Experts say stigma and silence to blame for youth HIV increases

Gay Youth’s New Burden, Part I: HIV/AIDS epidemic’s resurgence among gay and bisexual youth

by Matt Comer  Editor  editor@goqnotes.com
Published: January 4, 2013 in News

[Ed. Note — This is the first in a three-part series exploring new data on HIV infection rates and the work of local activists and prevention experts working to address HIV/AIDS issues on the local level. In this first part, we explore new data from The Centers for Disease Control and Prevention and some efforts by local organizations to address rising infection rates among young people. In parts two and three, to be published on Jan. 18 and Feb. 1, we will discuss the experiences of HIV-positive youth and explore how Mecklenburg County health officials and Charlotte-Mecklenburg Schools are addressing the topic.]

Fig. 1: Estimated new HIV infections in the U.S., 2010, for most-affected sub-populations. Courtesy: CDC.Fig. 2: Estimated new HIV infections, 2010, by transmission category. Courtesy: CDC.Fig. 3: Estimated new HIV infections among men who have sex with men (MSM), aged 13-24, 2008-2010. Courtesy: CDC.

CHARLOTTE, N.C. — Local organizations working with young people and those affected by HIV/AIDS took note of new data released by The Centers for Disease Control and Prevention (CDC) in December. The new national estimates reveal a sharp increase in the number of new HIV infections among gay and bisexual men and, in particular, among young men ages 13-24.

The data, which includes statistics from 2010 and trends from prior years dating back to 2007, showed a 22 percent national increase in new HIV infections since 2008 among young gay and bisexual men ages 13-24.

Prevention workers like Jaysen Foreman, the Empowering Positive Youth program coordinator at Charlotte’s Regional AIDS  Interfaith Network (RAIN), said it is important to pay close attention to the new numbers. He said it is a sign of crucial changes in how HIV is being perceived nationally, a reality he sees reflected among the young people he serves locally.

“HIV doesn’t have this scary face anymore — it’s not the face of 30 years ago,” he said. “There are no sunken cheeks and face, no lesions on the body. HIV is not a threatening or horrible, gruesome thing anymore.”

HIV-positive people, Foreman said, are living healthy and long lives. The medical breakthroughs, though, have brought about a new silence.

“I think this bit of complacency within our community has really caused the resurgence of people being infected and affected by this and our LGBT youth are bearing the brunt of this burden,” Foreman said.

Young African-American men who have sex with men represent the most at-risk population among young people. According to the CDC, they account for more new infections than any other group, coming in near 10 percent — about 4,800 individual cases — of the total number of 47,500 new infections in 2010.

Geneva Galloway, who works as RAIN’s director of community services, said stigma and fear continue to be a defining factor in the spread of HIV.

“It boils down to this: If we don’t get a grasp on the stigma, HIV-positive people are not going to be willing to speak up about it,” Galloway said, noting the importance of disclosing one’s status. “Our goal should be educating people about the stigma that keeps people from disclosing their status.”

Disclosure, Foreman and Galloway said, is becoming a more challenging problem.

“The amount of clients we see who disclose their status to others is dropping daily because of the negative reactions and rejection they’ve had from friends and family,” Foreman said.

As stigma and other challenges remain strong, the two RAIN workers said their organization has taken a “prevention for positives” strategy that works to encourage healthy living among HIV-positive people. One program, Empowering Positive Youth, targets HIV-positive young people ages 13-24, the very demographic the CDC reports is experiencing increasing infection rates.

“We try to stabilize housing, we use group and peer-to-peer support,” Foreman said. “We do a lot of HIV education…and empower our youth to make good decisions and be healthy stewards of their status.”

Such lessons include the importance of using condoms, appropriate use and access to antiretroviral medications and regular medical care.

“We’re trying to get viral loads down,” Foreman said. “If we can get them down to undetectable levels, the chance of transmission is cut down by 95 percent.”

Safer-sex messaging is also an important lesson taught by staff at Time Out Youth, Charlotte’s local LGBT youth support and services organization.

“We start every group with condom demonstrations,” said Rodney Tucker, Time Out Youth’s executive director. “We have condoms available for free to all the youth. We do monthly testing now.”

Every quarter, Tucker said, the organization discusses safer-sex issues as a topic in youth group discussion meetings.

“We’ve had people come in who are positive,” he said. “That puts a face on it and makes it a reality, something different than the rote discussion of safe sex.”

Prevention efforts for positives and safer-sex lessons are important, but more should be done to unite and amplify the voices of those most at-risk, said Foreman and Galloway.

“It is time to find a voice, especially for the African-American community,” said Foreman. “It feels like we are still struggling to find a cohesive voice to speak for us. In the beginning, people banded together and they got what they needed from the government and from the community. Something has to change. Something has to give and until the people who are being affected by this the most — African-American men and women — until we have a voice of cohesion, I don’t think it will change.”

Galloway said young people, and especially young African-American men, need to “stand on the front lines” like many gay men did during the early years of the epidemic.

That voice for change will have to come from within, Galloway said: “Now we have a younger generation. Will they be on the front line to represent that unheard voice?” : :

more: Be sure to pick up the Jan. 18 and Feb. 1 print editions for parts two and three of this three-part series. You can follow the series online at goqnotes.com/newburden/.

Other CDC data

According to The Centers for Disease Control and Prevention, gay and bisexual men of all ages continue to be most at-risk. Sixty-three percent of all new infections were among gay and bisexual men. The number of new cases grew 12 percent between 2008 and 2010.

Other key findings of the new data include:

  • African-Americans represent 44 percent of new infections.
  • Latinos represent 21 percent of new infections.
  • New infections among African-American women are on the decline (21 percent fewer infections in 2010 compared to 2010). However, African-American women still represent 64 percent of new infections among women.

[Ed. Note -- This article was originally published on Jan. 4, 2013, 8 a.m., and updated on Jan. 5, 2013, 3:19 p.m., with the addition of additional CDC statistics above.]