By Frederick Sparks
The HIV infection rate among black men who have sex with men (MSM) in the U.S. now rivals what is seen in the worst impacted parts of the world, including Southern Africa, according to recent studies. The numbers were more alarming than expected for health care providers, researchers and policy professionals already focused on this issue.
A study by the HIV Prevention Trial Network (HPTN) found that black MSM in the U.S. who are under 30 have a 5.9% infection rate, which is 3 times the rate among their white peers and is comparable to rates in the general population in sub-saharan Africa’s hardest hit regions.
The findings of the Black AIDS Institute’s recently released report on AIDS among black gay men in the U.S. paint a bleak picture as well. An estimated 25% of black MSM in the U.S. at age 25 are HIV positive, at age 40, the number goes up to 60%. Sixty.
Yet studies do not point to a higher degree of risky sexual behavior as the explanation for the higher rates among black MSM as compared to their white counterparts; in fact some studies show black MSM are less likely to engage in risky sexual behavior than their white and Latino counterparts. The discrepancy results in part from diminished access to and utilization of health care services, including testing allowing for early diagnosis and for antiretroviral treatment that lower viral loads and reduce the chance of passing the virus. Lower rates of testing also result in higher rates of other untreated STDs which increase the chance of transmission.
The study also found that black MSM in the Bible Belt south have seen the greatest increase in infection rate, and are also least likely to have access to HIV related resources, due in part to political leadership which hardly prioritizes such concerns; many of the governors of these states have vowed not to implement portions of “Obamacare” that have the potential to level the playing field in terms of access to health resources.
But black mainstream and white LGBT mainstream organizations and political leadership have also largely ignored the epidemic among black MSM. The report identifies the black church as “both a challenge and an opportunity” to build leadership on this issue, noting that the church plays a role in the marginalization of MSM and in reinforcing internalized homophobia.
The report also calls for initiatives to increase the level of testing among black MSM, increasing access to and use of for treatment of HIV as well as prophylaxis that can prevent infection if taken soon after an exposure to the virus, and for an end to the disparity in treatment and prevention programs aimed at black MSM.