Health & Wellness

Black Gay, Bisexual Men, and HIV

What Can We Do to End the Epidemic in Our Community?

For Black Gay and Bisexual Men, HIV awareness is not about one day; it is about choosing to put our health first and our being willing to address hard issues and have tough and difficult conversations. It’s

about reconstructing the walls of stigma, misinformation, and fear with the facts, along with love and support that create safe spaces for people to learn, be tested for HIV, seek care, and stay in treatment. Stopping HIV starts at both the personal and community level; we must work together to make it happen.

Cultural biases like stigma, discrimination, and homophobia place Black Gay and Bisexual men at greater risk for HIV. These barriers prevent many of us from seeking routine HIV testing or receiving HIV preventative care and treatments due to fear of judgment from family, the community, and peers. In fact, many Black Gay and Bisexual Men living with HIV are unaware of their diagnosis. Without knowing they have HIV; they cannot take advantage of the is a lack of comprehensive sex education in schools across the country: less than half the states require that sex education be taught in public schools. Even in liberal cities sex education has started only recently, within the last few years, and in many parts of the country, there is no sex education at all.

By Brodderick D. Roary

treatments that can lead to viral suppression and prevent them from unknowingly transmitting the virus to others.

There are three things we should do to reduce HIV among Black gay and Bisexual Men. First, given the moral narratives often associated with HIV, it’s important to understand that higher rates of HIV among Black MSM are not due to higher rates of risk behaviors. Black gay and Bisexual Men have fewer sexual partners than White gay and bisexual men and we are less likely to use substances before sexual activity that might disinhibit their behavior and lead to taking greater sexual health risks.

The circumstances that make Black gay and Bisexual Men more vulnerable to HIV infection than White gay and bisexual men have grown through the decades and are directly related to lower rates of adequate health insurance and access to health care. They include higher rates of undiagnosed and untreated sexually transmitted infections that can facilitate HIV infection, higher rates of undiagnosed HIV infection, and lower rates of antiretroviral treatment adherence if diagnosed with HIV.

Second, we need a renewed focus on educating young people about HIV and sexually transmitted infections. There

We must work together as a community to end the HIV epidemic in the south.

Third, we must support efforts to expand Medicaid eligibility in the South. Of the millions of Americans who are too poor to afford subsidized insurance

but not poor enough to qualify for Medicaid most of them live in the South. To date, 39 states including DC have adopted Medicaid expansion and 12 states have not adopted the expansion including the following Southern States – Tennessee, North Carolina, South Carolina, Georgia, Alabama, Mississippi, and Florida.

Efforts to promote the expansion of Medicaid eligibility up to 138 percent of the poverty line will disproportionately benefit Black Americans, half of whom live in the South, and could help Black gay and bisexual men and Black heterosexuals access the preventive health care they need and deserve.

Forty years into the HIV Epidemic we have come a long way, but we still have much work to do.

HOLD. INQUIRE. VALIDATE: HOLD. INQUIRE. VALIDATE:

By Dr. Umieca N. Hankton

When a loved one, colleague, or stranger discloses they are living with HIV or AIDS, your response should be one of compassion, kindness, understanding, and support. Your response should not include the fact that you know someone else who lives with HIV or AIDS. Your response should not be stigmatizing or fueled by judgment or ignorance. Your response should not be followed up with a series of questions about who, what, when, why, or how. A simple “I am here for you or how may I show up for you” may be sufficient, as words tend to be inadequate in moments of stress, loss, or pain.

The moment(s) after learning one has been diagnosed with HIV can temporarily feel physically and psychologically paralyzing. The body may instantly go into fight-orflight mode as the brain attempts to process and make room for this new information to be added to the pre-existing details about one’s self. Receiving a diagnosis of HIV is NOT a death sentence

and should not be treated as such. With 1 in 7 Americans diagnosed with HIV, you either know someone, love someone, or you are the one living with HIV. Admittedly, living with HIV and loving someone living with HIV can be scary because it is common to hyper-focus on the label “HIV” vs. focusing on the action of “LIVING.” As we approach HIV/AIDS awareness day, we must redirect our attention to the idea of “LIVING”

because those diagnosed with HIV are indeed “LIVING” with a medical

health condition. Be open educating yourself and those closest to you to decrease stigma, discrimination, and the spread of erroneous information about HIV and AIDS.

What are some ways that we can support those “LIVING and THRIVING” with HIV?

Hold Space and Hold Confidence: It can be painstakingly difficult to disclose one’s health status to others. When your loved one shares their health status with you, listen attentively with your ears and heart. Resist the urge to bombard your loved one with questions. Understand their desire or lack of desire to talk in detail about their health status. Be a person of your word and hold on to their truth as if it were your truth. It is not your responsibility to be the public service announcer of your loved one’s health status. If your loved one disclosed their health status to you, it is because they value you and the strong connection you share. Honor this connection by continuing to be present in their lives and being intentional about Living, Learning, Listening, Laughing, and Loving as you did before they disclosed their health status.

Inquire & Invite: Do not make assumptions about what your loved one will need to be well. Ask how you may support them, particularly when the breath-snatching waves of grief, anger, and confusion hit. Support them in prioritizing their emotional and physical health as the mind and body are interconnected. There will be times when your loved one will want you to be more present and hands-on; other times, they may request time and space to reflect. Invite them to be direct with you regarding these times and let them know that you will be there for them as best as possible. Unfortunately, stigma and shame increase isolation. If you notice changes in your loved one’s pattern of behaviors, acknowledge awareness of the shift, assure them of your love and desire to spend time with them, and invite them to get out and live with you.

Validate & Value: Due to fear of rejection or discrimination, talking about one's health status may be emotionally draining. Please express gratitude for your loved one's willingness to share and trust you with their health information. Remind your loved one of their value in your life and the ways you may serve as an advocate. Reaffirm your ability and intention to be a softlanding space for them. As often as necessary, validate their feelings and experiences by allowing them to talk about their anxieties, grief, and plans to flourish.

Dr. Umieca Dr. Umieca N. Hankton N. Hankton

Dr. Umieca N. Hankton is a licensed clinical psychologist and owner of UNH Counseling Services. Dr. Hankton's clinical interests include the mental health and wellness of Black women, LGBTQ+, clergy, and college students. Clinical services are available to those located in TN, LA, TX, GA, WI, AL, D.C., IL, MN, & KY. To learn about the services offered, please call 901-300-9082.