You put the emPHAsis on the wrong sylLAble: CDC, HIV, and the homo gay

The internet is all abuzz on some stats just released by the CDC:

Prevalence and Awareness of HIV Infection Among Men Who Have Sex With Men --- 21 Cities, United States, 2008

These are Google News stories on that report:

1 in 5 gay, bisexual men in US cities has HIV
The Checkup: CDC -- One in five sexually active gay urban men has HIV
44 pct of gay, bisexual men with HIV don't know it

The authors of those articles didnt read the report. Or if they did, they didnt catch onto what I view as the most important findings of the report. Yes, there are still a lot of bisexual and homosexual men in urban areas that are unaware of their HIV+ status*-- of the bisexuals that tested HIV+, 63% didnt know. Homosexuals, 39% didnt know. When the numbers were combined, 44% of urban bi/homosexual men didnt know they were HIV+ (63% of the heterosexuals tested didnt know, but they only tested a few heterosexuals-- 5 of the 8 that tested HIV+ didnt know. not statistically comparable to the bi/homosexual numbers).

That sucks. We need to fix that.

But thats not what I focused in on when I looked at their table of data.

Of the people who tested HIV+ and didnt know they were +, 57% had no health insurance. 81% hadnt seen a health-care provider within the past year. Thats insane. Thats unacceptable. And I bet I know what some of these men are thinking. "I dont have health insurance. I cant even go to a doctor for a general check up. Whats the point of getting tested for HIV if I cant afford to treat it anyway? Better not to even know."

There are government programs to make sure everyone diagnosed HIV+ gets treatment. If everyone knew about these programs, I think that would help get people in and tested... but even those budgets are getting cut in todays economy.

59% of the black men tested didnt know they were positive (whites were at 26%). Baltimore had 73% + but didnt know it (city pop 63.4% black). Detroit had 70% + but didnt know it (city pop 81.6% black). Philly had 70% + but didnt know it (city pop 43.5% black). The African American community needs to get their heads out of the sand and step up to the fucking plate.

There were lots of journalistic angles you could take with this data. Professional journalists took the easiest, dumbest, path of least resistance. Their headlines and conclusions took no thought at all. And they missed a chance to point out major disparities, economical and cultural, that could have made people think. Or even better, save some lives.

* The CDC asked 28,468 people to complete their survey and an HIV test. Of those 28,468, 8,153 said 'yes'. Seems like you might be biasing your survey against people who knew their HIV status, either +/-, and didnt want to do the survey for a free test and $25, but whatever. Theyre the CDC, I assume they know what they are doing.

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But you see, it's much easier to hate on teh homos than make any criticism, valid or not, on teh blacks these days.

And you know what? The continued stigmatisation of HIV/AIDS as the "Gay Plague" is what causes this. The black community seems to be even more homophobic than typical for the US, maybe partly due to the Christians, maybe partly due to the gangsta rappers, I dunno. Thus we have a health crisis brewing due to a massive overlap of conflicting cultural prejudices. "Why should I get tested? Only gays get AIDS! What you trying to say?"

And the fact that most +ves who don't know it don't have health insurance? Well who would have predicted that?

Great post Abbie.

By theshortearedowl (not verified) on 24 Sep 2010 #permalink

Right, and if you can't afford health care, how can you afford condoms for sex that can't get someone pregnant?

I think that's the scariest rational I've ever heard...

By Kemanorel (not verified) on 24 Sep 2010 #permalink

Another aspect of seeing what they're looking for: combine the numbers a different way, and the percentage of HIV+ men who have sex with women who don't know they're HIV+ is significantly higher than the percentage of exclusively homosexual HIV+ men who don't know. Given the small size of the heterosexual sample here, the other reasonable alternative is to define the sample as "sexually active men."

If the difference in numbers between bisexual and heterosexual men is more than an artifact, it might have something to do with bisexual men being less than welcome in many gay and straight social groups. Or it might mean that the outreach telling the gay community to get tested is more effective than the outreach to the rest of the population.

I haven't had a chance to read the whole report yet, but the headlines themselves illustrate another example of journalistic easiest-dumbest-path-of-least-resistanceness (which @Vicki's comment hints at): namely, the unwarranted sorting of people into the discrete (and ultimately arbitrary) categories "homosexual," "heterosexual," and "bisexual." These definitions are often inaccurate at best. The report separates these categories out in the figures, but doesn't mention them in the text (or doesn't appear to, anyway, after skimming it and using the browser search function). Instead the authors use the much more appropriate "men who have sex with men." There are plenty of men who do have sex with men who identify themselves as heterosexual, the case of Atlanta Bishop Eddie Long (apparently) being only the most recent of many public examples of this phenomenon. Appending the labels "gay" and/or "bisexual," (which is, granted, at least a better descriptor) is easier, but can be misleading.
Luckily though, the American public, which is committed to tolerance, understanding, nuance, and unwavering support of all people's rights regardless of race, gender, or sexual orientation, will surely see through this veil of journalistic lassitude and recognize both that sexuality is much more fluid than these categories imply and that HIV education and testing is important to all of us, not just "gays."
Right?

As opposed to what?

The "hetero gays"?

By ShadowWalkyr (not verified) on 25 Sep 2010 #permalink

Even if we take those numbers to read 20,000 out of the 28,000 knew they were negative, the result is still abysmal, an order of magnitude higher than I thought worst case scenario. It also shows that HIV prevention utterly fails in the black community, presumably due to the stigma of homosexuality in those circles (several good comments on the web right now in regards to the Long fellow).