The Promise of Equality: Fighting HIV Among African Americans

 

 

When President Obama stood on the steps of the U.S. Capitol on Martin Luther King Jr. Day to take his second oath of office, he said, “We, the people, declare today that the most evident of truths, that all of us are created equal, is the star that guides us still, just as it guided our forebears through Seneca Falls, and Selma, and Stonewall.”

It was a significant and historic moment for the gay rights movement — and for the fight against HIV/AIDS among African Americans. Only when we achieve full equality and inclusion of everyone, as the president so boldly envisioned in his inaugural address, will we truly end the AIDS epidemic as we’ve known it in the United States. On this National Black HIV/AIDS Awareness Day, it is important to reflect on the tremendous progress we’ve made, and to rededicate ourselves to the hard work still ahead to stop the spread of HIV among people of color and expand access to lifesaving care.

The most recent surveillance report from the U.S. Centers for Disease Control and Prevention shows a 21-percent decrease in new infections among black women. This is tremendously good news, despite the fact that African-American women still make up the majority of HIV/AIDS cases among women nationwide. But we must continue the momentum, not only among women but particularly among young black gay men, who are still suffering greatly in this epidemic.

Between 2006 and 2009, new HIV infections increased 48-percent among young black gay men aged 13 to 29. It is imperative that the public health community now put its full attention toward making significant progress with this group. We owe it to these young men, not just as HIV advocates but as the broader LGBT community, not to let them fall through the cracks. Black gay men and their transgender sisters are at the intersection of multiple communities and civil rights struggles — the exact ones President Obama spoke of: Seneca Falls, Selma and Stonewall. They are key constituents of each and deserve targeted attention to address this persistent crisis. As the president said, our journey as a nation is not complete until we all achieve the promise of full equality. That means lifting up the most marginalized among us. That means lifting up young gay black men.

This work begins with reducing HIV stigma in the black community so that testing becomes routine and access to care is a given for those who test positive. According to a recent survey of HIV testing practices among African-American primary care physicians, although 80 percent support routinizing HIV testing, only 55 percent report routine screening (rather than risk-based testing) as the primary reason for testing their patients. Furthermore, physicians report testing only one third of their patients for HIV in the past year. HIV stigma and fear of offending their patients were top reasons for not recommending HIV testing. This must change; black physicians must begin to view routine HIV testing as a standard of medical care, not a judgmental statement about their patients.

 

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