For Gay Black Men, Risk of HIV/AIDS infection Is Higher Than Ever

HIV among gay black men is getting worse.

Actually, much worse, says Phill Wilson, founder and executive director of the Black AIDS Institute, the only organization in the country dedicated to specifically catering to HIV-positive African Americans.

"Gay black men continue to be first in line when it comes to need, but remain at the back of the line when it comes to assistance," Wilson said, mimicking the message of a newly released report by his nonprofit.

The 75-page report, called "Back of the Line: The State of AIDS Among Black Gay Men in America," was released this July.

Out of men who have sex with other men (MSM), a young black man has roughly a 1-in-4 chance of being infected by age 25, the report shows. By the time he is 40 years old, the odds that he'll be alive are about 60 percent.

The report got its information from different governmental agencies, like the Center for Disease Control, books and medical journals. It took four months to put together, Wilson said.

Black gay men only represent a minute part of the U.S. population-about one in every 500 Americans is a black MSM-yet they are the group with the highest risk of new infections. From 2006 to 2009, the rate of new infections among young gay black men rose by 48 percent, but why?

According to Wilson, their disproportionate risk of HIV can be traced to their poor access to health services, a high prevalence of sexually transmitted diseases, and sexual activity at an early age among gay men. He adds that governmental agencies and LGBT organizations just don't care as much about this affected minority and thus do not allocate the necessary resources.

"The natural homes for black gay men-the black and LGBT communities- have similarly failed to prioritize the AIDS fight among black men who have sex with men. And the philanthropic sector, once a robust presence in the AIDS fight, has withered away, with a mere handful of funders continuing to support community-based AIDS programs," the report reads.

California Democratic Congresswoman Maxine Waters agrees.

"Current policies do not adequately address the unique needs of Black MSM in America. Local and national leaders must remain vigilant in the fight against AIDS, especially in the Black community, which continues to carry the heaviest burden," Waters said in a statement. "Unless we change the way we do business, we cannot reverse the epidemic."

In addition to citing infection rates, the study ranked 25 major cities to see which addressed the needs of HIV-positive black MSM most effectively. Washington, D.C., Los Angeles, and New York hit the top of the list, while Gary, IN, Memphis, TN, and Richmond, VA, were the three worst.

While Florida didn't make the cut for the worst cities, Wilson says the HIV prevalence among Black MSM in Florida is "unacceptably high."

According to 2008 statistics from the Florida Department of Health , the HIV/AIDS rate for black men (straight or gay) is nearly five times the rate for white men: 1 in 31 black men in Palm Beach County had HIV or AIDS. In Broward County, 1 in 41 black men were infected; and in Miami-Dade, 1 in 29.

Numbers from 2009, specifically in terms of black MSM, state that one in 12 men in Florida has AIDS. In Miami-Dade, it's one in eight.

The problem, Wilson says, is that available resources in South Florida are not explicitly targeting gay black men.

"It makes a difference who's delivering the message, it makes a difference who's being targeted, and that's why it is important that a part of the care delivery continuum be exclusive programming for black gay men," he said.

However, Ronald Henderson, FDH's statewide minority AIDS coordinator, thinks that progress is being made in the state.

He said that the number of new cases diagnosed among gay black men from 2002 to 2011 decreased by 34 percent; going from being the first leading cause of death among black man between the ages of 25 to 44, to being the fourth.

"You just can't put in a sign because there's a stigma," Henderson said in regard to reaching out to the black community, adding FDH's AIDS division is working on several initiatives to try to educate and bring awareness about disease to black communities statewide.

That stigma is associated with family and community acceptance, two big factors that play a part in the spike in HIV infections among gay black men.

When former NFL player Wade Davis came out to his sister seven years ago, she made a comment saying she was going to be their parents' favorite from now on. When he approached his mother, she told him that being gay is an "abomination" and that "you already have enough being black."

"That process was very hard; me and my mother are still evolving. I've been with my partner for 6 years and she's never met him. It wasn't acceptable for her, and we never talk about it when we see each other," said Davis, now 34, a former defensive back for the Tennessee Titans, Seattle Seahawks and Washington Redskins.

Davis grew up in Louisiana, where he says religion is one of the biggest pillars of the African American community.

"No one talked about sex in the church. It was like 'don't ask don't tell'," Davis said. "It's not at the point where you go to a black church and they say 'we're going to have a talk about safe sex'."

Davis thinks that in order to bring down AIDS cases in the African American community, we need to redefine what masculinity means.

"The idea of masculinity is something that people grew up with in the black community. That makes you question, can I grow up strong black gay man? They think you're weak, effeminate. It's a black community problem, not a black MSM problem.

Phill Wilson, who became infected with HIV at 24 years old, shares that sentiment: "There is a stigma in the black community that's based on sexual orientation, and that has a damaging impact on gay men's desires to get tested or to seek treatment," he said.

The Institute's study recommends several things to turn the tide against AIDS, including access to testing, treatment and prevention services; reducing sexually transmitted diseases; introducing pre-exposure prophylaxis (PrEp) and building sustainable community infrastructure and the involvement of national leaders to make the fight against AIDS a priority.

But Wilson believes the implementation of the Affordability Care Act is the biggest shot gay black men have at lowering the risk for HIV infection.

"It's going to allow us to eliminate preexisting conditions as a barrier to get HIV care, it's going to limit the ability of pharmaceutical companies to limit or deny people care because it's too expensive," Wilson said. "This is going to be very important in ending the HIV fight in America."

LGBT youth seeking support or advice can reach Wade Davis on Twitter at @Wade_Davis28