Global AIDS Conference Comes to U.S.

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Some blame homophobia in the African-American community for preventing males from coming out about their sexuality and infecting female partners.

But, Williams said, the reasons are "more complex."

"There is a subset of men who are bisexual and not disclosing and also a group of men who fluidity across sexuality at different times in their lives," he said. "Incarceration is also a huge problem for black men."

He and Wyatt point to the gay white community that convinced the federal government to raise money in the fight against AIDS when the epidemic came to the national forefront in the mid-1980s. They have "served as a model for the rest of the world," they said.

Such efforts have not been replicated in the African-American community, which needs its own leaders and to be able to "heal themselves," Williams said.

Cornelius Baker, senior adviser for the National Black Gay Men's Advocacy Coalition, said poverty, culture and behavior contribute to new infections.

"For men in the African-American community, broadly, a high level of unemployment persists ... 15 to 30 percent, double or three times the national average. When you have an environment of that kind of endemic poverty, it certainly facilitates more drug use and sex work and almost a futility of life," he said.

"Prevention is an act of protecting your future. If you are in a culture that doesn't believe it has a future, than what becomes important is that moment and the decision to have unprotected sex."

In impoverished communities such as Washington, D.C., there might be access to health care but a lack of "health literacy," Baker said.

People don't get regular check-ups.

As for younger men, "they don't think anything is going to happen," he said.

And in a compact city like Washington, where there is little economic mobility, the virus circulates more virulently.

"These men don't have more sex or more drug use than their white, gay, counterparts, but they are in an environment that has more disease, more poverty and more HIV present in the community," Baker said. "They may have only one partner, but there is a greater likelihood, he has HIV."

Washington is a city where most have access to health coverage, but there are no hospitals in the African-American neighborhoods. "Few doctors are based past 16th Street in Northwest [D.C.]," Baker said. "People have to travel all the way across city to go to doctor."

He argues that the African-American community is no more religious and socially conservative and than U.S. Catholics.

"The difference is that the Catholic Church may condemn using birth control, but women have enough economic opportunities to ignore it," Baker said. "The challenge for young, black, gay men is not that there is a greater level of homophobia, but they are dependent on their families and communities for their survival."

Numerous African-Americans have helped lead the way, Baker said. The first significant bill was enacted by Gov. Willie Brown of California in 1972, followed by other black leaders in Washington, D.C., Chicago and New York City.

President Obama lifted a ban on travel visas for those who are HIV positive, making this week's U.S. conference possble.

"This concept that black people haven't been major partners or homophobia paralyzes us is false," Baker said.

Still, the statistics speak volumes and AIDS experts say more strategies need to address the rising number of HIV infections in these communities.

"Getting more and more people aware of their status is critical," Baker said. "Getting people to the treatment they deserve is not only a fundamental public health, but a fundamental human rights goal."

As for young African-American men, he added, "we have to prove to them that their lives matter."

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