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A Review of “Obama’s” National HIV/AIDS Strategy: Will it Benefit Black People?

by Cleo Manago

(Taken from a posting on Facebook)
(Jul 15, 2010) – On Tuesday, Jul 13, 2010, president Obama presented the National HIV/AIDS Strategy (NHAS) for the United States. According to his administration, the NHAS is a concise plan for moving the country forward in the fight against HIV and AIDS with three primary goals: reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities.

The NHAS is a good first start for America. What I appreciate about the strategy is its’ unprecedented existence. No other administration has created a White House Office of National HIV/AIDS Policy, or has had so many progressive people in its midst. (The NHAS is now available to the public: http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf).

Theoretically, this is a history making initiative. However, upon close review, NHAS content features elements that are not necessarily signs of innovation or a framework shift in terms of how HIV services may roll out or be resourced. It appears that the strong [white] gay identity bias (to be explained in more detail later) will continue to skew attempts at culturally diversifying how HIV services are framed, funded and prioritized.

Though diverse groups in America are impacted by HIV/AIDS, blacks, by a large percentage, are more impacted than all other groups in the country. Yet, deciphering this could be a challenge as presented in this NHAS excerpt, “While anyone can become infected with HIV, some Americans are at greater risk than others. This includes gay and bisexual men of all races and ethnicities, black men and women, Latinos and Latinas, people struggling with addiction, including injection drug users, and people in geographic hot spots, including the United States South and Northeast, as well as Puerto Rico and the U.S. Virgin Islands. By focusing our efforts in communities where HIV is concentrated, we can have the biggest impact in lowering all communities’ collective risk of acquiring HIV.”

This NHAS passage also abstracts the disproportionate depth of HIV in black communities by bundling everyone as “Communities where HIV is concentrated.” This passage, “While anyone can become infected with HIV, some Americans are at greater risk than others. This includes gay and bisexual men of all races and ethnicities…” muddles the fact that – by leaps and bounds – black men, specifically, are the most HIV impacted group in the United States. Yet, what is not abstract is how much the NHSA affirms gay identity, despite that many homosexual and bisexual men of color don’t identify with or as gay. Over the last 30 years, this gay identity bias and barrier has been a contributing factor to diverse black men at HIV sexual risk not seeking HIV services or internalizing prevention messages.

While Obama’s White House is committing resources and efforts to initiatives like HIV/AIDS and healthcare, the explicit context of race and culture continues to be overlooked.

The first HIV/AIDS services paradigm in America was designed by white gay men, and ultimately was very effective for that community. Despite the relative success of the white gay community at saving itself from HIV/AIDS, a once frequently deadly disease, the disease has since gotten blacker and blacker. To date, there are no published examples of similar HIV success among African Americans. Even after three decades. Not to mention, gay identified men – black and white – have controlled and directed this epidemic, and blamed its failure to blacks simply on “homophobia.”

The organization identified as the Black AIDS Institute once featured an article stating, “Homophobia Causes AIDS (http://www.blackaids.org/ShowArticle.aspx?articletype=NEWS&articleid=168&pagenumber=1).” Yet, if this was true, given the still very present existence of the rabidly anti-homosexual white right-wing – Pat Roberson, Rush Limbaugh, the legacy of Jerry Falwell and most republicans – the white gay community should still have an HIV problem – equal if not similar to African Americans. But they don’t.

Frequently, within the black HIV industry, while black gay identity and “pride” (in being gay identified) are often encouraged, engagement of the symptoms of social injustice toward black communities and self-concept, cultural affirmation, repair and restoration are very rarely included as HIV problem-solving strategies. The white gay community understood one thing: in order to eradicate the numbers of new HIV cases they had to empower their community, while at the same time address the self-esteem damage done by homophobia, discrimination, hatred and oppression. Their primary HIV prevention strategy was (because, ultimately, most finally knew how HIV was transmitted) to publicly and actively resist social injustice toward their community, and affirm [white] gay identity. As a result, it has been comparatively (to all others) very successful at managing HIV/AIDS.

Unfortunately and concurrently, the white gay community has had little interest in resisting [white] racism within its community or society as a whole, just homophobia. And the black gay-identifying movement and approach (including within HIV services) has taken on that same paradigm; not an approach that is directly relevant to black culture, history, circumstance, problem-solving, diversity, process and under-engagement of relevant black issues. “Gay” acceptance is often more important than issues directly relevant to diverse black life, culture, history and healing. As a result, many black gay identified HIV leaders have become ill-equipped to address black community issues, to counter the risk behavior inducing impact of internalized racism, institutionalized racism, black male or female trauma and white biases internalized by [black] America.

Essentially identity politics have superseded capacity to effectively engage diverse black subgroups and communities facing disproportionate HIV threats. The NHAS, while strong on affirming gay identity, fails to affirm black specific culture, diversity and relevance.

The gay paradigm creates little to no encouragement for same-gender loving (SGL) and bisexual African American healing and cultural affirmation. Being limited to “gay” has created HIV issue disenchantment among Black men who have sex with men (MSM). As a result, black homosexual subgroups have emerged in an attempt to connect more with the rhythms of black life and culture. Many black homosexual and bisexual males do not have an affinity with gay identity and culture, seeing it as white or culturally unrelated. There are “homo-thugs,” men on the “down-low,” and more in the affirmative men who identify as same-gender-loving (SGL) or bisexual. If more space was created for homosexual and bisexual black males to be fluid and “black” regarding their identity, more would likely self-identify.

In the late 1980s, the Centers for Disease Control and Prevention (CDC) discovered that the term or label “gay” was a barrier in getting black and Latino men to identify as men who had sex with men, and disclose HIV risk factors. As a result, the now widely used term MSM, or men-who-have-sex with men was derived. Initially, white gays and black homosexuals who internalized the gay politic balked at the term, claiming it was homophobic. The fact of the matter was the term MSM was more neutral in terms of identity, inclusive and culturally responsive to the diverse ways of being among homosexual and bisexual black men.

A footnote excerpt from the NHAS states: “Throughout this document we use the terms “gay and bisexual men” and “gay men” interchangeably, and we intend these terms to be inclusive of all men who have sex with men (MSM); even those who do not identify as gay or bisexual.” In other words, even if you are not gay, or don’t identify as gay, or don’t want to, we are referring to all homosexual and bisexual men as gay regardless. This is not helpful to African Americans and is an example of an institutionally racist barrier to life and ways of being very present within black communities.

Sure, many of us are used to simply calling all homosexuals gay. In the black community this is not the result of an identify poll taken in the community, but because SGL black people have rarely been rationally engaged in a Black community context. While the powerful white gay community vigilantly profiles its gay idenity politics and ideas, this does not necessarily represent all homosexual and bisexual Black people.

Without these considerations or an examination of the relationship cultural barriers have to HIV risks among Black women and men, the NHAS will likely have limited impact on advancing the Black HIV landscape. As a result it may be discreetly shelved by many Black organizations.

While the National HIV/AIDS Strategy (NHAS) for the United States does represent a potentially progressive step forward, its’ lack of specific strategies for African Americans has resulted in some response. National organizations are in the process of generating recommendations to the president as an addendum to the historic NHAS. All African Americans interested in getting involved or contributing somehow to this effort are earnestly invited to do so. If interested in contributing call The National Black Leadership Commission on AIDS (NBLCA) at 800-992-6531,  or the Black Men’s Xchange National at 888-472-2837

July 16, 2010 Posted by | African-American News, Black Gay Men, Black Gay Men Health, Black Men, Black Men Health, Blogroll, Caribbean, Caribbean Community, community, Elderly LGBT, Health, HIV, HIV Status, LGBT community, LGBT Rights, LGBT Seniors, Male Health, Mental Health, Obama, Politics, Public Health | , , , , , , , , , , | Leave a comment

HIV/AIDS orgs respond to Obama’s HIV/AIDS Strategy

Following release of National HIV/AIDS Strategy

By Antoine Craigwell

(Wednesday, July 14, 2010) – Paul Kawata, executive director of the National Minority AIDS Council, posted on the social networking site, Facebook, a letter signed by 180 national and community organizations at the forefront of the fight against HIV and AIDS. This letter was in response to the announcement and release of the National HIV/AIDS Strategy (NHAS) yesterday.

The text of the letter below:

Honorable Barack H. Obama
President, United States Of America
The White House
Washington, DC

Dear President Obama,

On behalf of the180 national and community based organizations (see list below) on the front lines of this epidemic, thank you for your leadership and commitment to fight the HIV/AIDS epidemic. Each of us stands here in the footprints of so many heroes we’ve lost to HIV/AIDS. Our friends who fought so hard in the early days could probably never imagine a President holding a reception at the White House to honor the HIV/AIDS community. Most would have loved to be part of this event. We miss them and will never forget the sacrifices they made so that we can be here today.

In the first 18 months of your administration the travel ban on those living with HIV was removed, restrictions on the use of federal funds to support needle exchange were removed, the Ryan White Care Act was reauthorized, and $30.4 Million was set aside as part of the Prevention and Wellness Fund for HIV/AIDS Prevention. However, we’ve also had our challenges in ensuring adequate funding for PEPFAR and other international HIV/AIDS initiatives.

As you implement the National HIV/AIDS Strategy (NHAS), we ask that the first thing you address is the AIDS Drug Assistance Program (ADAP) funding crisis. We appreciate the $25 million to see us through September 30, 2010. We are concerned that is not a long-term solution and will only get us through a limited period. As of Jul 8, 2010, 2,291 individuals are on waiting lists. This number does not include individuals in states that don’t keep waiting lists, have significantly reduced the drug formulary, or have significantly changed the income eligibility levels. On Jul 1, Georgia became the 12th state to close enrollment and start a waiting list. Ohio changed its income eligibility levels so that more then 1,000 HIV/AIDS patients will lose their benefits. New Jersey also changed its income eligibility levels so that 947 HIV/AIDS patients will lose their benefits. Without an immediate solution, other states will follow.

As you consider solutions, please make it [funding for ADAP] multi-year funding through 2014, support states that don’t keep waiting lists but have closed enrollment or that are on the brink of a waiting list, ensure that all the necessary drugs are covered, and [the] integration of a permanent solution into health care reform.

We look forward to the reviewing the National HIV/AIDS Strategy and the opportunity to work with your administration to ensure its implementation across the country. Thank you for your support and leadership.

Sincerely,

2 God B The Glory, Inc     A Brave New Day     A Family Affair

ACT UP Philadelphia     Action for a Better Community    Advocates For Youth

African American Hispanic Health Education Resource Center

AID For AIDS Nevada      AIDS Alabama

AIDS Alliance for Children, Youth & Families

AIDS Care Services, Inc.   AIDS Community Research Initiative of America

AIDS Foundation of Chicago    AIDS/HIV Services Group (ASG)

The AIDS LIFE Campaign   AIDS Resource Center of Wisconsin

AIDS Project of Central Iowa     AIDS Resources of Rural Texas

AIDS Treatment Activists Coalition (ATAC)      Albany Damien Center

Amanda Beck-Myers     Ananias      Anxiety Disorders Association of America

Asian Media Access     Asian & Pacific Islander American Health Forum

Asian & Pacific Islander Coalition on HIV/AIDS

Asian & Pacific Islander Wellness Center

Aspirations Wholistic Tutorial Services     Baton Rouge AIDS Society

Bienestar Human Services    Black AIDS Institute

The Black Women’s Health Imperative     Broadway Cares/Equity Fights AIDS

Paul Browne       CAEAR Coalition      CALOR

Camden NJ Area Health Education Center (AHEC)

Camillus Health Concern, Inc.    CARES     CareSouth Carolina

Cascade AIDS Project        Central City AIDS Network, Inc.

Central Illinois FRIENDS of People with AIDS

CenterLink: The Community of LGBT Centers

William H. Chastang Consumer Advocate/Outreach Coordinator

Christie’s Place, Inc.        Citywide Project/Citywide Ministries

Coai, Inc.       Community Access National Network

Community HIV/AIDS Mobilization Project (CHAMP)

Community Information Center, Inc.        Comprehensive Health Education

Connecticut AIDS Resource Coalition         DeKalb Prevention Alliance, Inc

Desert AIDS Project         Gregory W. Edwards, EdD

Eternal Hope Community Development Corporation, Inc.

Family Heath & AIDS Care Services International     Family Health Project

Family Planning Association of Puerto Rico        F.L.A.S., INC.

Fort Worth Northside Community Health Center, Inc.

Greater Love Tabernacle    Gregory House Programs    GROUP Ministries, Inc.

Harlem United Community AIDS Center      Harmony House, Inc.

Hawaii Island HIV/AIDS Foundation     Hermanas de Luna y Sol    HEROES

HIV/AIDS Alliance for Region Two, Inc.

HIV/AIDS Services for African Americans in Alaska    HIV-AIDS UETS

HIV Care Program       HIVictorious, Inc.

HIV Planning Council Santa Clara County      Housing Works

Illinois Alliance for Sound AIDS Policy       Iris House

Johns Hopkins Local Performance Site

PA/MidAtlantic AIDS Education and Training Center

Monica Johnson, NMAC Board Member

Lambda Legal     Lark Lands, M.S., Ph.D.       H.O.P.E.

The LaStraw, Inc.      Latino Commission on AIDS

Latino Community Services

Helen Lemay, Distinguished Teaching Professor Emerita, Stony Brook University

Liberty Research Group

Don Little, MPH, Former Chair of the Oklahoma Native American AIDS Coalition

The Living Room     LMPHW Specialty Clinic

Love Heals, the Alison Gertz Foundation for AIDS Education

Lower East Side Harm Reduction Center

Kentucky HIV/AIDS Advocacy Action Group

Michigan Positive Action Coalition (MI-POZ)

Minnesota AIDS Project

Minority AIDS Council of Orangeburg, Bamberg, and Calhoun Council, Inc.

Missoula AIDS Council             M OCHA Center Inc.

Multicultural AIDS Coalition, Inc.       he NAMES Project/AIDS Memorial Quilt

Native Health             National African American Drug Policy Coalition, Inc.

National AIDS Fund         National AIDS Housing Coalition

National Association of People with AIDS

National Association of Social Workers

National Latino AIDS Action Network          National Minority AIDS Council

National Native American AIDS Prevention Center

NCLR/CSULB Center for Latino Community Health, Evaluation and Leadership Training

New Jersey Women and AIDS Network        New Destiny Recovery Ministry

New York AIDS Coalition          New York City AIDS Housing Network

Nightsweats & T-cells, Co          North Carolina Harm Reduction Coalition

Oklahoma City Indian Clinic         One Heartland       One Love Project

Open Door Clinic        Leonardo Ortega, NMAC Board Member

David G. Ostrow, MD, PhD              Partnership Project

Choyce Perkinds, Advocate For AAHHERC           Positive Efforts, Inc

Project Aware at Stanley Street Treatment & Resources

PROCEED, Inc.      Project HANDLE, Neighborhood House         Project Lazarus

Project Link of South Florida, Inc.       Proyecto SOL Filadelfia

Puerto Rico Community Network for Clinical Research on AIDS (PR CoNCRA)

Andre Weatherby Rawls     Recovery 2000, Inc.       Redemption Outreach Intl

Regional AIDS Project

Genevieve Rohan, FNP-C, AAHIVMS and Tegest Hailu, MD, AAHIVMS, Hailu/Rohan Family Practice

SAYFSM          Vanessa Sasso, Seattle HIV/AIDS Planning Council

Shanti

S.H.A.P.E. (Stop HIV/AIDS and Addiction through Prevention and Education)

Carlton R. Smith, Baltimore Black Pride, Inc. Founder, Churches United Against AIDS; Board chair

South Carolina Campaign to End AIDS (SC-C2EA)

South Central Educational Development, Inc.   South Jersey AIDS Alliance

South LA Access Center        Southern AIDS Coalition (SAC)

Southwest Louisiana AHEC         Stanley Street Treatment & Resources

Street Works       St. Luke AME Church/ Treat Me Right Inc.

Suburban HIV/AIDS Consortium (SHAC)

TACTS-THE Association of Clinical Trials Services

Tampa-Hillsborough Action Plan           C. Taylor

Ti-chee Native AIDS Prevention Project          Rose Todd-Stanford

Total Health Awareness Team            Treat Me Right Inc.

Treatment Access Expansion Project          Treatment Action Group

Two Spirit Society of Denver            U Can Do It 2!

Evelyn Ullah, NMAC Board Member            Us Helping Us

Valley AIDS Information Network Inc.

Vermont CARES        VillageCare

Volunteers of America Greater Baton Rouge

West County Health Centers, Inc.             Who’s Positive          Willis Center

The Women’s Collective      Women’s Health Center

Women Together For Change           Women Watch Afrika, Inc

July 14, 2010 Posted by | African-American News, Black Gay Men, Black Gay Men Health, Black Men, Black Men Health, Caribbean, Caribbean Community, community, Elderly LGBT, Health, HIV, HIV Status, LGBT community, LGBT Immigrant rights, LGBT Rights, LGBT Seniors, Male Health, Obama, Politics, Public Health | , , , , , , , , , , , , | Leave a comment