New Black MSM Data Beg This Question: Do We Have the Will to End the AIDS Epidemic?

According to data released by the CDC last week, H.I.V. infections among most populations in the United States, while unacceptably high, have remained relatively stable in recent years. But among young Black gay and bisexual men ages 13-29, the data show a 48 percent increase in new infections from 2006 to 2009. Our nation’s H.I.V. prevention efforts have stalled at best, and among young Black gay and bisexual men, we have clearly failed.


These new numbers reinforce what many of us have known for a long time—we are not going to be successful in driving down new infections unless and until we invest in those populations most at risk, and in America today those populations are Black Americans, gay and bisexual men of all colors and especially young Black men who have sex with men.  We have to build the infrastructure and the capacity in these communities to respond to this epidemic in an appropriate manner.  We have to build a mass mobilization effort “for and by” the most at risk populations in our country.

As we have reported many times, there is no evidence that young Black men who have sex with men engage in high-risk behavior to any greater degree than their counterparts in other racial and ethnic groups. But their risk is significantly higher.  In order to address AIDS among this population, we have to confront some of the structural social determiners of health. At the same time that we see rising H.I.V. rates among young Black men who have sex with men, we also see continued mass incarceration of young Black men in America, rising unemployment and falling college enrollment.  It is an outrage that we’ve seen a 48 percent increase in new HIV infections among young Black gay and bisexual men.

AIDS does not happen in a vacuum—poverty, unemployment, lack of access to primary health care, incarceration and other structural factors magnify Black men's risk. And regardless of how hard some Black men who have sex with men have tried, compartmentalizing their sex lives does not protect them from being impacted by such structural determinants. Preventing H.I.V. requires dealing with the whole person, not just one aspect of their life as so many HIV-prevention efforts attempt. It is also an outrage the there are more young Black men in jail than in college and the unemployment rate for young black men in some cities is as high as 50 percent.

We have the tools to finally end the AIDS epidemic. With ever-expanding testing technologies, we can diagnose the disease easily and inexpensively.  We can identify where the epidemic is most severe by measuring community viral load—in some cases down to the zip code.  We know how to prevent exposure to the virus. We know how to interrupt acquisition of the virus; in most cases, we know how to treat the virus; and we know now to interrupt transmission of the virus through treatment as prevention.  With all of these recent advancements, the question is no longer “Can we end the AIDS epidemic,” but “Will we?”

Yours in the struggle,