Black Men Are 16 Times More Likely to Have HIV — But Why?

According to the CDC, one in two gay/bi black men in the United States are projected to get HIV in their lifetime, compared to one in four queer Latino men, and one in 11 queer white men. Young black men, however, actually engage in safer sex habits than white men with fewer sexual partners and more lifetime HIV tests, according to a recently published paper in the Journal of Acquired Immune Deficiency Syndromes, which analyzed data from 1,015 gay/bi men between the ages of 16 and 29. The young black men in the study didn't report higher uses of condomless anal sex than the other racial groups either.

"Their social and sexual networks are more dense and interconnected, which from an infectious disease standpoint makes infections transmitted more efficiently through the group," senior study author Brian Mustanski, professor of medical social sciences at Northwestern University Feinberg School of Medicine and director of the Northwestern Institute for Sexual and Gender Minority Health and Wellbeing told reporters this week of the seemingly contradictory findings."That, coupled with the higher HIV prevalence in the population, means any sexual act has a higher chance of HIV transmission."

Another contributing factor likely has to do with the fact that queer black men were significantly more likely to have a detectable viral load, according to the study, even though they are more likely to get tested. Having a high viral load increases the likelihood of passing on the virus.

Still, these are only a few of the overarching factors the contribute to the higher HIV rate seen among black men. The much larger answer is racism David Johns, executive director of the National Black Justice Coalition, explained by phone.

"Saying that makes a lot of people uncomfortable," Johns said. "[But] there are intentional efforts to ensure that black people are disproportionately concentrated in spaces where they are negatively affected in ways that benefit white people." According to Johns, in these space, it's tougher to gain access to healthcare. But even when there is access, there are still issues.

"Even when there is access, stigma and prior racism in healthcare--such as the infamous Tuskegee Syphilis Experiment--has created a pathology of mistrust, which leads us to not utilizing healthcare systems until it becomes an emergency," journalist and activist George M. Johnson said.

While there's no simple solution that answers the question of how to combat HIV/AIDS health disparities seen among young black communities, Johns believed it's necessary to "talk about the ways in which both racism and sexual minority status combine to doubly oppress individuals in that category."

Taking an intersectional approach will increase the number of culturally-competent healthcare providers who will not only have knowledge of but also be sensitive to the specific needs of black men who have sex with men. This, in turn, will encourage more young black men to seek preventative treatment. Or conversely, once diagnosed with HIV, these men can work with their doctors to obtain and sustain an undetectable viral load, as to not accidentally transmit the virus.

"Although black [men who have sex with men] test at a higher frequency, there are still many pockets of our community that have never been tested and a part of the community that lives with the virus unknowingly." Johnson said. "We have also not done enough to ensure that those on treatment are remaining adherent and that those who get lost in care are brought back into it."

Education, both men noted, is yet another key factor.

"We need to start teaching sexual health in a manner that is not centered around hetero-norms," Johnson said. "Anal sex is not a part of regular sex curriculum, nor is HIV rates and transmissions within our community."

Education will help to eliminate stigma and shame which impedes testing. "HIV is still a very touchy subject in many Black communities, and that must change. Proper education around the virus is the answer," Johnson concluded.

"My hope is that these data create a shift in the way we approach the topic of HIV, and we're able to address the issues of racism and lack of education which affects the black community," said Johns.