Moving Beyond Stigma

Published: April 30, 2012

In a roundtable discussion, health experts urge a better understanding of the HIV/AIDS epidemic among African Americans.

In his December speech to commemorate the 23rd annual World AIDS Day, President Obama said what should be obvious to all Americans yet is not: “When new infections among young black gay men increase by nearly 50% in three years, we need to do more to show them that their lives matter.”

Obama was referring to the rise in HIV infections for gay and bisexual African-American men between 2006 and 2009 — a period when infection rates among other populations remained steady, according to figures from the Centers for Disease Control and Prevention. Recent data on African-American women, meanwhile, shows rates of infection alarmingly higher than health officials once thought.

Together, the numbers illuminate a sobering reality: Despite myriad prevention efforts, the domestic HIV/AIDS agenda has done too little, too late, both in reducing infection and ensuring access to care for communities most at risk. “When this administration came into office, our domestic HIV/AIDS strategy was basically to keep doing what we were doing,” U.S. Secretary of Health and Human Services Kathleen Sebelius said in a February keynote at the White House Conference on LGBT Health. “We weren’t adapting fast enough. Agencies and programs weren’t working together well enough.” Sounding hopeful tones in her speech that echoed the president’s, Sebelius said the new National HIV/AIDS Strategy “has breathed new life into the fight against HIV and AIDS by focusing our resources on the populations that are most affected.”

Yet as the administration seeks to achieve the ambitious goals laid out in the national strategy, it is met with yet another troubling reality: complacency. Far fewer Americans consider HIV to be an urgent concern today than did in the 1990s. Even the gay community’s growing (and sometimes singular) focus on marriage equality, however laudable the goal, has shifted attention away from some of the most vulnerable LGBT Americans. If black Americans don’t believe the larger gay and lesbian movement cares about their lives, why should they invest in it?

HIV/AIDS isn’t the only health crisis facing black Americans, who also have higher rates of diseases such as diabetes and sickle-cell anemia. But understanding the real reasons for why new infections have risen dramatically has proved duly challenging. Far too often, experts and advocates say, the media have been obsessed with the “down-low” phenomenon and the false assumptions that come with it rather than concerned with how factors such as poverty and access to health care fuel the epidemic.

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