The HIV epidemic has been plaguing our country for almost 35 years, and it has always disproportionately impacted marginalized communities. Today, African-Americans account for only 13 percent of the population but 43 percent of new HIV infections, the majority of those among gay and bisexual men and transgender women. The question is why?
Why do black people carry the burden of this disease, especially when it didn't start out that way? It's not that African-Americans engage in riskier behavior; in fact, studies have shown they use condoms more and drugs less than their white counterparts.
There's actually a confluence of factors that make HIV significantly more difficult to face and overcome in black communities. Here are just five of them.
Black people are equal on paper, but the same can't always be said in practice. Changing laws haven't done enough to undo almost 400 years of oppression that have lead to countless disadvantages that black people have to overcome every day. HIV impacts black populations disproportionately because the majority don’t have adequate access to the tools to prevent and treat the disease. Through policies and procedures, institutionalized racism creates a system that implicitly and sometimes explicitly disadvantages people of color.
The 2012 US census reported that 28.1 percent of black people are living in poverty compared to the national average of 15.9 percent.The greater numbers of black people living in poverty are, in part, a result of the limited opportunities for upward mobility afforded to them. Often living in poverty means lack of education, lack of access to healthcare, increased risk of substance use and homelessness, and increased likelihood of engaging in sex work as a source of income. All are factors that can increase the risk of acquiring HIV. For those living in poverty who become HIV-positive, priorities do not change. Their concerns on a day-to-day basis are finding and maintaining income, keeping food on the table, and ensuring a place to sleep at night.
According to the U.S. Religious Landscape Survey conducted in 2007, 87 percent of black people are affiliated with a religion. In the face of racial discrimination and hatred, the black church has always provided a sense of togetherness and belonging. However, when a black person comes out as LGBT, many don’t have that same support. Unfortunately black people in the church still make up a large portion of anti-gay America.
Traditionally the black church organizes and rallies when the community is faced with a crisis. However, the response to the HIV epidemic has been slow to non-existent. The reality is black, gay and bisexual men and transgender women are in a state of emergency when it comes to HIV/AIDS, yet they don’t have the full support of the black community.
While interracial dating continues to be on the rise in the United States, black people remain the minority group that has relationships outside of their race the least at 19 percent. This means that the majority of black people have sexual partners who are also black. And given the smaller population size, once the black community was exposed to HIV it spread quicker and the negative impact was and continues to be greater. This means that black people who choose other black partners are more likely to come in contact with someone who is HIV-positive than other people who date within their race. This is especially true in LGBT communities as the CDC has reported that more than 1 in 4 black gay and bisexual men and 1 in 2 black transgender women are testing positive for HIV, compared to .06 percent of the general population.
The "down low" is a concept rooted in homophobia that leads to misguided assumptions about HIV in black communities. Studies have shown that the majority of black men who have sex with men do identify as gay or bisexual, and those who don’t are less likely to be HIV positive, have multiple male sexual partners and have engaged in unprotected anal intercourse in the past 6 months.
The idea of large numbers of black men being on the down low does a disservice to the community as a whole. It implies that being gay or bisexual is something to be ashamed of and it assumes that if you are an HIV-positive man who identifies as heterosexual you must be lying about who your sexual partners are. If you are an HIV-positive woman then you must have had sex with a man who wasn’t honest about his sexual partners, which eliminates the possibility of bisexuality and makes the woman a victim and void of the ability to empower herself and require protection during sex.
Ashley Innes is the director of prevention programs and services at AIDS Arms, Inc., an HIV and AIDS service organization in Dallas, Texas. For more from Ashley, follow her on twitter.
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