African-American men, transgender women hit hard by HIV – QNotes

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The HIV epidemic in the African-American community is one of the biggest under-reported stories of the past few decades.

HIV/AIDS, long thought to be an urban disease, has migrated south to communities that lack money, resources or education to combat the epidemic. Poor access to comprehensive healthcare in many southern communities is an added hurdle for those who try to get help.

Nearly 50 percent of new HIV infections in the United States are in the South, even though the region only makes up a third of nation’s population. And African-American men and women are the hardest hit by far.

It’s estimated that 1 in 5 African American gay and bisexual men in the South is living with HIV. The rates are even higher among African-American transgender women.

In 2010, African-American gay and bisexual men accounted for almost as many new infections as white gay and bisexual men, despite their differences in population size.

In 2010, there where an estimated 10,600 new infections among African-American gay and bisexual men in the U.S. By comparison, in the same year, there were 11,200 new infections among white gay and bisexual men and 6,700 among Hispanic/Latino gay and bisexual men.

Young African-American gay and bisexual men ages 13-24 are especially affected by HIV. In 2010, they accounted for approximately 4,800 new HIV infections — more than twice as many estimated new infections as either young White or Hispanic/Latino gay and bisexual men.

In America’s South, a combination of factors has created the perfect environment for HIV to thrive, especially within the African-American community.

These factors include widespread poverty, lack of HIV testing and education, racial discrimination, stigma, incarceration, barriers to healthcare and housing, a shortage of accessible medical specialists in rural areas and persistent prejudices by many in the Bible Belt.

There are specific factors that put African-American gay and bisexual men at risk.

Socioeconomic factors: African-American men more likely than any other ethnicity or race encounter limited access to and use of quality healthcare. They also experience lower incomes, with an average income of $20,000 a year; lower educational attainment; and higher rates of unemployment and incarceration.

All of these factors explain why African-American gay and bisexual men living with HIV have lower rates of linkage to health care, retention in care, being prescribed HIV treatment and experiencing viral suppression.

Greater risk of exposure: African-American gay and bisexual men are a small subset of all gay and bisexual men and their partners tend to be men of the same race.

Because of the small population size of the community and prevalence of the disease in the population, African-American gay and bisexual men have a greater statistical risk of being exposed to HIV in their sexual networks.

Sexual relationships between older and younger men: Sexual relationships with older men, who are more likely to have HIV, may also increase the risk to exposure among young African-American gay and bisexual men.

This may be due to the dynamics of the relationship where the older man may have the power and control because of his educational background, maturity and financial stability.

It can be a situation where transaction sex is involved. The younger man may need a place to live or financial support and the older individual provides those in exchange for sex, which can contribute to high-risk activities.

Lack of awareness of HIV status: Many African-American men with HIV, particularly young men, are unaware of their status. Individuals who do not know they have HIV do not get into medical care and may not adopt behaviors that will lower their risk factors. They can, therefore, unknowingly infect others.

Stigma, homophobia, discrimination and religion beliefs: The stigma associated with the disease in some black communities can fuel denial. Many do not believe they are at risk of catching a virus that can affect gay people, even if they are men who sleep with men themselves.

Stigma puts African-Americans at risk for bullying, shame, loss of family and friends support, love and interpersonal relationships and isolation.

Young African-American gay and bisexual men have been put out of their family homes and forced to live with friends, strangers or on the streets, which can contribute to their risk of being exposed to HIV.

We are at a crossroads. We must combat this pandemic that has taken over our community.

Our house is on fire. If we don’t do something to control the raging flames, it will burn down to the ground and all that are inside will perish.

We must take the dis-ease out of the disease and save our brothers’ lives. : :

— Brodderick Roary serves on the Board of Directors of the North Carolina AIDS Action Network, a statewide organization dedicated to improving the lives of people living with HIV/AIDS and affected communities.