Black Affairs, Africa and Development
Why The AIDS Epidemic Matters To Black Lives
About a year ago I attended a gathering of activists who focus on issues for Black men related to mass incarceration, the war on drugs, police brutality, and stop-and-frisk issues, shape notions of masculinity for Black men and boys. I was asked on the last day to jump in and talk specifically about how homophobic violence and notions of masculinity impact Black men, particularly gay and bisexual men, and the alarming rates of HIV infection. After I discussed these issues, one attendee, a young straight Black man seemed annoyed that I was bringing HIV into the discussion, and offered, “We already know HIV is genocide against the Black community, and I wouldn’t be surprised if it was man made.”
This isn’t the first time I’ve gotten this response. Like HIV, many Black people view the policing and prison institutions as being intentional in their efforts to commit violence against people of African descent, and to destroy communities. Yet, unlike police and prisons, understanding government neglect or malfeasance has not helped inspire massive mobilizations in Black communities to challenge local, state or federal governments towards efforts to end the epidemic. In fact, it seems to have had the opposite response — silence and resignation. But if we are to make the world make good on the mandate that Black lives matter, we have to be able to imagine and make good on Black led mobilizations toward issues including but beyond police violence, and HIV/AIDS provides us with some prime opportunities.
Despite representing only 14% of the US population, Black Americans accounted for nearly half of all new HIV infections among adults and adolescents in 2010, a new infection rate 8 times higher than that of white Americans, according to the Centers for Disease Control and Prevention. The US Southern states, where the vast majority of Black people live, is also increasingly becoming the epicenter of the US HIV epidemic, with 7 of 10 US cities with the highest rates of HIV infections being Southern cities.
In Atlanta, Georgia, a city known to have large numbers of Black gay residents, anEmory University study in March 2014 found the rate of HIV incidence in young Black gay men in Atlanta, Georgia at 12.1% a year. This rate is one of the highest figures ever recorded in a population of a resource-rich nation, and means that a young, Black gay man sexually active at 16-years-old is 60% likely to acquire HIV by the age of 30. In attempting to understand factors contributing to the high incidence rate, the study’s researchers found a lack of health insurance coverage, unemployment, and incarceration as considerable social determinants of disparity among Black gay men.
Black transgender people are affected by HIV in devastating numbers. In the largest survey ever conducted of transgender people in the US, the 2011 National Transgender Discrimination Surveyreports that20.23% of survey respondents reported to be HIV-positive and 10% were unaware of their status. This compares to 2.64% of transgender respondents of all races and 2.4% for the general Black population in the US.
Though recent reports show new infections among Black women in decline, Black women still accounted for nearly two-thirds (64%) of all estimated new HIV infections among women in 2010 — an incidence rate 20 times higher than that for white women.
Most notably, as numerous research studies demonstrate that Blacks are less likely to engage in risky behavior compared to their white counterparts, issues of racism are often cited as contributing factors to the HIV epidemic upon communities of color. In attempting to understand factors contributing to the high incidence rate among young Black gay men, researchers found that a lack of insurance, unemployment, and incarceration were drivers of the epidemic. Black transgender women face a lack of access to employment opportunities, which may lead to poverty and unstable housing, disproportionate policing and criminalization and a lack of access to health care.
At the same time, access to care remains elusive for many African Americans, regardless of HIV status. A report by Kaiser Family Foundation showed that due to the blocking of Medicaid expansion under the Affordable Care Act in states with large Black populations has created a dynamic where 40 percent of Black people who would have gained health care through the ACA state Medicaid expansion are still without access. African Americans have worse outcomes on the HIV continuum of care, including lower rates of linkage to care, retention in care, being prescribed HIV treatment, and viral suppression.
While rumors of HIV conspiracies are frustrating, I am not blaming Black people for being having them. A study published last month in the American Journal of Public Health, looking at the impact of HIV conspiracy theories in Black communities noted “Rumors may encourage behaviors that appear ignorant, but the source of conspiracy theory rumors about the origins of HIV/AIDS within the African American community…is not ignorance, but distrust combined with high social anxiety…The sources of the trust gap may be connected to the lack of sustained and effective funding for and attention to the general health of African Americans, the history of health professions’ abuses against African Americans, and the persistence of HIV/ AIDS among African Americans (as the focus group data suggest, some African Americans see the very mention of high infection rates among African Americans as ‘blaming,’ which reinforces the sense of distrust).”
So the question for me is, why are we so able to mobilize Black communities around policing issues, armed with historical fact and current events, and contemporary public policy challenges in policing and massive imprisonment, and yet the very mention of HIV disparities is reduced to blame?
So whether you believe in HIV conspiracies or not, clearly we have an epidemic impacting Black people for which there is much improved treatment that undoubtedly saves lives but access to health care remains a huge problem, no less important than police violence. And yet when I mention HIV/AIDS in many spaces with activists, either I’m greeting with the issue of it being “man made” as a way to shut down the discussion, or the eyes sort of glaze over. Sometimes people who are very vocal on other issues as writers, scholars and activists, will only speak to me about HIV in private, thanking me for raising the issue because they lost a child, an uncle, a cousin, or many friends over the last 35 years to the disease. These losses, no less painful than losing a loved one at the hands of law enforcement, do not motivate many of these folks to get active in many of the fights around HIV prevention, treatment and care, that a dedicated few of us have diligently committed ourselves to–and have definitely included issues of policing/imprisonment, gender-based violence, education and employment as impacting factors. Yet we receive very little in the way of similar connections being made.
Our Black future will require a focus on the varying theories, rhetoric, and institutions that perpetuate violence and premature death, whether directly connected to prison or policing.
We’ll know all Black lives will matter when all forms of Black suffering, including those from HIV and AIDS, aren’t hidden in shame and silence.
This post is part of the “Black Future Month” series produced by The Huffington Post and Black Lives Matter for Black History Month. Each day in February, this series will look at one of 28 different cultural and political issues affecting Black lives, from education to criminal-justice reform. To follow the conversation on Twitter, view #BlackFutureMonth — and to see all the posts as part of our Black History Month coverage, read here.