While HIV affects people of all backgrounds, in the United States, Black Americans continue to be disproportionately infected, and at the center of the storm are Black men who have sex with men or MSM, a term used because not all of them identify as gay or bisexual. My research on access to HIV care finds deep racial inequities baked into legal codes, including laws that criminalize HIV in many Southern and Republican-dominated states.
New CDC data finds racial inequities in HIV infections
Just last week, the CDC released data showing a remarkable decline in overall HIV infections. But rates among Black MSM and people in the South remain disproportionately high.
In a recent article, social policy PhD candidate Aaron D. Camp and I used the phrase “racist body politics” to indicate many of the states that criminalize HIV are in the GOP-led South, the region where most Blacks with HIV reside. The term refers to politicians’ intentional practices and policies of exclusion through which society regulates the Black body.
In more than 30 states, it is still illegal for someone with HIV to have sex without disclosing their status. Black men such as Robert Suttle have served time in state prison even though they never transmitted the virus. Politicians who support these laws stigmatize HIV+ people in general, and Black men in particular, who are already disproportionately arrested and jailed.
Long-term HIV survivors include anyone who has lived with HIV for at least 10 years. Studies find Americans in this category are more likely to be Black than any other race or ethnicity. Black men accounted for 49 percent of new HIV diagnoses between 2008-2016, despite making up only 7 percent of the U.S. population. Today, many in the long-term HIV survivor category are Black millennials.
Among people diagnosed between June 1981 and August 1986, 25 percent were Black, even though Black Americans make up only 12 percent of the population. By 1993, HIV had become the leading cause of death among Black men and women ages 25-44. Today, 72 percent of the women living with HIV are Black, and men who identify as gay or bisexual make up an estimated 2 percent of the U.S. population but 55 percent of all people living with HIV.
Blacks’ continued disparities in HIV diagnoses render them invisible as overall HIV/AIDS funding decreases, although the ratio of Black people living with HIV has not changed. In another recent article, Camp and I concluded that Black Americans remain disproportionately affected because, in their communities, they are more likely to come in contact with the disease while being less likely to have access to treatment.
Pride and progress
For Black LGBTQ Americans, these sobering statistics create a paradox of pride. Many fight a daily emotional and physical battle against HIV while also celebrating the increasingly public embrace of our identities. To be both LGBTQ and HIV+ creates what W.E.B. DuBois once called “two warring ideals” — in this case, of survivability and celebration, of hope and concern.
Medical advances such as ART have sustained life for more than a million Americans with HIV. Advancements in biomedical treatments happened because gay HIV+ activists — often Black men such as Craig Harris — demanded the government invest in saving lives. In recent years, new breakthroughs have included Pre-Exposure Prophylaxis (PREP), a medicine that helps to prevent HIV infection. So does the U=U campaign, for “undetectable equals untransmittable”; this public information campaign encourages treatment by spreading the word that HIV+ people who achieve and maintain an undetectable “viral load” of HIV in the blood cannot sexually transmit the virus to others.
The magazine Poz reports that these efforts have dramatically reduced new infections. At the same time, more Blacks are living with HIV or have already died of AIDS than any other single racial or ethnic group. Just last month, “Pose” actor Billy Porter, age 51, revealed he contracted HIV in 2007. Even Black celebrities and those who may no longer live in underserved communities aren’t protected from the political failure to eradicate HIV.
New coalitions bring new opportunities
Today’s political climate includes frank discussion of race at the highest levels of government. The White House has named racial equality as a governing priority, at least some state legislatures are doing so as well, and the American Public Health Association has named racism a public health emergency.
At the same time, the Black HIV/AIDS crisis remains staggering. In every congressional session since 2013, Rep. Barbara Lee (D-Calif.) has introduced the Repeal HIV Discrimination Act aimed at creating incentives and support for states to reform laws criminalizing people with HIV. To date, neither Rep. Mondaire Jones (D-N.Y.) or Rep. Ritchie Torres (D-N.Y.), the two first Black and Afro-Latino openly gay members of Congress, have signed on to co-sponsor the bill — even though both have been praised as the most legislatively active freshmen members.
Because Black LGBTQ Americans are disproportionately infected with HIV, many perceive the epidemic as a “Black interest.” Both Jones and Torres represent districts in which Blacks are in the minority. My research into Black politicians in mostly non-Black jurisdictions suggests many hesitate to prioritize issues that affect a minority of their constituents. That shows the limits of descriptive representation, or having marginalized minorities in political office.
Discrimination and stigma continue to make it harder for HIV+ candidates to win public office. HIV criminalization laws that penalize nondisclosure remain on the books in most states. Although a lot has changed in the 40 years since HIV was first reported, much remains the same for Black Americans observing HIV Long Term Survivors Day.
Ravi K. Perry is chair and professor of political science at Howard University, immediate past president of the Association for Ethnic Studies, and author most recently of “The Little Rock Crisis: What Desegregation Politics Says About Us” (Palgrave MacMillan, 2015). He is writing “Black Queer Electoral Politics: Introducing America’s Openly LGBTQ Black Politicians.” He is HIV+.