Bay Windows - Local News, October 28, 1999
Beth Berlo, Bay Windows staff

While deaths from AIDS in the United States have plunged since 1995, they have been slow to decline in communities of color, particularly among gay and bisexual African-American men.

New figures released by the Centers for Disease Control (CDC) show that AIDS killed 17,047 people in the US last year, a 20 percent drop since 1997.

But the CDC statistical breakdown reports that a total of 8,316 African Americans died from AIDS last year, while 5,436, or 32 percent, of Caucasians did. A group that's only 13 percent of the U.S. population accounted for nearly 50 percent of AIDS deaths. In addition, 3,114 or 18 percent, of Hispanics died from the disease in 1998.

Health officials speculate there are many reasons for the disparity. "I think the risk behaviors that have led to new infections [among African-American men], which are equally important, are intravenous drug use and men who have sex with men," Dr. David Holtgrave, director of HIV and AIDS prevention intervention research and support at the CDC, told Bay Windows. "These two risk factors are approximately tied.

Many African-American men live in poorer communities where there is higher substance abuse rates, tuberculosis and sexually transmitted diseases, Holtgrave said. "All of these lead to higher transmission rates."

Another factor being looked at closely, officials say, is the prevalence of bisexuality in communities of color. During the HIV Prevention Conference at the CDC in Atlanta in August, Tracy Mayne and colleagues from the New York City Department of Health and the Gay Men's Health Crisis found that of 7,065 men in gay venues, 20 percent of African Americans reported bisexuality, compared with just 12 percent of Hispanics and 4 percent of Caucasians. That, not IV drug use, may be what's fueling the spread of HIV infection among African-American women also, officials say.

Holtgrave partially attributed the higher percentage of bisexuality to differing attitudes surrounding homosexuality in minority communities. "It could be more difficult accepting gay men in racial and ethnic communities, and denial of homosexuality is one explanation," she said. Because of bisexuality, health advocates who once referred to men who have sex with men as gay men, now use the term MSM.

"Talk to any of the kids who are sex workers," said Pamela Johnson, executive director of MOCAA. "They'll tell you who's out there," she said, referring to a large percentage of married straight men who pay money in exchange for sex with GLBT youth. Several of the youth who are MOCAA regulars are also sex workers or M2F transgendered, Johnson said.

MOCAA's main purpose is to provide prevention education and safer sex messages to the African-American community. "We have a number of groups," said Charles Robinson, community programs director. "Shades of Brown is a group for MSM, and we have a number of youth drop-in groups for people between the ages of 18 and 25."

Asked if she's seen a rise in the number of gay youth coming to the center over the past year, Johnson responded with an emphatic "yes," but not necessarily because they are HIV-positive.

"The youth that are coming in now are reporting really high incidences of HIV-positive parents," Johnson said. "We have a youth program called PHAT (Preparing Hiphop Adolescents for Tomorrow). Our work with them is around education and prevention. We do workshops and treatment groups. This is where we're discovering a lot of this information."

Prison, many observers say, is a population often overlooked as a prime suspect for contributing to the higher rates of HIV infection between men of color. "There are large numbers of African-American males who are imprisoned who would not necessarily identify as gay or bisexual yet are engaging in same-sex liaisons," Johnson said.

After the August HIV conference, Dr. Holtgrave concurred with Johnson, saying, "I think that is quite plausible."

In coordination with MOCAA, the Boston Living Center (BLC) holds what program director Ron Smith called "salon evenings."

"They're not strictly limited to men of color, but we do [coordinate] with MOCAA," he said.

Smith described it as a night of "sharing information and having a meal together, and usually there's a topic [of discussion]." He reported "a 50 percent increase just this year" in program attendance, saying the average age of attendees falls between 25 and 50, "particularly in the MOCAA Salon evening."

Within the past two months, the BLC has added what Smith referred to as a People of Color Community Group. "[Its] purpose is to develop community and fellowship ... and ... education, social, and peer opportunities."

What's being done on a large scale effort to prevent under-recognized communities from falling victim to this largely preventable disease?

"We have a variety of prevention and education programs that we fund across the state that target different communities based on demographics," said Thera Meehan, assistant director of policy and planning at the Massachusetts Department of Public Health. "We tailor our efforts to certain communities so a blanket message is not being sent across the state."

Though he couldn't release the names of the organizations, Holtgrave said, "What's really exciting this year, is that next week we are about to release the names of organizations that were successfully funded, and we also have a roughly $7 million program that will fund community-based programs for gay men of color. The preponderance ... will be for African-American organizations."

Dr. Helene Gayle, director of the CDC's National Center for HIV, STD, and TB Prevention, underscored the continued need for communication with the African-American community, saying, "We will need every facet of [that] community to join us, get involved, and openly address the real challenges we face, in order to stop the spread of the disease that is devastating our community."
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