The persistently higher HIV infection rate among black gay men and ways to reduce that rate were expected to be among the leading topics of discussion at events across the country on Saturday, Feb. 7, to commemorate National Black HIV/AIDS Awareness Day.
In D.C., Whitman-Walker Health and Us Helping Us, the city’s two leading private AIDS service providers reaching out to the LGBT community, were scheduled to offer HIV testing and HIV prevention information along with some entertainment and refreshments at separate locations in connection with National Black HIV/AIDS Awareness Day.
Spokesperson Shawn Jain said Whitman-Walker would host an HIV testing event on Friday, Feb. 6, from 1-4 p.m. at the Anacostia Metro Station. He said a separate testing event, in partnership with WPGC-FM Radio, was scheduled for Saturday night, Feb. 7, from 10 p.m. to 1 a.m. at the Bachelor’s Mill, a popular bar and dance club with a mostly black gay male clientele at 1104 8th St., S.E., near the Washington Navy Yard.
Us Helping Us Executive Director Ron Simmons said his organization would host an HIV and Hepatitis C testing event at the Us Helping Us offices at 3636 Georgia Ave., N.W. from 12-8 p.m. on Friday, Feb. 6. Snacks and beverages along with possible entertainment hosted by WPGC-FM Radio were also expected to part of the event, Simmons said.
This year’s National Black HIV/AIDS Awareness Day comes on the heels of yet another study showing that the HIV infection rate among black gay men remains alarmingly high and shows no signs of abating.
The study, published in November by medical journal The Lancet, was conducted by researchers from Emory University’s Rollins School of Public Health in Atlanta and The Foundation for AIDS Research, known as amfAR.
Among the researchers that co-authored the study was Gregorio “Greg” Millett, a former White House adviser on AIDS policy, former researcher with the U.S. Centers for Disease Control and Prevention and current vice president and director of public policy at amfAR.
“Unfortunately, the HIV response is failing black gay men in particular in the United States,” Millett told the Washington Blade in a Feb. 2 interview. “And that’s really concerning because if we actually take a look at the impact by the numbers it’s unfathomable the degree to which black gay men are impacted,” he said.
“Black gay men are only about 1.4 percent of the black population, but comprise 53 percent of new infections that take place each year among African Americans,” Millett said.
“And black gay men are only 0.2 percent of the U.S. population but 23 percent of new infections that take place in the U.S. each year. So they are a quarter of the new infections that take place each year but only 0.2 percent of the U.S, population,” he said.
As if that were not enough, Millett points to recent CDC figures showing that the rate of viral suppression among black gay men who are HIV positive is just 16 percent, which he describes as another alarming figure.
AIDS doctors and researchers use the term “viral suppression” to describe the generally healthy condition of those with HIV who succeed in greatly lowering their viral load through treatment with the current generation of highly effective anti-retroviral drugs. In addition to resulting in people with HIV remaining healthy, AIDS experts say viral suppression also results their being significantly less likely to transmit the virus to someone else.
Millett notes that studies show that white gay men with HIV have a viral suppression rate of about 33 percent, which is also alarmingly low and an indication, similar to black gay men, that gay men with HIV in general are not getting the scientifically proven medication that easily can render them virally suppressed and help them remain healthy.
A combination of factors, including lack of access to adequate health care, income and educational disparities, and a lack of culturally sensitive prevention and outreach efforts appear to be responsible, at least in part, for why both black and white gay men with HIV don’t have much higher rates of viral suppression.
But Millett notes that the extraordinarily high HIV infection rate among black gay men has also made it extraordinarily difficult to lower that rate.
“It’s very clear over 30 years of research that black gay men are not engaging in higher rates of risk behavior compared with white gay men,” he said. “You find that in study after study black gay men have fewer partners compared with white gay men. They have just as many instances of unprotected sex as compared with white gay men,” he said.
There are several theories on why the infection rate of black gay men became so high and has remained high. According to Millett, one theory holds that in the very early years of the epidemic, black gay men may have engaged in higher risk behaviors for a longer period of time than white gay men and other population groups – partially because black gay men did not have access to education and prevention efforts available to other groups.
Millett said studies also show that there’s a higher proportion of black gay men who are HIV positive but don’t know it, making it more likely that they unknowingly transmit HIV to their partners.
“So we do know from various analyses from CDC that people who are HIV positive and don’t know it contribute to at least half of the infections that take place in the United States,” Millett said.
“Part of the reason black MSM have higher rates of HIV infection and don’t know about it is because black MSM are also less likely to have access to health care than white gay men,” said Millett. “If you don’t have health insurance you are less likely to be screened for HIV, and you’re also less likely, if you’re already positive and diagnosed as positive, to have access to health care.”
Yet another possible component to why black gay men have higher HIV rates, Millett said, is they are more likely to be disenfranchised and marginalized.
“We know that people who have lower incomes, from CDC data, are more likely to be HIV positive,” he said. “People who are unemployed are more likely to be HIV positive. People who have lower education are more likely to be HIV positive.”
A multi-pronged approach to breaking the cycle of high HIV infection rates among black gay men, Millett said, should include an aggressive effort to identify people who are HIV positive and get them into treatment which, in turn, will make them far less likely to transmit the virus to other black gay men.
At the same time he said black gay men who are HIV negative should consider more aggressive steps to engage in protective sex as well as consider pre-exposure prophylactic drugs that are now readily available and which, according to Millett, “dramatically reduces the risk of HIV infection.”