By Sharon Egiebor

Even though HIV/AIDS is being discussed from the church house to the state house to the White House to the jailhouse, stigma still keeps many African American men who sleep with men from getting tested and seeking medical care, according to leading researchers.

African American men, those who identify as gay and those who sleep with men but do not identify themselves as gay (MSM), are increasingly being diagnosed of HIV/AIDS at higher rates than men of other ethnicities.

“There can be many reasons for the increases,” said Dr. Jose Nanin, director of education and training for the Center for HIV Educational Studies and Training (CHEST) at Hunter College, City University of New York (CUNY). “The big reason right now is the speculation of seeing HIV linked to so much stigma in our community.”

Working with grants from the New York City Department of Health and Mental Hygiene and the New York City HIV Prevention Planning Group, Nanin and researchers from the Gay Men of African Descent (GMAD) developed a pilot study to explore the barriers and facilitators for HIV testing among black MSM.

“The research revealed a lot of African Americans are still concerned with the stigma of being associated with HIV,” said Donald Powell, Health and Wellness Coordinator for the GMAD. “MSM have been seen as vector’s of the disease and that is the only identity that they have been given. There is also the stigma of being black MSM in a community that really, really holds masculinity up as a banner of what a black male should be.” The Centers for Disease Control and Prevention raised concerns about the resurgence of HIV in MSM populations in 2001, following years of consistent declines.

In a five-city surveillance released in June 2005, 25 percent of the participating MSM population tested HIV positive, and of that 25 percent, nearly half of them were African American MSM. Whites composed 21 percent and Hispanics composed of 17 percent of the men who tested positive. Most of the men, regardless of race, were unaware of their positive status.

Nanin, who also is assistant professor of health education at Kingsborough Community College of the City University of New York (CUNY), said researchers do not believe African American MSM have a higher incidence of unprotected sex.

“It has a lot to do with the disproportionate number of sexual infections that occur in our community,” said Nanin, who is multiracial. “People are finding out that they have gonorrhea and syphilis, but they are not getting an HIV test along with it.”

By the time the men take the HIV test, too many are getting a double diagnosis – HIV and AIDS, he said.

“The majority of the brothers who are having sex with other men are testing. In studies, the rate of men not testing is still under 40 and 30 percent. The majority of men are testing regularly,” Nanin said. “We’re just afraid of those who don’t and who are unaware of their status and unaware that they may be positive. These men may be more likely to have unprotected sex and to spread the virus.”

In the smaller, New York pilot study, Nanin said participants mentioned the various ways they experience stigma, which keeps them from testing.

 

• The men said walking through the door of any testing site leads to the perception by others that a black MSM is at risk for HIV or is probably gay.

• The belief also exists that testing sites are not well equipped to deal with the needs of men of color; some felt dismissed when they went for HIV testing services at certain clinics and community-based organizations.

• Others mentioned the fear of disclosure and breach of privacy.

Other reasons for the increasing number of HIV infections may result from most men’s natural reluctance to seek medical care, unless it is an emergency.

Nanin said the CDC’s recommendation for routine HIV testing in all medical facilities, would benefit black MSM. He cautions that the testing should come with pre and post test counseling.

Powell said the greater community and especially the religious community could do a lot to ease the pressure and stigma black MSM feel.

“As a people, a lot of us are really rooted in the church. We are going to have to have much more than a position of tolerance from the church,” Powell said. “When you ask individuals to be themselves some place away from where they got comfortable. In order for me to be all that I am, I need to go to a church that is designated just for me. It sends a message that I am not welcome in my community.

“If your family base, your school and your community have told you all your life that your are an abomination, how do you reconcile that?” Powell said.

Powell said new studies are needed to see why 54 percent of the men in the CDC surveillance remained HIV negative.

“What is working with them? What systems of support do they have in place that allows them to maintain boundaries in their status?” Powell said. “The bottom line of HIV is if I am negative, I want to continue my negative status. There are a lot of men who believe that at some point, he is going to test positive anyway because he is a gay, black man.”

Powell said researchers need to find a way to stop that fatalistic viewpoint.

Sharon Egiebor is the project manager for the BlackAIDS.org site.
sharon@egieborexpressions.com
www.egieborexpressions.com