HIVandBlackGayMeninAmerica

From UBC Wiki

Introduction

Human immunodeficiency virus (HIV) is a virus that is transmitted through the exchange of bodily fluids such as blood and semen.[1] Overtime, the replication of the HIV virus in the body destroys a cell the immune system called the CD4 lymphocyte.[1] This attack on the CD4 lymphocyte leaves the body unable to defends itself from viruses and often develops into acquired immune deficiency syndrome, better known as AIDS. There is currently not a vaccine or cure for HIV or AIDS, but treatment is available to prevent the transmission from one individual to another.

HIV is associated with intravenous drug use and men who have sex with men, as those two groups face higher contraction rates. Consequently, the social stigma and homophobia associated with these behaviors is often echoed in the stigma facing people with HIV and AIDS, as it is seen as a consequence of socially “deviant” behavior.

HIV Racial Disparity

Among gay and bisexual men, there is disparity across racial groups in the percentage of men living with or at risk of contracting HIV. In many groups, the rate of HIV contraction is decreasing. Black gay men, on the other hand, are increasingly contracting HIV. In a recent survey of black, gay, American men, 28% of black gay men tested for HIV tested positive, and 59% were unaware of their HIV positive status.[2] One man in the survey referred to himself as “triply cursed” due to the discrimination and social stigma associated with navigating the world while having the intersectional identity of being both black, gay, and HIV positive.[3] Negative outcomes for HIV positive African American gay men include a higher mortality rate, an increase in proportion of aids cases from 19% to 34%, and the lowest decline in death rates across all groups.[4]

Black men who have sex with men have higher rates than the general population, and higher rates than men who have sex with men of other racial groups.[5] This disparity is thought to be driven by factors other than risky behaviour, as rates of unprotected anal intercourse, sex work, drug use, and history of HIV screening are similar across groups.[6]

Potential Causes for HIV Racial Disparity

Antiretroviral Therapy

Antiretroviral Therapy (ART) has been proven to lower the viral load of HIV to a point where it can not be detected or transmitted.[7] Despite this, rates of ART usage among HIV infected black gay men are substantially lower than the white population of HIV infected individuals.[8] This results in an increase in HIV transmission if these HIV positive men then go on to engage in sexual acts, as their partners are not protected through antiretroviral therapy. Black gay men are more likely than white gay men to be diagnosed with HIV at a late stage when taking ART is strongly recommended, but are still less likely to be taking ART.[8] This is often not because of will, but because of a lack of access.

A reason that this may disproportionately impact the black community in America is the differences in access to healthcare that those of different economic groups have access to. As black people in America have faced social and economic marginalization since before America’s confederation, the economic legacy of this marginalization can still be seen today. Many black people have less financial resources than their white counterparts, and this can prove to be a barrier for purchasing the ART drugs needed to protect others. These drugs can run into the thousands of dollars per year, and without a universal pharmacare plan in place many Americans simply cannot afford to purchase them. Furthermore, many black gay men avoid groups that could offer resources and outreach to support their diagnoses, as they find them to have exclusionary tendencies and histories.[9] For example, black activism groups may have a history of homophobia or gay rights organizations may have a history of racism.

HIV Screening

Black men who have sex with other men have a lower rate of HIV screening than their white counterparts.[10] This lack of screening causes an increase in the amount of HIV infected people who are unknowingly infecting others with HIV. As people are more likely to have sex with people of the same racial group, this leads to a magnification in the spread of HIV among the black population in America. Again, in many places in America HIV testing programs are not publicly funded or are inadequately funded.[11] In instances where men are unable to afford a routine screening they are more likely to be unaware of their HIV status. In a a 5-city study, it was found that only 1%-13% of HIV/AIDS intervention budgets were spent targeting communities of colour, despite being logically at odds with their higher rates of HIV.[12] This indicates that these groups face further marginalization as the skin colour of black gay men becomes a further barrier to finding out their HIV status as they are left on the fringe of the solution to an issue they predominantly face.

  1. ↑ 1.0 1.1 Melhuish, A., & Lewthwaite, P. (2018). Natural history of HIV and AIDS. Medicine, 46(6), 356-361. doi:10.1016/j.mpmed.2018.03.010
  2. ↑ Arnold, E. A., Rebchook, G. M., & Kegeles, S. M. (2014). ‘Triply cursed’: racism, homophobia and HIV-related stigma are barriers to regular HIV testing, treatment adherence and disclosure among young Black gay men. Culture, health & sexuality, 16(6), 711
  3. ↑ Arnold, E. A., Rebchook, G. M., & Kegeles, S. M. (2014). ‘Triply cursed’: racism, homophobia and HIV-related stigma are barriers to regular HIV testing, treatment adherence and disclosure among young Black gay men. Culture, health & sexuality, 16(6), 715.
  4. ↑ Mays, V. M., Cochran, S. D., & Zamudio, A. (2004). HIV prevention research: Are we meeting the needs of African American men who have sex with men?. Journal of Black Psychology, 30(1), 80.
  5. ↑ Millett, G. A., Flores, S. A., Peterson, J. L., & Bakeman, R. (2007). Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. Aids, 21(15), 2083-84.
  6. ↑ Millett, G. A., Flores, S. A., Peterson, J. L., & Bakeman, R. (2007). Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. Aids, 21(15), 2084-85.
  7. ↑ Millett, G. A., Flores, S. A., Peterson, J. L., & Bakeman, R. (2007). Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. Aids, 21(15), 2088.
  8. ↑ 8.0 8.1 Millett, G. A., Flores, S. A., Peterson, J. L., & Bakeman, R. (2007). Explaining disparities in HIV infection among black and white men who have sex with men: a meta-analysis of HIV risk behaviors. Aids, 21(15), 2089.
  9. ↑ Kennamer, J. D., Honnold, J., Bradford, J., & Hendricks, M. (2000). Differences in disclosure of sexuality among African American and White gay/bisexual men: Implications for HIV/AIDS prevention. AIDS Education and Prevention, 12(6), 528.
  10. ↑ Mays, V. M., Cochran, S. D., & Zamudio, A. (2004). HIV prevention research: Are we meeting the needs of African American men who have sex with men?. Journal of Black Psychology, 30(1), 92.
  11. ↑ Mays, V. M., Cochran, S. D., & Zamudio, A. (2004). HIV prevention research: Are we meeting the needs of African American men who have sex with men?. Journal of Black Psychology, 30(1), 92.
  12. ↑ Mays, V. M., Cochran, S. D., & Zamudio, A. (2004). HIV prevention research: Are we meeting the needs of African American men who have sex with men?. Journal of Black Psychology, 30(1), 93.
Retrieved from "https://wiki.ubc.ca/index.php?title=HIVandBlackGayMeninAmerica&oldid=523409"