out at me: 50% of gay black men are expected to get AIDS; in one major city, 40% of gay black men already have AIDS.
Half? It has never been this bad.
We are told constantly of progress, but now it is half? That is not progress. That is insane.
Half? It has never been this bad.
We are told constantly of progress, but now it is half? That is not progress. That is insane.
214
We agree on the gravity of the numbers, but the CDC statistic quoted indicates that "50 percent of African-American gay men are expected to get H.I.V. during their lifetime," which is not equivalent to getting AIDS. HIV is a virus that can in most cases be suppressed, while AIDS is the syndrome caused by advanced HIV infection and the resulting decline in one's immune system. The distinction is significant.
9
This story could have been written in the early eighties in NYC. What is it about our society that allows pockets of privilege, even in information sharing.
99
So, these "poor gay men of color" can't get google on their smart phones?
Instagram, yes, but WebMD, no...is that it?
Instagram, yes, but WebMD, no...is that it?
3
Wonderfully written. May God bless Mr. Ced.
131
Another American tragedy made more tragic by Trump.
The Affordable Care Act and government programs were helping those in need of help so, of course, both must be gutted.
Making America heartless should have been the slogan ... tragedy is upon us and we are turning into a third world country, run by those with no pity and much avarice.
The Affordable Care Act and government programs were helping those in need of help so, of course, both must be gutted.
Making America heartless should have been the slogan ... tragedy is upon us and we are turning into a third world country, run by those with no pity and much avarice.
186
blame Trump? did you bother to read the article? these unfortunates feel shame and hide. Good bless those who minister to them, but is certainly isn't The Donald's fault!
it's getting to tiresome hearing him blamed for everything, including the weather.
it's getting to tiresome hearing him blamed for everything, including the weather.
30
Oh good grief. I hate Trump as much as the next person, but this has absolutely nothing to do with him.
17
Jerry Kiernan,
Trump's trying to kill Obamacare. That means that ca. 24 million people will be without health care within a few years. The House has passed his non-health care plan; we pray that the Senate will not pass Trump's plan to kill most health plans for Americans. Trump wants to kill any kind thing that Obama did. He is filled with jealousy of Obama's talents and popularity.
Trump's trying to kill Obamacare. That means that ca. 24 million people will be without health care within a few years. The House has passed his non-health care plan; we pray that the Senate will not pass Trump's plan to kill most health plans for Americans. Trump wants to kill any kind thing that Obama did. He is filled with jealousy of Obama's talents and popularity.
13
Excellent coverage of the still ongoing HIV crisis within the African American community.
Without intent to disparage anyone, I recall the day in 1991 when Earvin "Magic" Johnson was pressured to publicly disclose he had contracted the HIV virus.
Back then Haitians refugees were still blamed for the U.S. epidemic. Ignorance about the disease and its transmission was rampant. It was still a "drug-user-gay-disease." Fear and homophobia were the order the day.
Today, poor men of color, and in particular gay men of color, are still stigmatized. If only we all could be like Magic.
Without intent to disparage anyone, I recall the day in 1991 when Earvin "Magic" Johnson was pressured to publicly disclose he had contracted the HIV virus.
Back then Haitians refugees were still blamed for the U.S. epidemic. Ignorance about the disease and its transmission was rampant. It was still a "drug-user-gay-disease." Fear and homophobia were the order the day.
Today, poor men of color, and in particular gay men of color, are still stigmatized. If only we all could be like Magic.
42
Let's not forget that he bragged at the time about having had sex with 500 women! Not my hero.
2
"I may be a compulsively, pathologically promiscuous dog with no respect for women, but at least I'm not gay!"
I had the pleasure of attending Dr. DeMarc Hickson's panel last autumn at a conference where I learned of My Brother's Keeper. I am so thankful that he and his colleagues are working tirelessly to serve their patients.
73
I practice infectious diseases in the south and greatly appreciate this article. I would like to just note something about the multi-pill regimen that a participant in the article takes. At diagnosis, the vast majority of people will be able to take a one pill, once a day regimen with very few side effects. Where things become difficult is when interruptions in treatment, which occur for many, complex reasons, result in the virus mutating. It then becomes resistant to the medications that come in the co-formulated pills leading to increased pill numbers. But I want to emphasize that the 'old days' of handfulls of pills with horrible side effects is not the world of today. Most of my patients are on one pill once a day with no side effects and a great immune system. Some people delay seeking treatment once diagnosed for a myriad of reasons and the mental image of taking handfulls of pills sometimes plays a role. I encourage everyone to reach out and speak up because the HIV of today is not the HIV of even 10 years ago, much less the 1980s. There is hope and we want to help you.
536
Erin...you are a walking, breathing Hippocratic Oath.
Thank you for your overarching humanity.
Thank you for your overarching humanity.
156
Erin, thank you for your explanation. Now if we could only get the powers that be to understand why making sure that people with HIV and everyone else need access to health care without the interference of the health insurance industry, high cost prescription drugs, etc.
14
[[Some people delay seeking treatment once diagnosed for a myriad of reasons and the mental image of taking handfulls of pills sometimes plays a role. I encourage everyone to reach out and speak up because the HIV of today is not the HIV of even 10 years ago, much less the 1980s. There is hope and we want to help you.]]
Excellent advice. Thanks.
Excellent advice. Thanks.
8
Good ROI on proactive public health measures are documented in other nations around the world. All we are lacking is comprehension.