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.

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.