Thursday, September 20, 2007

Health Advocates Ponder How to Curb Rising HIV Rates Among Young Gay Men

The fight against AIDS continues to dominate my journalistic palette with this latest story for EDGE which chronicles reaction to the New York City Dept. of Health & Mental Hygiene report which indicates a spike in new HIV infections among young gay and bisexual men. Black and Latino men under 30 showed disproportionately high numbers of new infections in comparison to their white counterparts. The causes are arguably obvious: poverty, racism, homophobia, machismo and even the Spanish-to-English language barrier. The first cases of what became known as AIDS appeared in gay Meccas across the country in 1981. The epidemic has evolved, and more importantly, devastated countless lives and even communities over the last quarter of a century. Something certainly needs to be done to reduce new infections through new and innovative intervention, prevention programs and other initiatives. The stark reality remains, however, is that the epidemic continues to disproportionately impact young gay and bisexual men of color with little end in sight of significant changes to current policy don't take place. People's lives remain at stake. They will remain at stake as long as the status quo continues.

More than 25 years after the Center for Disease Control reported the first cases of a mysterious cancer and pneumonia appearing among gay men in New York and Los Angeles, HIV conversion rates are skyrocketing among young men who have sex with men (MSM).

On Sept. 11, the New York City Department of Health & Mental Hygiene released a report that found new HIV infections had risen 33 percent among MSMs under 30 years old. The report, which covered the years 2001 to 2006, indicated that twentysomethings and younger account for nearly half of all new diagnoses reported in the city.

Officials added that the epidemic continues disproportionately to affect young MSMs of color. More than 90 percent of MSM under age 20 diagnosed with HIV in 2006 in New York were either black or Latino. Black MSMs received twice as many diagnoses as their white counterparts, according to the report. Latino MSMs were 55 percent more likely to contract the virus than gay or bisexual white men.

New York City Health Commissioner Dr. Thomas Frieden said every neighborhood except suburban Staten Island experienced an increase in new HIV infections among MSMs under 30 since 2001. Perhaps not surprisingly, he reported that the most gay-friendly neighborhoods in Manhattan--Harlem, East Harlem, Chelsea and Hell’s Kitchen--saw the most significant increases there. In Queens, a semi-suburban area of the city, there was a 49 percent increase.

"We’re headed in the wrong direction," Frieden said in a statement.

Theories abound to explain the upsurge in new infections among young gay and bisexual men. These include so-called AIDS amnesia among those born before the epidemic broke in 1981, ineffective safer-sex curricula in public schools and the growing popularity of barebacking (sex without condoms) in the gay porn industry and in young MSMs.

Frieden did not acknowledge any of these possible causes. He did, however, urge MSM to reduce their number of sexual partners and to use more condoms. "We must ask all New Yorkers to accept some responsibility for helping our young people protect themselves," he urged. "We cannot drift backward."

Even as public health officials continued to sound the alarm, this report only confirmed a stark reality many HIV prevention activists and others continue to see on the ground. The Centers for Disease Control released the findings of a controversial--and some argue hyped--2005 study which concluded 46 percent of black MSMs in Baltimore, Los Angeles, Miami, New York and San Francisco were HIV positive. The report further said gay and bisexual men of color were twice as likely to contract the virus than other MSMs.

Michael Roberson, executive director of the Brooklyn-based People of Color in Crisis, bluntly scoffed at those who expressed surprise at these statistics. He added the lack of local, state and federal funding specific to black gay and bisexual men remains what he called "genocide by neglect."

"Those of us who do this work and those of us who are black and have sex with men are not surprised," he told EDGE. "I don’t know why it’s a shock."

Roberson might find support for his thesis in inner cities like Detroit, where blacks are a large majority. The Motor City, long mired in decline, suffers from Michigan’s highest HIV and AIDS rates. Hank Millbourne, deputy executive director of AIDS Partnership Michigan, blamed poverty, a lack of health care and even low literacy rates for enhancing the epidemic’s spread in Detroit.

Milbourne further singled out the Bush administration’s abstinence-based HIV prevention initiatives as an additional and glaring failure to reduce new infection rates among young gay and bisexual men in his city. "There’s a whole political climate that works against us," Millbourne said.

Lorenzo Herrera y Lozano, of the national LGBT advocacy organization Unid@s, agreed. The Austin, Texas, activist added immigration status and even the Spanish language barrier pose additional hurdles to many gay and bisexual Latino men who seek access to health care, prevention programs and other services.

Victoria Arellano’s death in a Southern California federal detention center in July highlighted the plight many immigrants with HIV and AIDS face. Immigration & Customs Enforcement officials allegedly denied the transgendered Mexican national an antibiotic necessary to curb the virus’ many side effects.

Her family plans to file a wrongful death lawsuit against ICE in the coming weeks. Many activists point to Arellano’s death, the hundreds of Puerto Rican men with AIDS who languished for months on waiting lists in the American territory earlier this year to receive medications and other cases they feel highlight bureaucratic neglect that only enhances the epidemic’s devastating effects.

Roberson further singled out homophobia within the Black church and other social institutions. "It’s amazing that the neglect that continues to happen with black gay men," he concluded. "When this data is released it’s like ’Oh my God its crazy. What are we going to do.’"

The United Fellowship Church remains the largest denomination within the black church to minister to the LGBT faithful. Many congregations operate HIV and AIDS ministries and other related outreach across the country. Millbourne said other churches outside the UFC have begun to follow suit but he remained somewhat skeptical.

"They can’t come as saviors because they’ve talked about these people," Millbourne said. "They need to come with bowed heads and an apology on their lips."

As the chief executive officer of New York’s Gay Men’s Health Crisis, Dr. Marjorie Hill heads the nation’s largest private AIDS service organization. She sees the elimination of homophobia within the Black church as a key component of what her organization and others need to do in order to curb the epidemic among young gay and bisexual men of color. Traditional prevention and outreach initiatives must continue in addition to efforts to eliminate societal and especially cultural stigmas, she added.

Millbourne would only add that the Black church, HIV-prevention organizations and especially young MSM themselves all share a responsibility to reduce new infection rates. "Everybody’s got to own a piece of this," Millbourne said.

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