The importance of sexual identification in AIDS rates

Gregory in Seattle left the following comment on my AIDS post yesterday and I thought it was worth reposting in its own right.

You might find this of interest: an interactive map giving the HIV infection rates in the US by county, per 100,000 population. According to the CDC, about 25% of Americans, aged 13 or older, with HIV are women. Of them, 64% are African American. Of all the people with HIV in the US, an estimated 20% do not know they have the virus.

I’m a member of the Community Advisory Board for the Seattle HIV Vaccine Trials Unit. We’ve discussed the racial and regional disparity of the pandemic in the US. Education and religion are parts, but there is also a strong element of identification. Many African American men who have sex with men do not self-identify as gay: they do not march in parades, they do not go to bath houses, they do not fall in love and build a common life with other men. Being gay is a white thing, and the popular sentiment is that only gay people get HIV.* This identification divide exists even in major cities on the coasts. Because much of the outreach over the last 20 years has focused almost exclusively on gay men and has been done through gay newspapers and through outreaches to bars and pride events, nearly all of the “Be Safe” message never reaches them.

Another huge issue is the availability of low-cost, anonymous testing resources. It is established that people who can get tested are much more likely to get tested, and that provides an opportunity for education. Tests can cost around $50 if paid for retail, and few insurance companies will cover them. Even if you have that kind of money, in much of the south getting a test means either driving a hundred miles or more to a city where you can be tested anonymously or explain to your personal physician why you think you need such a test. The result is that people just don’t get one.

So yeah, a lot needs to change before HIV rates in the black south will change.

(*) It is conveniently ignored by the people pushing the “gay = HIV” lie is that, as of the end of 2010, about 2/3rds of the people on the planet with HIV lived in sub-Saharan Africa. That in several countries in southern Africa — South Africa, Swaziland, Lesotho — 15% to 28% of the adult population is HIV+. That about 10% of all people with HIV are children aged 14 or younger, and that most of those got it from infected mothers either transvaginally during birth or from the virus expressing itself in breast milk. That of all adults on the planet with HIV, 56% are women. And that since 2006, HIV/AIDS is the leading cause of death among women in their reproductive years.

It is pretty damn grim.

He also pointed me to the following collection of links from a presentation he gave for MENSA recently.

AIDS in the South: Religion is the enemy of social justice

The South is the new epicenter of HIV transmission — half of all new infection happen here, though we have less than a third of the American population.  South Carolina is 8th in the nation for rates of HIV, but other southern states are doing poorly as well.  Louisiana, Georgia, Mississippi, Texas… HIV is not going away.  And there’s more bad news, if you get HIV in the south, you’re more likely to die from it.

So why is everybody getting AIDS?  Well, you could look at our education scores, our poverty levels, our resistance to decent health care coverage, the rural populations with little access to doctors, or the Bible thumping hatred of homos that makes people terrified to get tested or admit they’ve contracted the disease.

Those making under $10,000 are three times more likely to get HIV than those making $50,000+.  People making under $10,000 a year can’t afford medicine and doctor visits, they can’t afford to be driven to where they can get tested and get treatment.

And in the south, most poor people are black.  According to the Washington Post, one in five gay black men in the south has HIV.

Researchers say that African Americans in the South are especially likely to see homosexuality as immoral. In response, gay black men in the South often live on the “down low,” leading ostensibly straight lives with girlfriends and wives while having sex with men.

“In the African American community, men who are gay are more likely to hide their sexual activity,” said Saag, who also directs a HIV clinic in Birmingham. “So it’s more common for the virus to spread from gay men to heterosexual women.”

Good work, Good Book.  Religion is also to thank for the limited sex education provided in many of the southern states.  Abstinence only education?  Not great for telling people how to use condoms when they act on hormones or get married.  Combine that approach with the Nikki Haley-esque Christian Conservative approach to healthcare, and you find a lot of people who get missed by healthcare.  25% of people with HIV in SC live in rural areas, care for people far from urban centers is difficult, even more so when your state refuses to fund or accept funding to help them.

So what can be done?  The Washington Post again:

Many who work with HIV patients including Saag, the Birmingham HIV clinic director, are trying to win over churches. Many say that churches in the South often foster HIV stigma, presenting the disease as part of a sinful gay lifestyle. Saag and others are working to persuade pastors to see HIV as a health problem rather than a moral issue. Some observers are hoping that the new Affordable Care Act will improve HIV care in the South, and elsewhere, by increasing funds for Medicare and Medicaid recipients.

You know what else can be done?  Increase the stigma of being a Christian who thinks that helping the poor is bad and being gay is a sin.  Accept that if you’re not black and not gay, you’ve got a lot of privilege and need to work really hard to understand that other people have it worse than you.  We are not all given equal circumstances.  As a white woman in this state, my chances of getting HIV are incredibly small and it’s got nothing to do with my choices and everything to do with how I was born.  If I’d been born a gay black man, I’d have a 20% chance of being HIV positive, which is five hundred times my risk as a white woman.

Why am I telling you this?  Because you should care.  Because social justice issues should be important to atheists. Because religion hurts people. And we can do something about it.

—————————-

Have some stats from the glorious state of South Carolina:

Who has HIV:
04.6% are white women (34.7% of population)
19.4% are white men (33.8% of population)
25.0% are black women (14.2% of population)
46.9% are black men (14.9% of population)

Demographics of the state:
34.7% are white women
33.8% are white men
14.2% are black women
14.9% are black men
(15% of the population makes up almost half the HIV cases)

Percentage of Population w/HIV:
0.04% of white women
0.19% of white men
1.07% of black men
0.51% of black women

Or look at it this way:
1 in 100 black men
1 in 200 black women
1 in 600 white men
1 in 2500 white women

Or look at it this way:
White men are 4.3 times as likely to get HIV than white women.
Black women are 12 times more likely to get HIV than white women, and 2.7 times more likely to get HIV than white men.
Black men are 25 times more likely to get HIV than white women, 5.7 times more likely to get HIV than white men, and over twice as likely to get HIV than black women.

http://www.census.gov/popest/data/state/asrh/2011/SC-EST2011-03.html
http://www.dhec.sc.gov/health/disease/sts/docs/cntyrate_2010.pdf

Richard Dawkins Welcomes Ratzinger

Joseph Ratzinger is an enemy of humanity.

He’s an enemy of children, whose bodies he’s allowed to be raped and whose minds he’s encouraged to be infected with guilt. It’s embarrassingly clear that the church is less concerned with saving child bodies from rapists than with saving priestly souls from hell. And most concerned with saving the longterm reputation of the church itself.

He’s an enemy of gay people. Bestowing on them the sort of bigotry that his church used to reserve for Jews before 1962.

He’s an enemy of women, barring them from the priesthood as though a penis were an essential tool for pastoral duties.

He’s an enemy of truth, promoting barefaced lies about condoms not protecting against AIDS, especially in Africa.

He’s an enemy of the poorest people on the planet, condemning them to inflated families they cannot feed and so keeping them in the bondage of perpetual poverty. A poverty which sits ill beside the obscene wealth of the Vatican.

He’s an enemy of science. Obstructing vital stem cell research on grounds, not of true morality, but on pre-scientific superstition.

Ratzinger is even an enemy of the Queen’s own church, arrogantly dissing Anglican orders as “absolutely null and utterly void,” while at the same time shamelessly trying to poach Anglican vicars to shore up his own pitifully declining priesthood.

Finally, perhaps of most personal concern to me, Ratzinger is an enemy of education. Quite apart from the lifelong psychological damage caused by the guilt and fear that have made Catholic education infamous throughout the world, he and his church foster the educationally pernicious doctrine that evidence is a less reliable basis for belief than faith, tradition, revelation, and authority. His authority.

Forgive my Gay Politics for a Moment; Good news

Three pieces of potentially good news on the National Front for Gay Rights and AIDS

1.  The US is poised to lift its travel and immigration ban on people with HIV.  This means that people applying to live in the US or visit it will no longer be discriminated against solely because they have AIDS.  Obviously, this is positive for more than just gay men, and will be a good thing for Africans and anyone else with HIV.

2. A vaccine in Thailand reduced HIV transmission by 31%.  While this isn’t enough to market it as a vaccine yet, it is the first indication that an HIV vaccine is even possible.

3. Since 1994, Congress has been trying to pass ENDA, the Employee Non-Discrimination Act, which would prevent employers from discriminating based on Sexual Orientation and Gender Identity has the best chance yet of getting passed. In 29 states, it’s legal to fire someone because they’re gay and in 38 states, it’s legal to fire someone for being transgender.