Black AIDS disparities on the rise

Panel tackles rising HIV rates, prevention challenges

When it comes to racial disparities, African Americans continue to be the most impacted on everything from housing and jobs to health. HIV/AIDS is no exception, with African Americans accounting for nearly half (47 percent) of all new infections in 2016.

Heterosexual Black women, in particular, accounted for 61 percent of all new infections among women. This is despite African Americans only making up 12 percent of the U.S. population, reported the Centers for Disease Control & Prevention (CDC).

This year marked the 30^th anniversary of World AIDS Day, a day dedicated to raising awareness and battling the pandemic affecting nearly 40 million people worldwide, and 1.2 million in the U.S. While new infections have declined in the U.S., annual infections and diagnoses have increased amongst people of color, overall.

HIV infections for Black gay men and trans women are also on the rise, noted Cree Gordon, PrEP outreach and HIV testing coordinator for Youth AIDS Project. “When I first started this work, one in four…were going to get HIV in their lifetime, and now it’s one in two,” said Gordon at a panel discussion hosted by Hennepin County on Monday, Dec. 3.

The panel featured experts from various communities impacted by HIV who talked about prevention, treatment, and how to break the pandemic. “We need to address race and racism,” added Gordon, who goes by non-binary pronouns, including they, them, their and themselves. “That, in itself, is HIV prevention.

“It’s not like magically sometime in the early ’90s Black people outnumbered their White counterparts,” they continued. “We have always been disproportionately affected, but it was never addressed until…White gay men became the face of the disease.”

Reneka Evans, event coordinator for the Red Door Clinic and a Black transgender woman, added, “I really want more than just gay [and] trans people to realize that they are at risk.” High-risk behavior includes unprotected sex, sharing needles and sexual contact with multiple partners.

While moderator Jake Maxon, Positively Hennepin strategy coordinator, tied risky behaviors and drug use to the increase in infections, Gordon challenged the audience to look to the causes of those risky behaviors.

“We have to address the reasons for drug use,” said Gordon, noting it is often due to concerns like housing and mental health — issues people of color are also disproportionately affected by. Add to that a general mistrust of health care, and people of color are left on the short end of the proverbial stick.

“When we talk about public health, there are still mind spaces in the African American and people of color communities that don’t trust public health,” said Evans. As an example, she noted the stark difference in response to the ’80s/’90s crack epidemic, which led to mass incarceration of Blacks and Browns, versus the current opioid crisis.

“Thirty years later and it’s a public health crisis,” said Evans. “‘We’re not going to send you to jail and we’re going to find resources for you.’ It saddens me to look back and see [how] if it’s a White person in crisis, things get [done].”

The panel also called for more diversity in leadership and not just frontline staff to impact change, noting that cultural traditions can also inhibit prevention efforts.

“Sex is not something we culturally discussed and is considered to be private — especially within the older community,” said Princess, a staff member at the West African HIV Task Force (WAHTF). Coming from a homophobic community and culture, she said, even talking about sexuality and gender, let alone HIV, is taboo.

Mo Mike, HIV testing and outreach coordinator for Indigenous Peoples Task Force (IPTF), noted that growing up in Native American families, sex was rarely talked about in a serious manner. “It was always with humor.”

Mike noted, however, that programs like IPTF and WAHTF create safe environments to start the conversations. “You can have frank discussions. When we started HIV 101 sessions, that made it a lot easier.”

Those conversations are paramount to stopping new infections. “There are [still] a lot of people who don’t know what HIV is and how it impacts health,” said Princess.

Maxon also pointed to treatment as prevention. “If you get into care, you are able to take your meds as prescribed, you get undetectable, and you can’t give HIV to your sexual partner,” said Maxon. “We have PrEP for people not living with HIV, and that is another path for stopping new infections.”

PrEP (also known as Truvada) is a daily pill that allows people who either engage in, or are having sexual contact with someone who is engaging in, high-risk behavior to prevent HIV infection.

Evans questioned how to get community members to take a pill when they’re not sick, in addition to using condoms. “We’re accustomed to taking medicine when something hurts, something is wrong. But, you want me to swallow a pill — and it’s not a little pill — when I don’t feel anything is wrong,” she said.

“I believe these strategies can work,” added Gordon as they cautioned against thinking of treatment as the final step.

“But, when we center drugs as prevention, you’re again centering White gay men. I want everyone to remember that not every community is at that point where that’s readily a conversation we can have,” said Gordon.

“If you just take PrEP, you’ll reduce HIV, and if you just take your HIV meds, you won’t transmit HIV, but there is that historical mistrust and trauma that we need to address.”

Gordon also recommended updating HIV education and literature to make communities aware of these new treatments.

That conversation is key, said Princess. “If you can empower someone to take control of their health, they are usually moved to act.”

But with education must also come access, including meeting people where they are and using social media and other new technologies.

Referencing the success of Red Door’s PrEP program, Gordon asked, “Can you imagine starting the same program at the NorthPoint [Health & Wellness], in the Black community, where they can go to providers or people who look like them to have that conversation about PrEP? How many people would know and get PrEP if you actually had the program in the community?”

For more resources, visit:

Black AIDS Institute at blackaids.org

Indigenous Peoples Task Force at indigenouspeoplestf.org

Positively Hennepin at bit.ly/positivelyhennepin

Red Door Clinic at reddoorclinic.org

Youth AIDS Project at yapmn.com

West African AIDS Task Force at bit.ly/2FVMFa3