Just*in Time: April 2016

by Justin B. Terry-Smith

This is in response to the expected HIV infections in the Black Gay population that I saw in one of your posts. It cited stats from the CDC that fifty percent of Black Men will [likely] test positive as will thirty percent of Hispanics. My question is: Are we doing the right outreach in light of this prediction and, if not, what should we be doing?
—Bob Doyle

Photo by Don Harris © Don Harris Photographics, LLC. All rights reserved.
Photo by Don Harris © Don Harris Photographics, LLC. All rights reserved.

[dropcap]I[/dropcap] hope all is well. I will address your question, but let me further clarify to the readers just what it is you’re talking about. In late February the Centers for Disease Control and Prevention sent out a report on HIV infections among gay males and men who have sex with men (MSM) population.

Utilizing diagnoses and death rates from 2009–2013, CDC researchers projected lifetime risk of HIV diagnosis by sex, race and ethnicity, state and more. The CDC stated that if the present HIV infection rates continue on the trail that they are going, then 1 out of 2 Black/African American gay and bisexual men and 1 out of 4 Hispanic gay and bisexual men will be diagnosed with HIV in their lifetime; gay and bisexual Caucasians still have a 1 out of 11 risk of being diagnosed with HIV in their lifetime.

The release went on to say that regardless of sexual orientation 1 out of 20 Black/African American men and 1 out of 48 Black/African American women will be diagnosed with HIV in their lifetime. 1 out of 48 Hispanic men and 1 out of 227 Hispanic women will be diagnosed with HIV in their lifetime. Caucasian men and women have less than one percent chance of being diagnosed with HIV. Certain areas, such as the Metropolitan Washington, D.C. area, are and parts of Florida remain high.

Now, Bob, for the first part of your question: Are we doing the right outreach in light of this prediction? There seems to be a major disconnect between outreach on so many different levels. One of the important things to learn in public health is not to engage one community the same way you would another. The reason why is because needs across communities are different and how one population engages a public health issue may be entirely different than another. Also, for example, if there is a target population that speaks mainly Spanish, you would probably not advertise a public health program in English, with no translation whatsoever. The message has also changed from what it was to what it is now. The HIV that most remember is from the early AIDS epidemic of the early 1980s and 1990s, where many gay men and MSM, among others, were dying left and right, where AZT was the only known HIV treatment, where HIV was also known in the Black/African American community as a white man’s disease, etc. The generation of Millennials and some Generation Xers (through no fault of their own) don’t and can’t recall those things or images, unless they Google them, but they are not necessarily any wiser than earlier generations. The face has changed (and realize that that first face was not entirely accurate) and there needs to be a new messaging in HIV prevention, especially that which is marketed to minorities.

PrEP is now available and there has been marketing towards gay men and MSM of color, but it is not enough. There needs to be more and in a more innovative way, instead of going to night clubs that gay men and MSM of color frequent and handing out a flyer about PrEP. Messaging on PrEP also needs to be targeted to gay men and MSM of color in their own communities. There also needs to be more and more examples of public health leaders that are gay men and MSM of color on PrEP so that their communities see someone that is familiar to them and looks like them utilizing PrEP. When a community sees, hears, and feels something they are familiar with, they are usually more comfortable with it.


Justin B. Terry-Smith, MPH, has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal.blogspot.com. Presently, he is working toward his doctorate in public health. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at [email protected].