The Epidemic at Home Takes Center Stage
Reflections on the XVII International AIDS Conference
by Keith R. Green
I feel obligated to preface this piece with a little bit of context. If you have never attended an International AIDS Conference, it is important for you to understand just how overwhelming these things can be. There were over 22,000 people from all over the world who attended the conference this year in Mexico City (a city with a population which easily surpasses the 20 million mark), and more sessions, workshops, and posters than one could probably attend to in a lifetime.
I generally like to approach situations like this with a pre-set agenda. Typically, I glance through the Conference Program to see what captures my attention, and plan to attend those particular sessions or events. Not surprisingly, there were a great number of things that were of significant interest to me—presentations on everything from the worldwide criminalization of people living with HIV to sex work rights to a Cambodian hip-hop group performing in the Global Village section of the conference. As you can probably imagine though, with so much stimulus in one place at one time, it’s almost a given that things will not go as planned. My time spent at this year’s IAC was no exception.
The major distraction—home is where the heart is
Upon my arrival in Mexico City, news had already begun to circulate that the most recent and long-awaited HIV incidence data from the U.S. Centers for Disease Control and Prevention (CDC) had leaked, reflecting a 40% increase over the previous estimate (approximately 56,300 new infections annually versus 40,000).
Of particular interest to me was the data which suggests that African Americans, who make up approximately 13% of the U.S. population, accounted for 45% of new infections in 2006. Equally alarming was that gay and bisexual men of all races and ethnicities accounted for 53% of all new infections.
I thought it almost selfish, initially, to walk onto a stage set for discourse regarding the impact of the HIV epidemic globally, with my mind completely preoccupied with the havoc that it is wreaking in the land that I call home. And, considering that the nature of my travels was business rather than pleasure, I felt even more of an obligation to have a much broader perspective in my approach to this conference.
As an African American man who also identifies as bisexual, however, digesting these new data made such ideals much easier to sort out in my head than to actually act upon. These statistics were not just numbers showing how HIV affects people in some faraway land. Instead, they represented people who look and identify as I do. It didn’t help much either, that the conference center itself was all abuzz with talks about the U.S. epidemic, and the lack of political will to do anything about it.
Advocates call for national AIDS strategy
The more effort I put into expanding my focus beyond the U.S., the more I realized why such a focus was indeed necessary. I learned that one of the many conditions placed on the support that several foreign countries receive from the U.S. by way of the President’s Emergency Plan for AIDS Relief (PEPFAR), is that they have a national strategy in place for addressing the epidemic within their borders. The U.S. itself, however, does not have such a plan. I also learned that the prevalence rate among African Americans is greater than that of seven of the 15 countries receiving assistance from this program, yet there exists no U.S. strategy for even this severely impacted population.
I was reminded of a certain incident which followed the devastation of Hurricane Katrina and the impact that it had on the thousands of Americans living in the gulf region—Americans who were initially referred to by the news media as “refugees.” During a live televised relief effort, hip-hop superstar Kanye West stunned the nation by verbalizing a thought that many would not have the audacity to say aloud—“George Bush doesn’t care about Black people.”
To be fair, many of the countries that receive aid from PEPFAR have high concentrations of people of color living within them. However, due to the historical nature of what it means to be Black in America, African Americans are unquestionably in a class all by ourselves.
With respect to the epidemic on the home front, though, I would take Kanye’s statement a tad bit further. I would argue that perhaps it’s not just that George W. Bush doesn’t care about Black people; rather, it appears from his administration’s response to our national AIDS crisis that he doesn’t care about anyone who doesn’t fit the apparently homogenous—pure Caucasian, heterosexual, and deeply invested in “democratic capitalism”—American ideal.
Thankfully though, there are many Americans (and a host of allies) who do care. And, in the midst of an International AIDS Conference, several distinguished advocates and advocacy groups came together to bring global attention to the outright neglectful response of the U.S. government to the growing catastrophe among its own citizens, and to push for the development and implementation of a national AIDS strategy.
Ideally, according to www.nationalaidsstrategy.org, such a plan should:
- Improve prevention and treatment outcomes through reliance on evidence-based programming
- Set ambitious and credible prevention and treatment targets and require annual reporting on progress towards goals
- Identify clear priorities for action across federal agencies and assign responsibilities and timelines for follow-through
- Include, as a primary focus, the prevention and treatment needs of African Americans, other communities of color, gay men of all races, and other groups at elevated risk
- Address social factors that increase vulnerability to infection
- Promote a strengthened HIV prevention and treatment research effort
- Involve many sectors in developing the national strategy: government, business, community, civil rights organizations, faith-based groups, researchers, and people living with HIV/AIDS
I am anxious to see how this will play out, particularly in light of the U.S. presidential election. Presidential candidates from both of the major political parties issued statements shortly after the release of the CDC incidence data.
Senator Barack Obama specifically declared his commitment to the development of a national AIDS strategy, while Senator John McCain vowed to “work closely with non-profit, government, and private sector stakeholders to continue the fight against HIV/AIDS.” The proof, as they say, will be in the pudding, but I guess neither could do any worse than what the current administration is doing, or could they?
On being “left behind”
The Black AIDS Institute hosted a press conference in response to the CDC data, and in support of the BAI’s recently published report entitled Left Behind—Black America: A Neglected Priority in the Global AIDS Epidemic.
Speakers on the panel included Phill Wilson, CEO of BAI; Dr. Helene Gayle, president and CEO of CARE; Congresswoman Barbara Lee (D-Calif.); Jacob Gayle, deputy vice president of the Ford Foundation; Pernessa C. Seele, founder and CEO of the Balm in Gilead, Inc; and the beautifully talented Sheryl Lee Ralph, actress and activist.
The report breaks down the epidemic among Blacks in America by establishing a proverbial “Black America,” and discussing the impact of the virus on this population from the perspective of it being an independent nation, separate and apart from the United States.
My thoughts on this idea are enough for an entire dissertation; however, the point is well made that African Americans have contributed and continue to contribute significantly to this sovereign state, and that the neglectful response of the U.S. government to the HIV/AIDS crisis among this population is nothing short of criminal.
Sheryl Lee Ralph, forever the diva and activist extraordinaire, was most profound on this issue. She challenged the journalists in the room to “do something different” as it relates to communicating the issue of HIV/AIDS, particularly among Black America. She stressed that we must sincerely confront the “isms” that exist within America, if we are to ever really make a difference.
I couldn’t agree with her more. For it is, without question, the isms—classism, racism, sexism and heterosexism—that are fueling the epidemic in Black America. Ralph referenced an event where Senator Hilary Clinton recently commented that if AIDS were affecting the general population the way that it is devastating Black America, there would be a national health emergency.
And then, with the level of conviction that the world has come to know and love her for, she posed a rhetorical question that I have been asking myself and others around me for some time now. She asked, “When is somebody gonna value black people?” She said, “I am looking to be valued as a full, complete human being. I am black. I am in the world. Look at me and stop looking past me. I need a seat at the table.”
I watched her as the room transitioned from total silence, with folks hanging on to her every word, to a thunderous applause of approval. She sat back in her seat fighting off tears, her passion and sincerity most evident.
But the Black AIDS Institute leaves black gay men behind, some say
Following this press conference there was much talk among many black gay men (and others) that the Black AIDS Institute itself, headed by a black gay man living with HIV, has consistently neglected their issues over the years. The Left Behind report, for example, is 55 pages long but contains only a page and a half dedicated specifically to black gay men—a population with an infection rate that rivals some of the hardest hit regions in Africa.
Because I have worked with Phill Wilson on several occasions, and sincerely believe in what he attempts to do through BAI, I pulled him aside following one of the organization’s breakfast updates to ask him about this claim.
“We have a variety of programming that addresses Black gay men,” he said. “I think that it just depends on the point at which you intersect with us.
“It is a challenge though,” he admits. “Our core mission is to address HIV/AIDS health disparities in Black America regardless of gender, sexual orientation, or what have you. So it is a challenge to craft messages that will resonate with the larger Black population. Therefore, we have to be strategic with both our message as well as our messengers.”
That, in my opinion, makes perfect sense considering the enormous amount of homophobia that exists within “Black America.” Unfortunately, if a document such as the Left Behind report were presented with heavy content relating to black MSM, it would more than likely be dismissed by the larger black community as somebody else’s problem.
In spite of this, Phill insists, both the Left Behind report and BAI’s Call to Action do make strong recommendations for addressing the HIV epidemic among Black MSM. He also says that BAI is preparing a special report that specifically speaks to the issues facing this population, which will be released in December of this year.
Shortly after I returned home from Mexico City, I received an e-mail from Phill’s assistant, inviting me to take part in an advisory committee of black gay men that is being strategically developed to assist with constructing this document. I happily obliged.
| Unfortunately, if a document such as the Left Behind report were presented with heavy content relating to black MSM, it would more than likely be dismissed by the larger black community as somebody else’s problem. |
The take-home message
We cannot be leaders in the global fight against HIV if we are not addressing our own crises at home. Addressing this crisis, however, will require us to take a really good (and truthful) look at ourselves. I question whether or not that is something this prideful nation is really ready to do.
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