Hoping for change through restatement – Part I

Not much has changed

By Antoine Craigwell

With the release of the state of HIV in America and the Black gay community two trite sayings come to mind: the more things seem to change, the more they stay the same; and a definition of madness is doing the same thing repeatedly with an expectation of a different result every time.

When the U.S. Centers for Diseases Control and Prevention (CDC) released the results of their 2006 to 2009 study on Aug 3, showing that the numbers of new HIV infections are approximately 50,000 per year, a general sense of “what’s new” seemed to greet the announcement. The news that these infections are concentrated among Black gay men, and more pointedly, that the numbers of those infected with the virus are disproportionately affecting young Black men between 13 and 29 who have sex with other men is on the rise was greeted with a nonchalant, “So what?”

Since the U.S. government’s acknowledgement of the HIV epidemic 30 years ago, the U.S. Department of Health has become like a lactating cow, with one of its agencies, the CDC, the perpetually filled udder’s teats being sucked voraciously by the multitude of agencies, organizations and assorted individuals.

Some committed HIV advocates and activists are ringing their hands and scratching their heads: wondering what more they could have done and what else to do. Others, who pretend to be concerned, because of the government’s free hand in doling out grants for HIV prevention programs, shrug their shoulders and grin. To them the report means that their grant applications would continue to be approved and money would continue to flow like milk from the teat. Together, for a variety of reasons, some simple and others complex and convoluted, both government and independent agencies have failed the Black gay community. Many Black gay men, who have survived the devastation of the 80s and 90s, look on these numbers with skepticism, reflecting that nothing much has changed for them. Younger Black gay men, on the other hand, shrug their shoulders.

The Numbers

This CDC report expanded the results of a study released in 2008 by the New York City Department of Health and Mental Hygiene, which had concluded that in New York City not only was HIV infection concentrated in the Black community, it was particularly endemic among Black men who have sex with other men, regardless if they identified as gay, and that the rates of infection were increasing among young Black men between 13 and 22. According to the report out of NYC, HIV infection was three times the national rate, at 72 new infections per 100,000 people as opposed to the national rate of 23 per 100,000 people.

The CDC estimates that 300,000 people are infected with HIV but have not been tested and do not know they are infected. Additional statistics also suggest that every day, at least 50 people become infected with HIV.

Published statements from those at the CDC demonstrate more of the same. Kevin Fenton, MD, director of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention said in the CDC statement that while there is encouragement on prevention efforts to help avoid overall increases in HIV infections in the US and the significant reductions in new infections from the peak in the mid-1980s, “we have plateaued at an unacceptably high level.”

“Without intensified HIV prevention efforts, we are likely to face an era of rising infection rates and higher health care costs for a preventable condition that already affects more than one million people in this country,” Fenton said.

Again, what’s new? Was there a redoubling of intervention efforts to prevent HIV infection? For years, there have been ways of doing business, with the overwhelming government bureaucracy ensuring that there is no change in how multi-year HIV grants are executed. Many organizations, to get access to CDC funding for HIV started programs purportedly for HIV prevention. With skillful grant writers and applications many received funds for HIV prevention, which they used either to support budgets reduced in other areas or enabled unscrupulous heads of non-profit agencies, with the collusion of sympathetic or terrified government grant administrators, to live extravagant lives with inflated salaries and generous expense accounts for nebulous conferences. One cudgel hanging over the heads of grant administrators is that if they question or deny an application, they risk being accused of subtle racism against the Black community and inherent homophobia toward the Black gay community. HIV funding has spawned its own cottage industry: from providing minimal services in communities for a short time which then becomes defunct for lack of funds, to grant writers specialized in how to tell a particular narrative in compliance with grant requirements, to conferences with the many associated costs, all paid for by funds earmarked for HIV prevention. For many organizations, it is as if the only requirement that they are complying with the stipulations of their grant is to have some event or activity labeled as HIV prevention or set up some ad hoc testing to serve as justification for their grant reporting. The CDC and the respective states disbursing funds would readily admit that they lack the manpower or resources to monitor and ensure that the grants being awarded were being executed as they should. As a consequence, much about CDC awarded grants and funds are not properly managed. Instead, there is gross waste and misappropriation of funds.

Yet, the numbers of those with the virus continue to rise. But when examined closely, the CDC’s numbers are in some way questionable: in 2008, along with more refined testing methods, they began using a new formula for measuring the numbers of those infected with the virus, which revealed that more people were infected than before. The question now is, how many of this 50,000 is based on new testing methods and how many are based on a pre-2008 formula?

National HIV/AIDS Strategy

After calls and demands for a national HIV/AIDS policy, in July 2010 President Obama issued a national HIV/AIDS strategy. Some of the same groups and organizations that called for the policy decried it, claiming it was limiting in scope and didn’t really offer or suggest much. As a policy document, for the first time it demonstrated a strategy for addressing HIV infection on a national scale. Among the recommendations, the strategy demanded that the mental health of young Black men needed addressing as a way of intervention and prevention of the HIV epidemic.  It recognized that for a variety of reasons, young Black men are susceptible and vulnerable, and needed mental health intervention at the level where they could get counseling. But, it didn’t call on mental health professionals and Medicaid to step up to deal with the number of mental health issues in the Black gay community, especially among young Black gay men, which contribute and lead to HIV infection. It is likely that the strategy is limited as the government is afraid of awakening and reopening wounds of oppression, racial discrimination, bigotry and economic dispossession in the Black community, which for centuries has been buried under layers of adaptive behaviors, and which has festered and suppurated for generations.

Failure of Black Gay Organizations

Many in the Black gay community would say very little is being done to provide actual HIV intervention and prevention.  But as things seem to change, really they remain the same. Many in the New York City Black gay community cannot forget the betrayal by many of the so-called leaders who allegedly betrayed the community through mismanagement and embezzlement of CDC, state and city funds for their own gains. This came to light with the spectacular collapse of People of Color in Crisis (POCC). Many in Chicago, Los Angeles, Atlanta, Philadelphia and communities with large Black and Black gay populations would recall the organizations that closed its doors because the management had misappropriated funds granted for development of HIV prevention programs. Instead, many would recall how the leaders of these failed organizations have morphed into other agencies and continued to perpetuate milking the system. Many would also recall the National AIDS Education & Services for Minorities (NAESM) led by Rudy Carn, which according to published reports, obtained funds from the city of Atlanta for a center and even though a house was eventually obtained, funds were misappropriated and the organization investigated by the city. Carn did a classic reinvention: he minimized his operations in Atlanta, moved to New York City and with the help of a two former POCC employees, one who is on his organization’s Board, tried to step into and claim a piece of the CDC, state and city HIV funding pie. Along with hosting a number of conferences at big name hotels, NASEM’s Brooklyn office on Atlantic Avenue is reported to have closed, and yet the organization, partnering with the Black Gay Research Group, is gearing up for another conference in New Orleans.

Yet, many in the NYC Black gay community have wondered what has NASEM and Carn done for the community and how much money have they been able to collect from federal, state and local governments supposedly for HIV prevention? Earlier this year, a prominent national Black HIV/AIDS organization purportedly hosted a conference in the Caribbean. Reports from some who attended claimed that except for one day of some quasi-serious discussions, it was like a vacation where the attendees sampled the delights of the available men on the beaches. Funding for this jaunt was obtained because the head of this organization is a friend of a vice president of a non-profit organization committed to the global fight against HIV/AIDS, from whom he was able, in two weeks, to get the required funds to pay for the entire vacation cum annual retreat. Also, in what is seen as duplication and a waste of desperately needed funds, two Black gay organizations each had conferences about the same time with almost identical agendas.

According to reports, when many in New York were celebrating gay pride and the recently passed same-sex marriage legislation, that the legendary Gay Men of African Descent (GMAD) was unable to pay its staff, yet were able to fund a float for the gay pride parade. There are many, who despite recognizing the admirable hard work and commitment of some of the GMAD staff, have wondered about the organization’s HIV prevention programs. Their Website is vague and sketchy, but it is common knowledge that GMAD continues to receive HIV prevention funds from the CDC, the state and city. Also questionable is how GMAD is able to get grants when there is no transparency of their accounts, similar to other non-profit organizations which post on their Website their financial statements. A search of IRS records does not show any 990 filings.

Looking at the membership of a number of state and national Black gay organizations, one is likely to find some of the same people on various boards. It is as if they have created a tightly woven network and look out for each other. Over the years, in these networks, it has become common that in the event one of their members becomes sloppy and is caught misappropriating or embezzling funds, he shuts down the troubled agency, is welcomed and encouraged to set up anew in another place under another name and is never held accountable. This was evident when the NY State Black Gay Network filed for bankruptcy and dissolved in 2009. The collapse revealed the close ties of leadership personnel and co-mingling of funds with POCC, which some claim is normal and usual inter agency relations. Audit reports, however, materially questioned disbursement of funds, the absence of transparency, and yet, no one saw these activities as conflicts of interest.