National Black HIV/AIDS Awareness Day – Perspectives on ending the HIV epidemic among Black Texans

February 7th is National Black HIV/AIDS Awareness Day.  It is a day to raise awareness and spark conversations on the disproportionate impact that HIV has on Black communities.

There were 35,834 Black Texans living with diagnosed HIV in 2019.  Black Texans are about 13% of the total population of Texas but disproportionately carry roughly a third of Texans living with diagnosed HIV. 

The number of Black Texans acquiring HIV each year has fallen over the last decade, and progress has been made to ensure that Black Texans living with HIV are aware of their status. In 2019, 88% of Black Texans living with HIV were aware of their HIV status, close to reaching the Achieving Together goal of 90%.

More work must be done to address the impact that HIV continues to have on Black communities in Texas.  While significant progress has been made to address and decrease HIV among Black women, they still carry a disproportionate burden among women in Texas.  The number of Black gay, bisexual, and other men who have sex with men who acquire HIV each year has remained flat for almost a decade and more must be done to support this community in reducing the impact of HIV.

As we approach National Black HIV/AIDS Awareness Day, we asked several partners across the state to share with us their perspectives on what we all need to focus on in order to end the HIV epidemic among Black Texans.

Chris Allen, Health Equity Coordinator

From my perspective, ending the HIV epidemic among Black Texans requires a focus on systems; 

  • Ensuring access to economic, educational, and political opportunities;
  • Transforming organizations and building capacity within Black communities where we are able to make decisions and affect change for ourselves;
  • Ensuring social and environmental safety where we live, learn, work, worship, and play – and working with Black communities to identify what this means (it does not mean increased police presence)
  • Offering culturally competent, appropriate, and affirming health care when the need arises

We have to understand the historical context that has created the inequities we see today and allows them to persist. The first step towards doing this is realizing that a problem exists and making a commitment to be a part of the solution. For some, this may mean stepping back and allowing people with the lived experiences to take the lead.

Michele Durham, Executive Director B.E.A.T. AIDS

From my perspective, in order to end the HIV epidemic among Black Texans, we need to launch a full-on campaign in the churches, schools and in the African American families’ homes.  Some Black Pastors don’t want to talk about HIV or recognize that members of their congregations are affected by HIV.  Also, a lot of black families do not want to acknowledge that they have gay family members or that their children are having sex or that the community needs accurate information and education.  The public campaigns must saturate all of Texas saying “I’m Black and I’m Proud”, “Black Lives Matter”, “Black Girl Magic”, “Black Men are Strong Providers,” and “The Black Family is Loving, Caring, Kind and Beautiful.”  In other words, Black Texans need to know that they are important and loved and worth life.  Texans everywhere must speak-out to sisters and brothers everywhere and say “We Love you No Matter What and We are in this Fight with You!”  After all, “Together, We Can Beat AIDS.”  

Marsha Jones, Executive Director, The Afiya Center

We need to change the lens from which we view HIV in Texas and be prepared to do the hard work that will get us to an end. Ending stigma, access to affordable healthcare, housing, and equitable and fair wages are key.  However, if we are going to truly end HIV and its impact on Black people in Texas, we will have to change the lens to one that is informed by anti-Black racism and its direct connection to why in 2021 Black people continue to carry the greatest disproportionate burden of HIV in Texas.  The existence and practice of implicit biases among the folk who write and pass policy, run programs and serve those most marginalized in this state must be rectified if we with intentions want to end HIV. How we see people is how we treat people. I believe we can end HIV among Black people in Texas. In order to do so we must deconstruct these systems of oppression that continue to disenfranchise and deprioritizes the most vulnerable folk in its society.

Tarik Daniels, Executive Director/Founder, Whatsinthemirror?

The biggest question I thought I had for the week at first was: Why would J.Lo shout “Let’s Get Loud” in her America the Beautiful and This Land Is Your Land mashup performance? It was a very bizarre and confusing moment for me. But as the 2021 Inauguration of President Biden and Madam Vice President Harris continued, my attention was drawn closely to President Biden calling out white supremacy in his inaugural speech. After realizing he was the first president to do so, I wonder how many people in public health were actually listening?

As a Black queer health care worker working through COVID-19, I helped many black patients access HIV pre-exposure prophylaxis (PrEP) and HIV treatment, and most shared their sentiments with mistrust of the medical industrial complex in America. As a black boy born in the eighties, by the time I blossomed into a full queer, HIV had already become a black person’s problem that was disproportionately impacting Black MSM more than any other population. I must admit watching COVID-19 evolve into another health epidemic that began to impact black people at alarming rates became very triggering and I had to reach into my toolbox to cope with the new trauma I was experiencing as a person living with HIV.

“We do know that health inequities at their very core are due to racism,” said Dr. Georges Benjamin, executive director of the American Public Health Association. “There’s no doubt about that.” After that comment came in 2020, medical institutions and doctors were declaring racism as a public health crisis across the nation. I even had to write a statement as a Black health administrator managing several sexual health clinics in response to Dr. Benjamin’s comments. But very little seemed to follow. I soon realized that for many declaring racism as a public health crisis, they were also mistaking representation for actual change.

HIV-related stigma has continued being a factor as to why many black people don’t get tested or want to get into treatment. HIV-related stigma and discrimination continues to negatively impact African Americans living with HIV as well. The focus on ending the HIV epidemic among Black Texans and black folks across the nation should start with the acknowledgment of medical mistrust in public health amongst black people. The medical institutions must move past declaring racism as a public health crisis and take responsibility for why black communities have been impacted by HIV and other chronic illnesses at disproportionate rates. It is proven that black people are treated differently. We have data showing us that Black people get different quality of care. Why not create HIV prevention campaigns with the intention of boosting morale and trust in medicine with Black people? I no longer believe that it is ethical to use Black people as the face of HIV simply because we are mostly impacted without historical truth and justification. Let’s start having the conversations around racism in public health that’s been absent in HIV prevention and care and begin to change policies and attitudes. HIV is not the epidemic it once was thirty years ago but the racial inequities that lead to poor outcomes for black people are thriving more now than ever before.

Cordella Lyon, Baptist Hospitals of Southeast Texas

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