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Destigmatize HIV/AIDS.
On the last day of Rolling Loud, a prominent hip-hop festival, rapper DaBaby became the subject of countless headlines after making insensitive, homophobic remarks at the start of his performance. Despite receiving backlash, DaBaby initially defended his statement, causing swift criticism amongst fans. His homophobic comments fed off of negative stigma against HIV-positive people. They also perpetuate the false narrative that only promiscuous gay people have HIV/AIDS. Stigma against people with HIV, homophobia, and racism are especially harmful to those with multiple marginalized identities.
TAKE ACTION
Donate to NAESM, an organization committed to the wellbeing of Black gay men.
Use the CDC’s Stigma Language Guide to avoid promoting HIV/AIDS stigma in everyday conversations.
GET EDUCATED
By Sydney Cobb (she/her)
On the last day of Rolling Loud, a prominent hip-hop festival, rapper DaBaby became the subject of countless headlines after making insensitive, homophobic remarks at the start of his performance. Despite receiving backlash, DaBaby initially defended his statement, causing swift criticism amongst fans. His homophobic comments fed off of negative stigma against HIV-positive people. They also perpetuate the false narrative that only promiscuous gay people have HIV/AIDS. Stigma against people with HIV, homophobia, and racism are especially harmful to those with multiple marginalized identities.
HIV, the virus that leads to AIDS, can be transmitted through anal or vaginal sex, or sharing needles, syringes, or other drug-injection equipment (CDC). Contrary to popular belief, plenty of people aside from men who have sex with men (MSM) contract HIV: “In 2019, heterosexual people made up 23% of all HIV diagnoses in the U.S. and six dependent areas” (HIV.gov). The association between HIV and same-sex sexual contact or intravenous drug use can dissuade people from getting tested or treated, even though you can contract HIV from heterosexual sex in a monogamous relationship.
Among men who have sex with men (MSM), Black men are the most highly affected group, accounting for 39% of HIV diagnoses resulting from male-to-male sexual contact (Kaiser Family Foundation). Incarcerated men who have sex with men (MSM) are especially vulnerable to HIV. Misconceptions regarding HIV/AIDS often lead people to believe that being HIV-positive is a result of negligence. This notion fails to account for how systematic factors like mass incarceration, poverty, and lack of healthcare access contribute to Black MSM infection rates.
In 2018, there were 2,272 inmates per 100,000 Black men, compared to 392 inmates per 100,000 white men (Pew Research Center). Chances of acquiring HIV in prison are high for all incarcerated Black men due to inmates’ lack of access to condoms or medicine to prevent or treat HIV. The lack of testing and treatment resources for inmates directly contributes to the amount of people who unknowingly transmit HIV to other prisoners (Prison Policy Initiative).
The American healthcare system’s sordid history of neglecting African Americans has created a sense of distrust among the Black community: “About two-thirds of medically disenfranchised Black and Hispanic people said they don't feel like the health care system treats all patients fairly” (WebMD). Black people’s fear of mistreatment in healthcare settings makes them less likely to get tested for HIV or seek treatment if they have already been diagnosed. In addition, many impoverished gay Black people have little to no opportunities to get tested regularly because employment and housing discrimination have barred them from accessing healthcare.
Society has systematically oppressed people living with HIV as well as gay Black men. The intersection of homophobia and racism makes gay Black men with HIV feel isolated and ashamed. Having two oppressed identities already makes gay Black men the subject of discrimination and social ostracism, but having HIV imposes entirely different stereotypes on them. This internalized stigma often leads to low self-esteem and makes people afraid to disclose their health status.
One in two Black gay and bisexual men is likely to become HIV positive in his lifetime (CDC). The odds are undoubtedly stacked against the Black gay male community, yet somehow they are often forgotten in the response to HIV/AIDS. Many community-based programs and organizations are so focused on supporting the gay community as a whole that they fail to acknowledge the unique struggle Black gay men face. In order to destigmatize HIV/AIDS, society must change the general attitude toward HIV-positive people. Supporting HIV-positive people ranges from ensuring Black communities have access to PrEP (Anti-Racism Daily), medication that significantly reduces a person’s risk of contracting HIV, to adjusting how we speak about the virus.
By changing our language when discussing HIV/AIDS and ridding ourselves of negative stereotypes about HIV-positive individuals— specifically gay Black men— we can make it a less taboo subject. Decreasing this taboo would benefit heterosexual HIV-positive people by minimizing their fear of getting tested or disclosing their status, and it would elimate the negative stereotypes surrounding non-HIV-positive Queer and Trans People of Color. Having open conversations about HIV/AIDS will increase awareness of its dangers and encourage people to take their sexual health seriously.
Key Takeaways
The intersection of racism and homophobia negatively influences the way HIV/AID stigma affects gay Black men.
Internalized HIV/AIDS stigma often makes people who struggle with the disease feel isolated and discriminated against.
Despite being one of the most highly affected communities, gay Black men lack resources centered around HIV/AIDS prevention and care options.
Ensure access to PrEP.
The first HIV/AIDS case was officially reported by the CDC a little more than forty years ago (NBC News). Since then, there have been incredible advancements in HIV treatment options. Today, antiretroviral therapies can suppress the HIV virus enough to help HIV-positive people live with undetectable amounts of the virus.
Good morning and happy Wednesday! Preventative treatments for HIV can save countless lives, but disparities exist for who can easily gain access to these medications. Today, Tiffany explains the historical discrimination in HIV/AIDS treatment and how we can advocate for equitable access to PrEP.
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Nicole
TAKE ACTION
Support the Transinclusive Group (Instagram), a Black trans-led group offering HIV services in South Florida.
Educate yourself about AIDS history and Black efforts to address historical inequities. AIDS 1969: HIV, History, and Race.
Spread the word about resources such as Ready, Set, PrEP which help individuals interested in PrEP access to the medication at a low or no cost.
GET EDUCATED
By Tiffany Onyejiaka (she/her)
The first HIV/AIDS case was officially reported by the CDC a little more than forty years ago (NBC News). Since then, there have been incredible advancements in HIV treatment options. Today, antiretroviral therapies can suppress the HIV virus enough to help HIV-positive people live with undetectable amounts of the virus.
HIV prevention options have greatly expanded as well. Pre-Exposure Prophylaxis (PrEP) medication can reduce a person’s risk of contracting HIV through sex by 99% and their risk of contracting it through intravenous drug use by 74% (CDC).
But communities with the highest rates of HIV actually use PrEP the least. Men who have sex with men (MSM) – including gay and bisexual men as well as those who don’t identify as either – are at higher risk of contracting HIV. Though Black and Latinx MSM are five to ten times more likely to contract HIV than white MSM, white MSM both know about and use PrEP at higher rates than men of color (CDC). One reason for this discrepancy is the barriers people of color face in accessing care.
PrEP medication access is hardest for patients to access in the South, where 56% of Black Americans live (Pew Research). 38% of Affordable Care Act Marketplace health plans in southern states require prior authorization before individuals receive PrEP, a rate significantly higher than anywhere else in the country (JAMA). Requiring prior authorization means treatment will only be covered by the insurance company if the company approves it before the treatment is prescribed (TikTok). This increases the burden on doctor’s offices and causes delays in treatment. “Prior authorizations have been cited by clinicians as being one of the biggest barriers for PrEP uptake,” according to Dr. Kathleen McManus, who researched the subject (UVA). 90% of physicians stated prior authorizations delayed patient’s access to care and 75% stated they can lead patients to abandon treatments. (AMA).
Each year, 50% of new HIV cases occur in the South (CDC). Out of those new HIV cases in Southern states, Black women comprise 67% of cases in women, Black men are 70% of cases in men, and out of men who have sex with men, 50% of new cases are Black men (CDC). Insurance company policies create unnecessary hurdles for accessing crucial HIV prevention measures in a high-risk region where Black people are at disproportionate risk. This constitutes a deadly form of structural racism.
The government and medical establishment’s approach to HIV/AIDS has always been rooted in discrimination. Ronald Reagan’s administration refused to prioritize AIDS research and treatment in the 1980s since it was viewed as a “gay plague” (NBC News). It took years of activism and pressure from groups like ACT UP for the passage of the Ryan White Cares Act in 1990 to mandate serious federal funding and attention to HIV care and treatment (Hornet, History). Despite the historical framing of HIV as a virus that primarily affected gay white men, Black and Brown people have always been overrepresented in the HIV-positive population. They also long been central to AIDS activism and resistance (Drain).
In the words of Raniyah Copeland of the Black AIDS Institute, “HIV is a disease that affects the most marginalized: Black and brown people, LGBTQ people, people living in poverty, people who don’t have housing, people experiencing substance addiction, and so many others who aren’t able to thrive simply because of who they are, who they love, or where they live” (Black Aids Institute) The prior authorizations that delay access to HIV prevention medication are the product of a healthcare corporations and government policies that place little emphasis on HIV and other health conditions that disproportionately affect Black and Brown people and members of other oppressed and marginalized communities.
Southern state governments have the power to create laws that require their state healthcare plans on the exchange to include coverage of PrEP medications without requiring prior authorization. They must act. In the meantime, organizations like South Florida’s Transinclusive Group are acting to ensure HIV prevention isn’t pushed to the side for Black and Brown folks (Instagram). We must fix a system where discriminatory barriers block entire communities from life-changing treatments.
Key Takeaways
PrEP dramatically reduces the risk of HIV-negative people contracting HIV.
Black people in the South are at high risk of contracting HIV, but many ACA insurance plans in southern states require an additional step, prior authorization, before getting PrEP.
The government has long neglected HIV research and HIV-positive people because of systemic discrimination against queer people, people of color, poor people, and drug users.
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