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Thriving in a Hostile Environment on National Black HIV/AIDS Awareness Day


Living well in this stressful time could be a beautiful act of protest.

I can’t help but think this as we commemorate National Black HIV/AIDS Awareness Day today that taking care of ourselves can indeed be a political act, especially in the face of a new presidential administration that could walk back the strides we’ve made toward ending the HIV epidemic. Most importantly, we had turned a corner by expanding health care access to large numbers of young gay and bisexual men of color, especially black/African-American men.

The day was originally established in 1999 to call attention to the impact of HIV and AIDS in the black/African-American community, and 18 years later, it is a vital reminder that in Los Angeles County — and indeed across the country — the impact of HIV continues to be devastating. According to the 2017-2021 Comprehensive HIV Plan for Los Angeles County, for example, the HIV epidemic among the black/African-American community in our own backyard encompasses the following statistics:

  • Blacks/African-Americans are one of three racial/ethnic groups most impacted by HIV
  • Among men who have sex with men (MSM) blacks/African-Americans have the highest estimated HIV prevalence
  • Young (18-29) black/African American MSM are one of the fastest-rising groups contracting HIV
  • New HIV diagnoses  both adults/adolescent males and females is highest among blacks/African-Americans
  • Among females living with HIV, the majority are black/African-American

For a sobering perspective on the epidemic nationally, the Centers for Disease Control and Prevention last year reported that if current trends continue, one in two black/African-American MSM will contract HIV in their lifetime. Fifty percent. Even PrEP, the daily use of a pill that prevents HIV, approved four years ago, is not yet making major inroads in communities of color, due to lack of awareness, problems with access, and concerns about its cost as well as distrust of the medical establishment (the shameful legacy of Tuskegee still looms large).

The theme for this year’s National Black HIV/AIDS Awareness Day is “I Am My Brother’s and Sister’s Keeper. Fight HIV/AIDS!” I appreciate that it brings together the idea of watching out for each other but also includes the word “fight.” After all, in communities that can quite often feel under siege, every day — even if you are not living with HIV — can be a struggle. But we’re in this together.

The steps that this observance asks us to take are:

Get Educated
Everyone in our community has a responsibility to learn the facts about HIV as well as other sexually transmitted infections and talk with our friends, family, and sexual partners. This will go such a long way in ensuring that we are all informed. Additionally, it is important that we all know the truth about the ways to prevent HIV transmission (condoms, PrEP/PEP, HIV-positive individuals being in care and on medication). It is also important we support those who are HIV-positive. This reduces the stigma associated with living with HIV, which often prevents those who are HIV-positive from seeking the medical care they need or from talking to their loved ones.

In addition, if you have health insurance, talk to a medical provider about PrEP and other HIV prevention methods. If you don’t have insurance, find out if you qualify for a low-cost plan. In California, for example, Medi-Cal enrollment continues year-round, and PrEP is one of the benefits an enrollee can access for little or no cost. The Trump administration can’t take that away yet.

Get Tested
If you’re sexually active, get tested for HIV and STIs every three to six months. It’s easy to do, free even if you don’t have insurance, and confidential. Encourage your friends and partners to get tested and share their results too.

Get Involved
There are many wonderful HIV and health care organizations in our community that are committed to ending the epidemic. They need your support, whether through volunteering or financially. Reach out to them to see how you can help. In addition, lend your voice to the fight to keep Obamacare accessible for everyone. Access is a crucial component to fighting HIV and getting people in care.

Get Treated
If you are HIV-positive and not getting medical care, find out where you can get it. If you are in care, take your medication as prescribed. We know that when HIV-positive individuals are virally suppressed the likelihood of them transmitting HIV is almost zero.

We should never forget that we can help each other with each of these steps — that we are stronger working together. The future isn’t looking so bright out there at the moment, let’s be honest. But we can ensure we are doing everything possible with the resources above to stay healthy in body and mind. We can, and will, thrive despite those who would seek to strip care away from us.

TERRI L. SMITH is the director of HIV preventions services for APLA Health. For more on National Black HIV/AIDS Awareness Day, visit For more on APLA Health, visit

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Terry L. Smith