When We Feel Whole
The accelerate Initiative Supports Black Gay, Bi Men
by Hank Trout

Photos by Harley & Co.

Hoping to inform and inspire a wide range of community-based solutions to the disparity in healthcare and wellbeing of Black gay, bisexual, same-gender-loving and other men who have sex with men, ViiV Healthcare sponsors The accelerate Initiative.

The accelerate Initiative began with ViiV’s $10-million investment in the project in two cities hardest hit by HIV and other health problems, Baltimore, Maryland, and Jackson, Mississippi. The accelerate team collated and evaluated data collected between 2016 and 2019 by the Johns Hopkins School of Public Health, the University of Mississippi Medical Center, and the TCC Group; in addition, the accelerate Road Tour, a series of community listening sessions conducted with gay and bisexual Black men in those cities throughout 2019, collected quantitative surveys and did further research with accelerate participants. Their report, When We Feel Whole, was published on February 25, 2021.

Despite the pre-2015 groundbreaking scientific and policy advancements that had the potential to cut new transmission rates and increase quality of life for people living with HIV, such as pre-exposure prophylaxis (PrEP), treatment as prevention, the first National HIV/AIDS Strategy, and the Affordable Care Act, several reports highlighted the disproportionate impact of HIV among Black gay men, showing that between 2009–2010, only 16% of Black gay men were virally suppressed, and the CDC projected that one in two Black gay men would be living with HIV in their lifetime.

The place-based approach that accelerate took for their work is particularly relevant to addressing health disparities, as they are rooted in the social, cultural, political and economic determinants of health. Working with Black men affected by HIV in Jackson and Baltimore, accelerate worked with Black men affected by HIV to design, develop and deliver community solutions across those cities as high-prevalence cities. Informed by insights derived from the study, grant investments focused on four key areas: strengthening networks across affected communities; effectively adopting HIV testing as an entry point to HIV prevention, care, and treatment; strengthening peer navigation services; and making sex education relevant to the lives of Black gay men.

In addition to eliminating the disparities in health outcomes for Black men, accelerate also seeks to decrease HIV-related stigma. One such project is As Much As I Can, an immersive theater experience, a co-created innovation to reduce stigma that affects Black gay men—stigma around sexual orientation, gender expression, race, skin color, body type and HIV status. The live performances reached over 1,700 attendees from diverse backgrounds in Jackson, Baltimore, and New York, giving people an opportunity to hear others’ views and opinions in post-performance talk back sessions. Thus, voices and experiences of Black gay men were elevated to touch the lives of family and friends, faith leaders, care providers and the general public. After experiencing the play, 72% of viewers said they would speak out if they heard any stigmatizing language about PLHIV, 63% said they would speak out if they heard anti-LGBTQ language, 90% said they would talk about the play with friends, and 52% said they would talk about HIV prevention options with their friends.

The accelerate Initiative also aims to reduce the medical mistrust among Black same-gender-loving men, a distrust forged not only from the negative historic mistreatment of Black people in research and health care (e.g., Tuskegee Experiments) but also from everyday racism and stigmatizing messages from faith, medical and community leaders around sexual orientation. This reinforces the fear of being shamed, judged or “outed” because of seeking care. The Initiative focused on addressing mistrust by helping men build self-advocacy skills and confidence in healthcare settings.

Finally, the accelerate Initiative offered three principles to tackle the healthcare disparities experienced by Black HIV-positive men:

1) We need to develop flexible mechanisms for continuous community listening and identify essential design elements early on.

2) We need to acknowledge that HIV cannot be addressed in a vacuum. A person’s “whole self,” including housing stability, mental health, and economic well-being must be considered in healthcare approaches.

3) Leadership development is critical in order to strengthen communities, coalitions and organizations to drive impact.

4) Sharing learnings is a key opportunity for making change on a community and national level.

As for tackling the stigma attached to HIV, the accelerate Initiative cited another four findings from their study:

1) Stronger networks help men break down stigma, build social and economic supports and feel more empowered to engage and advocate for the care they want.

2) Safer spaces and peer navigation help men build trust and community connections, critical to making HIV prevention and testing the pathway to care that it should be.

3) Investing in the leadership and professional development of peer navigators builds overall community power and helps men move across the HIV care continuum by meeting men where they are and supporting them in getting to where they want to be.

4) Arts and culture activations are effective in engaging Black men and facilitate stigma reduction.

After five years of their place-based initiative in Baltimore and Jackson, ViiV Healthcare is building on this momentum and lessons learned with communities to amplify and sustain the most effective and innovative strategies. In 2021, ViiV Healthcare is expanding its commitment to support the health and well-being of Black gay, bisexual, queer, trans and other men who have sex with men through new funding opportunities and initiatives. In Baltimore, Jackson and nationally, accelerate will support networks with a focus on innovative safer space models, linkage, and engagement programs with a focus on peer navigation, and advocacy with a focus on leadership opportunities connected to pathways to employment.

In an email exchange, P. J. Moton-Poole, Senior Manager, External Affairs North America, at ViiV, told A&U, “To help continue the momentum of our pilot program, ViiV is expanding our commitment to support the needs of Black gay men nationally. As part of our $20M commitment to scale up resources to disrupt disparities in HIV care, the next phase of accelerate will build on the lessons learned from Baltimore and Jackson to drive community-centered solutions across the country. For the first time ever, organizations across the U.S. and Puerto Rico are eligible to apply for accelerate funding.

“At ViiV Healthcare, community insights are central to everything we do. We utilize a unique suite of tools; ethnographic research; storytelling gathering; community listening, and cultural interventions (like the play As Much As I Can, Being Seen podcast, and Take My Hand spoken word project) to reach people in authentic ways. As we continue to expand our accelerate programming, we’ll continue to utilize innovative tools and methods to meet people where they are with key findings on what we know works to help close gaps in care for Black gay men and end HIV once and for all.”

If you would like to read the full When We Feel Whole report, please log on to https://viivhealthcare.com/content/dam/cf-viiv/viiv-healthcare/en_US/When-We-Feel-Whole-Lessons-and-Learnings-from-the-accelerate-Initiative-v1.pdf.

Hank Trout, Senior Editor, edited Drummer, Malebox, and Folsom magazines in the early 1980s. A long-term survivor of HIV/AIDS (diagnosed in 1989), he is a forty-year resident of San Francisco, where he lives with his husband Rick.