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When It Comes To HIV, Black, Gay Men Most At Risk


I'm Michel Martin and this is TELL ME MORE from NPR News. Coming up, former South African President Nelson Mandela turns 94 today. He's known around the world as a great leader of our time, but to his family, he's simply Grandfather. We will hear from his granddaughter, Tukwini Mandela, in just a few minutes.

But, first, we want to turn to a health crisis here in the United States. This weekend, the International AIDS Conference opens in Washington, D.C. We'll be bringing you stories from that conference all week and the global fight to treat and prevent HIV and AIDS.

But, currently, no group in American is more at risk of becoming infected with HIV than gay and bisexual men. In fact, one in four new infections are among black men who have sex with men. What's behind that alarming statistic is detailed in a new report, "Back of the Line: The State of AIDS Among Black Gay Men in America 2012." That report was compiled by the Black AIDS Institute.

With us to talk more about that report is Phil Wilson, the institute's founder and executive director. Also with us, Cornelius Jones, Jr. He is an artist. He was diagnosed as HIV-positive 14 years ago. He lives in Los Angeles and his story was featured in the report.

Welcome to you both. Thank you both so much for speaking with us.

PHIL WILSON, FOUNDER, EXEC. DIRECTOR, BLACK AIDS INSTITUTE: Well, thank you. It's great to be with you today.

CORNELIUS JONES, JR.: Yes. Thank you. Same. It's very great to be here.

MARTIN: So, Phil, I'm going to start with you because you've been involved with this issue for more than 30 years and, in fact, in the beginning of the report, you talk about the fact that, among many of your friends, you know, you're the only one who's still alive. So you have a very long view of this issue, a very personal view of this issue, but we can't get around these very sobering numbers.

You mention that one in four new HIV infections is among this population of black men who have sex with other men. You note that 60 percent of this population will become HIV-infected by the age of 40. Why?

PHIL WILSON, FOUNDER, EXECUTIVE DIRECTOR, BLACK AIDS INSTITUTE: Well, there are a number of reasons, you know, why we are where we are. This is a population that's been neglected. People who ought to care didn't care. You know, we have issues where, in the beginning of the epidemic, you know, the epidemic was characterized as a white, gay disease. So, if you were black, it wasn't about you. In black communities, you know, certainly, people weren't thinking about, you know, HIV and AIDS and, quite frankly, at a time when people weren't talking about the reality that there were gay and bisexual men in black communities.

INSTITUTE: So there's a history of neglect. That provided the virus an opportunity to take hold, you know, and this is a disease of opportunity. The other factors that contributed to the problem is that there are all these other issues and continue to be other issues on the plate when HIV enters the room. Poverty doesn't take a vacation, unemployment doesn't take a vacation, teen pregnancies don't take a vacation. You know, violence doesn't take a vacation.

INSTITUTE: You know, you add on to that issues around a lack of access to health care even now, and there you have the issue around stigma and black gay and bisexual men struggling with what I say is no place to be, you know, where they feel home in black communities because of the issue of sexual orientation and they feel home in a larger white LGBT community because of the issues of race.

You know, so if you put all that together, regardless, you know, you would come out with something like HIV and AIDS and an epidemic that looks like the epidemic that we're finding among black men who have sex with men.

MARTIN: Cornelius, one of the reasons we wanted to talk with you is that you're a relatively young man. You're what, 34?

JR.: Yes.

MARTIN: Right. Which means that you've been alive pretty much throughout the course of this epidemic being known.

INSTITUTE: He was 2 when I got infected.

MARTIN: Yeah. What do you think connected you to this story? Is it lack of knowledge? Was it isolation? Was it not being aware? What do you think?

JR.: I came out at a very young age. I came out when I was 15. All I knew at that time was that guys my age and a little older than me were dying of HIV and AIDS and there was this big stigma lingering within our community and everyone was afraid. No one wanted to talk about it. No one knew anything about it and it was such a taboo, so hush-hush.

When I was 21, I found out and, a year before I got tested, there was a rumor that circulated within the community that someone I dated was HIV-positive. I was in a complete state of shock, fear and it took me an entire year to actually go and get tested because of fear.

MARTIN: It's not that you didn't know that HIV was out there. Was it that you thought it didn't have anything to do with you or is it because you grew up in a time when HIV/AIDS was not the death sentence that it was initially?

JR.: No, I think, during my time, it was - people were still dying. I'm speaking like in '95. When I found - that was 1998. Yes. We had advanced then, but people in my circle were still dying. It was still, like, this stigma, this fear around it. People just didn't want to know and it also went back to being HIV-positive meant you were gay, you were promiscuous, you were just this sort of vile, nasty creature. So there was a lot of internalized hate and internalized phobia, an AIDS phobia that I dealt with and friends in my circle dealt with. And so, yeah, at times it was just easier or safe to not really discuss it, not really find out and just live life and what happens is what will happen.

MARTIN: If you're just joining us, this is TELL ME MORE from NPR News. The 19th International AIDS Conference opens this weekend in Washington, D.C. We're talking with two guests who have a particular connection to this story. Phil Wilson is the executive director of the Black AIDS Institute. No group is more heavily affected by HIV/AIDS in the United States than black men who have sex with men or gay black men. We're talking about that. Also with us, Cornelius Jones, Jr., an HIV-positive artist who's featured in the report.

Phil Wilson.

INSTITUTE: What this report shows is that the problem is not that black gay men are engaging in riskier behavior than their counterparts. Even with all of that, you know, Cornelius was probably doing what he thought he could do, as other black gay men are doing what they think they can do.

But the problem is, again, HIV is about sexual networks and so we have a higher level of HIV to begin with.

MARTIN: But the report also found, though, that black men who have sex with men are less likely to seek out treatment than white gay men. Why is that?

INSTITUTE: Well, they're less likely to have health insurance. You know...

JR.: Yes.

INSTITUTE: They are more vulnerable to stigmatizing experiences with their health care provider. We know when we're...

MARTIN: Even now? Even now?

INSTITUTE: Even now.

JR.: Yeah.

INSTITUTE: I mean, but even separate from HIV, Michel, you know, there are these stories that - lots of data shows that black people get inferior care no matter what the disease. You know, I have insurance. I'm middle class. I'm black. You know, I have heart disease. I get different care than if I'm white and middle class, and the same thing holds true with HIV, as well.

MARTIN: Well, let me ask you a difficult question, then. If you're not a black gay man, why do you care?

INSTITUTE: This is why you should care. It's because HIV has no respect of person. We're all at risk. You know, we live next to each other. There are not black gay ghettos, you know, so it is your brother. It is your son. It is your father. It is your uncle. It is the man that you were intimately involved with and so, for us, you know, this is an issue that we have to address to save all of our communities.

MARTIN: Phil Wilson, I'm going to ask you a question that one of my editors used to ask me after a particularly tough day. He'd say, is anything OK?

INSTITUTE: I'm great. OK. I'm fantastic because I believe in us, you know, that we have the tools today to end the AIDS epidemic in our communities. The question is, will we do it? And there are some simple things that we need to do. Number one, we need to get tested. You know, we should have testing on demand. You know, if we can get as many folks in our communities to understand their HIV status, we go a long way to ending the epidemic.

The second thing, treatment on demand. Now, the treatments are better than they've ever been. You know, they're easier, they're more effective, there are fewer side effects. We also know that treatment is prevention and so, if we can get people on treatment, we can drive down their viral load. We can reduce their ability to transmit the disease by 96 percent.

So, for me, you know, I'm doing great. You know, I think that we're doing great. You know, black folks have been greater than any of the challenges we've faced in the past. We are greater than the Middle Passage. We are greater than slavery. We are greater than reconstruction. We are greater than Jim Crow. We are greater than Hurricane Katrina. And, together, we are greater than AIDS.

MARTIN: Cornelius, how about you? How are you doing?

JR.: I am living in my truth every day. I am hopeful every day. I wake up every morning and I am thankful. I share, I give, I receive. I just don't base my life around being HIV-positive. It's a part of me. I am living my truth. I am healthy.

MARTIN: Phil, I'm going to give you the final word. We've been talking about this for years - you and I. Are we going to continue to be talking about this throughout the rest of our lives?

INSTITUTE: I believe that we really are going to end this epidemic, and you've heard me give speeches.

MARTIN: In our lifetime?

INSTITUTE: In our lifetime. Yes. Absolutely. It will require for us to act. You know, I think there are some pieces in place. The fact that we can do a better job in diagnosing the disease, a better job in surveillance of the disease. We now know where the hot spots are down to zip code or census track. We now have a national HIV/AIDS strategy, you know, that President Obama released two years ago. So we have a roadmap to get there.

Health care reform is critically important, you know. If we can get those 30 million people into care, we can get those, you know, one out of five folks who are HIV-positive who don't know their HIV status. If we can get them tested to know their status, we can get people into treatment. If we can come together, we can beat this thing. I'm absolutely convinced of that and that's what I'm working for.

MARTIN: Phil Wilson is the executive director and founder of the Black AIDS Institute. He was with us here in our Washington, D.C. studios. With us from NPR West, which is in Culver City, California, Cornelius Jones, Jr. He is an actor and author. He's an HIV-positive man who was featured in Phil Wilson's report and he joined us, as I said, from NPR West.

Thank you both so much for speaking with us.

INSTITUTE: Thank you, Michel.

JR.: Thank you. Transcript provided by NPR, Copyright NPR.

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