According to data released by the CDC last week, H.I.V. infections among most populations in the United States, while unacceptably high, have remained relatively stable in recent years. But among young Black gay and bisexual men ages 13-29, the data show a 48 percent increase in new infections from 2006 to 2009. Our nation’s H.I.V. prevention efforts have stalled at best, and among young Black gay and bisexual men—men who have sex with men, or MSM, in public-health language—we have clearly failed.
These new
numbers reinforce what many of us have known for a long time—we are not going
to be successful in driving down new infections unless and until we invest in
those populations most at risk, and in America today those populations are
Black Americans, gay and bisexual men of all colors and especially young Black
men who have sex with men. We have to build the infrastructure and the capacity in these
communities to respond to this epidemic in an appropriate manner. We have to build a mass mobilization
effort “for and by” the most at risk populations in our country.
As we
have reported many times, there is no evidence that young Black gay and
bisexual men engage in high-risk behavior to any greater degree than their
counterparts in other racial and ethnic groups. But their risk is significantly higher. In order to address AIDS among this
population, we have to confront some of the structural social determiners of
health. At the same time that we
see rising H.I.V. rates among young Black men who have sex with men, we also
see continued mass incarceration of young Black men in America, rising
unemployment and falling college enrollment. It is an outrage that we’ve seen a 48 per cent in new HIV
infections among young Black gay and bisexual men.
AIDS does
not happen in a vacuum—poverty, unemployment, lack of access to primary health
care, incarceration and other structural factors magnify Black men's risk. And regardless of how hard some Black
men who have sex with men have tried, compartmentalizing their sex lives does
not protect them from being impacted by such structural determinants. Preventing H.I.V. requires dealing with
the whole person, not just one aspect of their life as so many HIV-prevention
efforts attempt. It is also an
outrage the there are more young Black men in jail than in college and the
unemployment rate for young Black men in some cities is as high as 50 percent.
We have
the tools to finally end the AIDS epidemic. With ever-expanding testing technologies, we can diagnose
the disease easily and inexpensively. We can identify where the epidemic is most severe by
measuring community viral load—in some cases down to the zip code. We know how to prevent exposure
to the virus. We know how to
interrupt acquisition of the virus; in most cases, we know how to treat the
virus; and we know now to interrupt transmission of the virus through treatment
as prevention. With all of these
recent advancements, the question is no longer “Can we end the AIDS epidemic,”
but “Will we?”
Phill
Wilson is the President and CEO of the Black AIDS Institute, the only National
HIV/AIDS think tank in the United States focused exclusively on Black people.
Follow him on twitter @iamphillwilson. Contact him at PhillWilson@blackaids.org
or (213) 353-3610 ext. 105. www.BlackAIDS.org. www.BlackAIDS.org.
