Last week I blogged about the CDC's report on the stable number of new infections; buried in the report's subtitle was the growing numbers of new HIV cases among Black gay men. Frank Oldham, preseident of the NAPWA (National Association of People with AIDS) has sent out an open letter, which is worth quoting at length here.
NAPWA and I personally salute the CDC for reporting Wednesday what we all already guessed: the number of new HIV infections is level for the country as a whole but is steadily rising in young gay Black men. Tom Frieden spoke for all of us when he said, "We're very concerned about this trend." As an openly gay Black man who has lived with HIV for twenty-two years and seen friends and partners die, I wholeheartedly agree: we have to change this.
Studies show that young gay Black men are at least as likely to use condoms as their non-Black peers, so we cannot blame the rapid spread of HIV among them on riskier behavior. On the contrary: it is driven by the high number of young gay Black men already infected and the high number of them who do not know they are infected. The special impact of HIV on these young people is caused by structural issues in American society that mainstream politicians and press don't like to talk about - especially in this Tea Party-driven political climate.
Structural issues are always hard to talk about. Poverty and prejudice are harder than any. But let's face facts: HIV's disproportionate impact on African-Americans and other Americans of color is the price this country pays for letting color mean poverty, and poverty mean substandard healthcare and health literacy. And HIV's disproportionate impact on young gay men has everything to do with stigma and homophobia, which discourage young men from learning their status and seeking treatment. Let those two problems come together and you have the perfect storm.
We need to address unequal economic and educational opportunity, which keep poor people poor, but that will be a generation's work. In the mean time, all lower-income Americans, White and Black, straight and gay, need fairer access to healthcare and support services. Achieving that, in this political climate, means driving home relentlessly the objective truth that three-quarters of HIV-related healthcare costs are borne in the public sector, and it costs the public less to test aggressively and treat early than to do nothing and let more people get sick. Our best defense in the coming deficit reduction negotiations is a good offense: it costs more to do less, and we can prove it.
Good figures on local HIV statistics are hard to come by. In Long Beach about 13% of the population is African American, yet they make up one quarter of new HIV cases. As Frank Oldham points out, drivers of the epidemic are not riskier behaviors, but riskier partners: if you're having sex with a segment of the population that is one quarter positive, the chances of being exposed are much higher. Compounding the problem is the number of people who have HIV but don't know it. Here in Long Beach, it's estimated to be 1500 people who are positive and have yet to find out. Because their HIV is not treated, levels of the virus are higher, making it easier for them to infect someone else.
As Oldham states, it costs less to test agressively and treat early than to do nothing and let people get sick. Here at the CARE Program we offer free confidential HIV testing with results in 20 minutes. Call 562-624-4900 to scedule a test.
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