CDC Concerned About Resurgence of HIV Among Young MSM
On Nov. 21, leaders in the fields of HIV prevention among young gay and bisexual men came together for the CDC’s webcast, "Combating a Resurgence of HIV Among Young Men." The panel, moderated by MSNBC’s Thomas Roberts, featured the Center for Disease Control and Prevention’s Jonathan "Jono" Mermin, HRC Vice President Jeff Krehely, National Black Gay Men’s Advocacy Coalition Daniel Driffin and the Ali Forney’s Center’s Executive Director Carl Siciliano.
"In recent years, we have seen a decline in the sense of urgency around HIV. The headlines have disappeared, and complicated issues for many men have been oversimplified. But the threat is no less real. HIV is again on the rise in gay and bisexual men," said Mermin, the CDC’s Director of the National HIV/AIDS, Viral Hepatitis, STD and TB Prevention.
Mermin said that today two-thirds of all new infections occur in gay and bisexual men. They are the only population in country where new infections are rising, more than 12 percent in past years. One in five gay and bisexual men is HIV-positive. And in some areas like Baltimore, 36 percent gay and bisexual men are infected with HIV. Gay men are at the center of the HIV epidemic, but youngest men face the biggest threat. Young MSM of color account for 1 in 3 new infections among MSM.
For many of these young MSM, coming out is what lands them in a situation to increase their risk of HIV infection. Siciliano, who founded the Ali Forney Center for homeless LGBT youth in 2002, said that, "they are thrown out of families who can’t handle having an LGBT child. Homeless youth are ground zero in terms of HIV risk. So many kids have no way to survive except prostitution or survival sex, which puts them at a high risk of HIV." Protecting them requires commitment on part of our community to providing homes for these kids.
Social and Mental Health Challenges
Coming to terms with one’s sexual orientation can cause emotional duress, like depression, suicide attempts and risk sexual behavior. The sweeping social changes that encourage young people to come out early are often not matched with the reality in some communities.
"We’re giving the message to youth that it’s safe to come out, that their families will be fine, their friends will be fine, their faith communities will be fine, and that’s not always the case," said Krehely. "Shame on those places, but youth are still taking their cues from larger social change. They hear the message that it’s safe to come out, but sometimes it’s not.
"The experience of being driven from your home and told that being gay makes you unworthy of being loved is a devastating experience," said Siciliano. "Compound it with hundreds of thousands of kids out on the street trying to find beds. They get the message from larger society that they don’t matter. These kids really struggle with hopelessness."
Race is also a large component in this issue. Driffin said that when he was coming out, there was no gay black face to serve as a role model. "No one ever looked like me, so I was only left to juxtapose it, if I was educated, maybe I could make it," he said.
Efforts to fight against the stigma of living with HIV have begun to help, but there is much to be done. We need to engage people in the issues around HIV like homophobia -- especially in the African-American community -- in order to address stigma. Living in the South or in the Bible Belt brings a heavy religious tint to things that cast a pallor around people who are gay or HIV-positive.
"But I do believe that in some communities, it is changing. There’s the mother and father who have a gay kid who is not put out on the street, who are spreading education around this," said Driffin.
Siciliano said that we have to create a sex-positive and safe environment for kids to be "open and real about who they are," and combine that with HIV education and the message that their lives matter. To do this, he said, we must providing housing, food and medical care that shows youth that they are valued and loved members of the community. The result is a great reduction in risk behavior. But for those still on the streets, that message is lost. About 20 percent of Ali Forney’s clients are HIV-positive; the risk is higher for those kids still on the streets.
Mermin said that health resources were welcomed much more among those who were empowered to believe that they had the self-efficacy to control their bodies and lives.
Roberts also asked whether the battle for marriage equality had subsumed the community’s struggle for civil rights and protecting our youth. Krehely said that there was a lot of corporate support for the quick outcomes of legislation, much more than the challenges of HIV or homeless youth.
"It’s time to start paying attention, donating time and resources and moving progress forward on these issues," said Krehely. "Marriage isn’t always the silver bullet. It’s inspiring, but it doesn’t get us all the way down the road."
Our movement and LGBT media is so focused on legal advancement and rights, that we don’t have enough focus on the homophobia and rejection that make young people destitute, said Siciliano, adding, "Less than 400 beds for more than 200,000 LGBT kids in this country shows we haven’t been struggling enough to provide resources to the poor and destitute kids in our community."
Mermin said that while scientific advances like Post-Exposure Prophylaxis could help people who have had sex with someone they know may be infected with HIV, without larger societal changes, science will not be enough to stop the spread of HIV.