Bay Windows - July 11, 2002
Mubarak Dahir, Bay Windows Staff

Not surprisingly, when the statistics were broken down by race and ethnicity, the study showed that minorities tended to fare worse. Of those in the study, 90 percent of blacks said they did not know their HIV status. For Latinos, the rate was 70 percent. And for whites, 60 percent. Of the total estimated 900,000 Americans with HIV or AIDS, about half are believed to be unaware of their HIV status.

Eerily, according to the report, most of the infected men perceived that they were not at high risk for contracting HIV--despite the fact that they reported participating in unprotected anal intercourse.

The study also showed that minorities continue to be diagnosed with AIDS in percentages highly disproportionate to their numbers in the general population. Blacks account for 43 percent of diagnosed AIDS cases. Latinos are 21 percent of the cases. And whites are 34 of cases. The remaining two percent of AIDS cases are made up of people from a variety of racial and ethnic backgrounds.

More disturbing news: gay men account for the largest percentage of the estimated 50,000 new HIV infections each year. Of the new cases, gay men make up 43 percent of new infections. People who contracted HIV through heterosexual sex make up 27 percent. And intravenous drug users make up 23 percent.

The numbers clearly show that existing HIV and AIDS messages are not making a strong enough impression where it counts: among young gay and bisexual men, and particularly among minorities.

There are a host of reasons why young gay men continue to put themselves at risk for HIV and AIDS. Most of those reasons can be addressed. But some of them may be out of our reach, no matter what we do.

Many young men did not live as adults through the worst years of the AIDS epidemic, before advanced drugs, and do not have the memories the rest of us do of burying friend after friend, attending memorial after memorial. Also, many young gay men came of age around the same time that protease inhibitors dramatically changed the lives of people with AIDS. Therefore, many young gay men incorrectly see AIDS as "not so bad," or similar to a long-term manageable illness like diabetes. Another factor is youth: young people always have and always will be a little more reckless and take more chances than more mature adults.

When it comes to minority populations, it gets even more complicated. It is hard for most of us to conceive that today, anyone could say they do not know what causes HIV and AIDS. But according to scores of HIV and AIDS experts I've talked to, that is indeed a problem, particularly in minority communities. Many young minority men still see AIDS as a disease of gay men. Even though these young men are having sex with other men, they do not see themselves as "gay"--and therefore, they do not see themselves at high risk for HIV.

Of course, there are other factors, too. One is simply education--how the HIV and AIDS message is delivered to them in ways they relate to. And also important is how many times they hear the message. We know that for any group, it takes constant repetition before any message sinks in. Minority gay men may simply not be getting the message as often and in ways that reach them personally as do white gay men.

Social and political factors have an effect as well. It can often be more difficult for young black men to broach the subject of their homosexuality in their communities. At the same time, these men often feel alienated and unwelcome in what they see as the larger "white" gay communities. This leaves them with precious little outlets for talking openly about such issues as HIV and AIDS.

Similarly, Latino men often face a specific set of obstacles culturally--coming out in an often machismo environment, in communities that can often be socially conservative and heavily Catholic. Again these young men frequently feel left out of the "white" gay community, and are left with fewer options and opportunities for getting information about and openly discussing the causes of HIV and AIDS.

Economics has a huge impact as well. Minorities are likely to be less affluent than white Americans, and thus are likely to have less access to healthcare. This may make just getting tested harder. And it certainly makes getting properly diagnosed and treated more difficult.

Finally, studies have shown that minorities are often more skeptical of authority--including institutions such as the doctors, clinics, and organizations that put out HIV and AIDS messages. This may make some young minority men more reluctant to seek testing and medical attention.

There's no single, silver bullet to solving the problem of young gay men who continue to come down with new HIV infections. But the data do give some indication of where the problem is the worst, and we already know many of the reasons why. Now, we need to direct both the will and the money to make significant changes where they are needed most.
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