Hoping for change through restatement – Part II

Not much has changed

By Antoine Craigwell

Continuing, this part examines the impact of HIV on the young Black gay community. Recently, the 2007 movie “Girl, Positive” featuring Jennie Garth as the teacher and Andrea Bowen as a student was on television. At one point, Garth said to Bowen, “HIV is no longer the death sentence it was.” But what emerged in the movie was an accurate representation of what is happening among young people.  Bowen echoed the feeling of many of her generation when she said, “Why should I take the [HIV] test, only to find out and live a life different from everyone else and have others look at me different as I’m looking at you?”

Many in their teens and 20s,  who obviously had not witnessed how the gay community was ravaged by HIV,  how it decimated many Black gay men, cutting them down in the prime of their lives; are oblivious and blasé about HIV. To many, the public service announcements and the specters of death and dying have lost their sting and relevance. Remarkably, the public images of young same-sex couples seems to have slowly reduced the levels of stigma, discrimination and homophobia, and a growing sense of acceptance, tolerance and “What’s the big deal, they’re people just like you and me” attitude among many that sexual preference or orientation is not an issue. Still persisting, however, many young people don’t want to take a test: they don’t want to know if they got the “monster”, as knowing would alter their outlook on life, especially their perception of their sense of invincibility and longevity, dreams of children and a long term partner for the future. One stigmatizing effect of being HIV positive that still persist is that many often feel as though they have been given a death sentence, the possibility of living a normal a life as possible has been removed, and for many, in an act of either revenge, anger or resignation, feel it is a license to have unprotected sex.

Advances in HIV treatment

With advances in HIV treatment, results have become more accurate and quickly available, compared to the time when a person had to wait 14 nail-biting and nervous days to know whether or not he or she had been infected. Additionally, improvements in HIV treatment medications are now one per day for those who are taking treatment for the first time with the increased likelihood of reducing the presence of the virus in the blood to undetectable, thereby re-opening more life possibilities, as opposed to the handful of pills many had to take, which while killing the virus, poisoned the person’s body and left him or her more ill than healthy.

While these advances have produced results, enabling those infected with the virus to live longer more productive lives, albeit with a lifelong disease, it is now more manageable, akin to someone living with diabetes. The flip side of these advances is that they have encouraged a false sense of complacency and security which has crept into the evolution of thinking about the effects of HIV and AIDS. Today, those who believe they have been exposed to the virus could go to the emergency room and take a pill, like a morning after pill, immediately and for a prescribed number of days to counter any possibility of infection.

These advances have spawned an attitude change of less concern about using protection and contracting HIV. Increasingly, many men who have sex with men are today eschewing condom use, preferring instead the pleasure derived from skin on skin contact. An examination of several gay sex sites would reveal the numbers who post in their profiles, while stating their HIV negative status, “Anything goes”, which means they are willing to engage in bareback, raw or unprotected sex. On the online sex sites, where once it was middle-age, elderly, and some young White men who advertised for unprotected sex, now there are increasing numbers of young Black men, in their late teens and early 20s whose profiles say they prefer unprotected sex.

A city for the HIV infected

Amazingly, another social component to HIV infection is that in cities such as New York provide programs, which include housing, cash payments and access to medications and healthcare, that many are choosing to contract HIV as a way of living off the system. Additionally, the prohibitive cost of combination HIV anti-retroviral treatment or HART can average more than $40,000 annually, which places it outside the affordability of many who may only be able to be treated by being enrolled in the state’s healthcare programs. In the meantime, those states without comprehensive healthcare coverage for their HIV infected citizens have seen in recent years a growing waiting list for the Ryan White Program or ADAP, which today is upward of 9,000.

One perception of a simple rite of passage today for someone who is gay is to become HIV positive. In the Black gay community, at least three in five are infected, with the chances of someone becoming positive increases. Among many, there is the belief that if one has unprotected sex with someone else and sero-converts to becoming HIV positive, all the infected person has to do is get tested, take a pill and go on treatment. Research suggests that those on treatment are less likely to engage in unprotected sex, but the reality is that many taking medication feel a greater sense of empowerment and invincibility, and as a consequence continue to engage in condom-less sex.  While those already on treatment know the routine, those uninfected often they think that becoming infected as the fad of the day do not know or understand the discipline involved in maintaining a regimen: taking pills at a certain time every day for life. Many are not only afraid, but are reluctant to allow themselves to be subject to such a regimen, which does not permit them to forget or miss a dose, or the consequences could be grave – the virus multiplying and possibly becoming resistant to that particular treatment.

What’s new to deal with this?

Ron Simmons, Ph.D., executive director of the Washington, DC-based Us Helping Us, suggests that there is a need and it is time for a paradigm shift in addressing the increasing numbers of HIV infection in the Black gay community. Simmons says that prevailing research points out that because of the concentration of the numbers of those infected in a community, anyone person has a greater chance of contracting the virus. He suggests on his FaceBook page: “I want us to be aware of the “paradigm shift” in HIV infection among Black gay men. Our comparative sexual risk behavior doesn’t correlate to our infection rate. Studies have found that Black gay men use condoms more than White or Latino gay men and have few[er] sex partners. The problem we face is structural and environment[al], i.e., sexual ecology. Because of the higher prevalence of HIV and STD’s in our sexual networks, we face greater odds of exposure to HIV even though we use condoms more. Addressing this problem will take many approaches, but it is important that we don’t think that the problem is because we are self-hating sluts who don’t care about HIV. That is what the media is going to imply and we have to let each other know the facts so we can decide what we must do about it.”

In what is seen as more of the same, as if to rekindle the fires of interest and commitment to fighting HIV, the CDC has unveiled a plan to launch “Testing Makes Us Stronger”, on Sept 27. The campaign is part of a five-year $45 million campaign initiated by the White House in 2009, and is intended to use social media and networks to increase awareness and encourage Black gay men to get tested.  One wonders, how much more effective this campaign would be and what happens beyond receiving a test result.

But, an independent film, “Slow” written and directed by Darius Clark Moore and produced by Moore, Rodney Parnther, and Mykwain Gainey while it acknowledges sex between two Black men, it seems to want to break the stereotype of Black gay men as people only concerned with having sex. The premise of the film, based on an assignation from an advert on a gay sex site, seems to follow what has become the norm in “hooking-up” with the fast paced insta-sex mental programming that goes with it, instead it departs from this expectation by suggesting slowing down and getting to know the person before having sex.