Homophobia and Racism Still Factors in High Rates of HIV in Black Community

In 1997, Lorenzo Robertson knew something was wrong. In the span of a couple of days, a small growth on his right eye grew from the size of a garden pea to a golf ball. The right side of his face was sagging. Doctors thought he had lymphoma. The situation quickly became dire. Family members were asked to say goodbye. But despite that bleak diagnosis, Robertson survived. Once doctors removed the growth from his eye, he was released from the hospital and sent back to work.

Then, his situation went from bad to worse. After a few hours back in the office, he became so weak that he couldn't lift his briefcase. He returned to the hospital for answers. After a month of poking and prodding, doctors couldn't figure out what was wrong. They finally decided to run an HIV test.

The results were staggering. Robertson had AIDS and only 11 T-cells. "That was the first day of the rest of my life being a person living with AIDS," he said.

Robertson is one of the more than 130,ooo people living with HIV in Florida. The Florida Department of Health says nearly half of them (49 percent) are black. Experts say that these numbers are startling since African-Americans make up only 15 percent percent of the state's population. Robertson believes there are many reasons for the disparity.

"I think there is still a lot of stigma, shame, homophobia, economic concerns, religious and family concerns. There are still men that are fearful of coming out and identifying as gay men, which leads to increased men being HIV positive and not sharing that with people they are intimately involved," Robertson said. "I mean there are so many reasons why Blacks are disproportionately impacted by not only HIV/AIDS, but also so many other health concerns. One of the biggest is that fact that so many Black gay men have been molested, but never told anyone or when some did tell they were not believed. Mental health issues and concerns also play a role in why we are more impacted by HIV/AIDS than other races and ethnicities."

February 7 is National Black HIV/AIDS Awareness Day. It comes amid even more grim news about the state of blacks and HIV. A new study by amFAR finds those racial disparities in HIV prevalence will likely persist for decades due to an alarmingly high concentration of the virus in black gay men. The report demonstrates the need to put more resources towards the black community's continuing struggle with HIV/AIDS.

"Many of the disparities are linked to larger disparities that affect racial and ethnic minorities such as higher rates of unemployment and less health insurance. If you do not have health insurance, you are less likely to be in care for HIV. People living with HIV who are not in care are less likely to be on medication to prevent HIV transmission," said Gregorio Millett, M.P.H., Vice President and Director, Public Policy.

Millett is a well-published and nationally recognized epidemiologist/researcher with significant experience working at the highest levels of federal HIV policy development at both the White House and the Centers for Disease Control and Prevention (CDC).

Robertson, who is now a Program Coordinator at the Pride Center at Equality Park South Florida, agrees.

"Some of this goes to systemic racism that exists in our community, especially in our gay community. There are many Black gay men that still do not have healthcare and are not accessing services that might be available to them. Some of the reasons also stem from lack of adequate housing, homelessness, unemployed, underemployed, incarceration, religion, family concerns, homophobia, etc. There is a litany of reasons why Black gay men are less likely to access a continuum of care, so don't feel they are worth the effort of taking better care of themselves," he said. "HIV disparity is a recurring theme we hear at our Kiki Project sessions. Many of the men that have attended our Kiki sessions indicate that some of the reasons mentioned are why they are not in care or do not continue care."

A report by the Kaiser Family Foundation found that misperceptions about how HIV is transmitted (e.g. toilet seat, mosquito bite, sharing a glass of water) had not meaningfully changed across the American public for 30 years.

"We forget that only 20-25 years ago, there was a lot of stigma against women in the black community who spoke about having breast cancer. This has shifted dramatically and having breast cancer is no longer the focus of hushed conversations. The same shift must happen with HIV," Millett said.

Robertson agrees that the black community has to get real when it comes to discussing HIV/AIDS.

"We need more education in our communities and more compassion for those of us living with HIV/AIDS. We also need to address the homophobia that is also living and thriving in our communities. Education can combat the issues and the disproportionate impact of HIV/AIDS in our Black communities. We have to start addressing HIV/AIDS head on and not continue to think that HIV/AIDS is someone else's problem," he said. "In the Black community we have to own that HIV/AIDS is still killing people and we are becoming infected as about the same rates they were over a decade ago and that is unacceptable. We are learning by talking to Black gay men they can gives us more insight into how best to address and serve them."

On Feb. 7, Robertson will mark this year's awareness day by performing his one-man show titled, 'me, myself and i.'

"It is a one-man show written about the life of a man on a quest of self and the many obstacles that block his path to greater self-awareness, understanding and contentment. "me, myself and I" is presented in 4 acts, each act explores complex issues that people can relate in their lives. This show will touch each person in a very different manner, but all that experience "me, myself and I" will be changed and enlightened by the journey," Robertson told SFGN.