A few days ago, a friend took me to a gay bar on Bourbon Street in New Orleans and a young white man walked over and asked if we wanted to take a free H.I.V. test upstairs. We declined. From what I could tell, not many others were walking upstairs either.
I’ve tested negative every time before and I routinely practice safe sex, but what if this time I was positive? Did I want to discover the news late at night, out of town in a bar? What would a positive result mean for health care coverage? And how would I afford expensive drug treatments if I needed them?
If an educated openly gay adult is asking these questions, imagine how difficult it is for teenagers and young adults without education, support systems, access to resources or health care. That’s why H.I.V. prevention and testing strategies that solely focus on H.I.V., without addressing the underlying socioeconomic conditions that contribute to the epidemic, are destined to fail.
To fight AIDS among young black men who have sex with men, first we have to fight homophobia. We can’t expect to resolve the crisis if people are too afraid to talk about it.
But we also have to provide resources so that young black men who have sex with men have health care, shelter, counseling and access to drug treatment if they test positive.
It’s a cruel twist of fate: at a time when promising new pre- and post-exposure treatments have been shown to reduce H.I.V. infections, cash-strapped state and local government are slashing H.I.V. prevention funding and the federal government is cutting trillions of dollars from its budget.
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