MSM

3 Comments Posted on by Ulysses III

Out Front: A Call to Action for U.S. Churches in the HIV/AIDS Response

The closing plenary of the EAA Interfaith Preconference of the 20th International AIDS Conference featured young adult voices in the fight against HIV from different contexts around the world. Panelists included a young woman from India who is living openly with HIV and a young man from Togo who is an actor and peer educator in the reduction of HIV in young men who have sex with men (MSM). I had the pleasure of joining them as a representative of the United States context where I talked about the tasks of the Christian Church in equipping ourselves for the HIV/AIDS journey beyond 2015.

If the Church is to remain relevant in the fight against HIV in the United States and in the world, the Church must improve its outreach to youth and young adults. It’s no secret that Millennials are all but absent from the Church, not because young people don’t believe in God or don’t desire a connection with something or Someone higher than themselves, but because the traditional Church has failed to reconcile its 2000 year old theology with the present day context and realities that Millennials struggle to navigate. The inclusion of youth and young adults in the Church not only is imperative for the survival of an aging institution, but it’s paramount in the Church’s efforts to end AIDS because HIV is reality for young people in the United States and in the world.

In 2014, HIV and AIDS is a reality for 1 in 4 young person’s age 13-24; expand the age range to 29 and the number increases to 1 in 3. Young people are at particularly high risk of HIV infection for a number of reasons including but not limited to: sexual discovery, drug and alcohol experimentation, unprotected sex, and lack of sex education. The equation of immature sexuality under the influence of state altering substances with insufficient education on how to protect one’s self = increased susceptibility to HIV infection. The Church can be and should be a first responder in addressing these challenges in the development of young people, however the Church cannot minister to or intercede on the behalf of a generation of people it does not have access to. So, if the Christian Church is to continue to have a foothold in the fight against HIV/AIDS in the United States and in the world, the Church much address its antiquated presence in the present day context of youth and young adults, especially as it relates to sex and sexuality.

Sex and sexuality have long been taboo topics within the Church, yet both are inextricably linked to HIV/AIDS. Therefore the Church must engage in healthy dialogue about sex and sexuality if it is to endure in the HIV and AIDS journey beyond 2015. The Rev. James B. Nelson explains in his book ‘Between Two Gardens’ that, “Sexuality and spirituality are inseparable elements of full personhood…” One cannot exist without the other and qualify as the wholeness of the body of Christ. Sexuality is a gift from God. Likewise one cannot discuss HIV and AIDS without discussing sex and sexuality because both/and make up the wholeness of the epidemic. The gift of HIV to the Church is that it has forced us to deal with the deafening silence on sex and sexuality in communities of faith. If HIV was cured today, the Church would still be mute on sex and sexuality, tomorrow. The Church must utilize this opportunity that HIV has given, to discuss the theology of homosexuality, for example, by studying the history of our religious texts, understanding the context under which the text was written and the people the text was written for; then use that bible study to inform conversations around homosexuality in today’s context. Such dialogue allows the Church to equip the next generation of theologians for the HIV and AIDS journey beyond 2015.

The Church would then be in a better position to minister to the demographic most affected and infected by HIV in the U.S.: men who have sex with men, specifically young MSM of color. Many mainline denominations in the States have a long standing history in delivering HIV services internationally, however domestic provisions have been few and far between. Black Churches in particular have been limited in the HIV/AIDS domestic response largely due to stigma and lack of resources. Unfortunately, the few inclusive Black led faith based HIV/AIDS capacity building organizations that had resources have been shut out for the next 5 years, as no Black led ASO or CBO was funded by the Centers for Disease Control for the next cycle. Considering the rate of HIV infection among Black Americans, and understanding the importance of cultural competency when providing services to a target population, Black Churches and faith based organizations are left to depend on each other for assistance. If the Church is to maintain a meaningful presence in the HIV response, it must truly become “Church;” collaborating and participating in ecumenical resource sharing that recognizes the value in community healing, and ignores the differences in denominational doctrine.

Someday HIV will be eradicated in the United States and in the world, and the question will be asked: Where was the Church in all of this? Will they say we were failing to reach youth who desperately needed guidance and grace? Will they say we were too busy arguing over how God feels about homosexuality, while millions of people died? Will the story be that we had all the resources and skills necessary to reach those most impacted by the disease, but failed to work together as one Holy Communion? Or will they say people of faith were there from the beginning to end? I choose the latter. The end of AIDS is in front of us, and I believe the faith community will be a key role player in its finale; so long as we can leave behind our collective differences, and get behind our united front: life, and life abundantly. End AIDS.

2 Comments Posted on by Ulysses III

How the West Was Lost

The 20th International AIDS Conference (IAC) is the largest gathering of clinicians, scientists, activists, advocates, journalists, government officials, and people living with HIV in the world, to address the global pandemic of AIDS.

Historically, this event has been heavily attended by African Nationals, with registration of African Nationals sometimes accounting for half of the total participation at the IAC; and rightfully so. Africa accounts for 25 million of the 35 million people living with HIV, equaling 71% of the epidemic worldwide. With 10% of the world’s population, 20% of the world’s overall health burden, but only 3% of the world’s healthcare providers, Africa is heavily burdened by malaria (#1 most deadly disease in Africa), tuberculosis, and HIV/AIDS with an inadequate supply of care to address this massive burden. As one result, Sub-Saharan Africa accounts for 8 of the top 10 countries in the world with the highest number of people living with HIV.

India ranks 3rd, which probably isn’t hard to believe considering AIDS is largely a disease of poverty, with 30 million of the 35 million people infected globally being of low to middle income countries as are India and Africa. What you may, however, find hard to believe is that the United States ranks 9th in the world in number of person’s living with HIV; the only high income country to make the top 10. When we think about disparity of any kind within the global village, the narrative almost always lies in the gap between the “haves” of the global north and west and “have not’s” of the global south. Thusly, it’s natural to never consider the United States in discussions associated to poverty, disease, civil unrest and any other social ill when compared to the rest of the world. Unfortunately the HIV epidemic in the United States is not one we can afford to lose in the midst of the larger global pandemic, or for that matter – in the midst of the largest gathering for HIV and AIDS in the world, the IAC.

An estimated 1.3 million people are living with HIV/AIDS in the U.S. with approximately 50,000 new infections and 18,000 AIDS related deaths annually, totaling ~619,500 deaths since the beginning of the HIV/AIDS epidemic in the early 80’s. Injection Drug Users (IDUs) account for 8% of new cases of HIV infection and 16% of people living with HIV in the U.S., but primary transmission remains to be through sexual intercourse, predominately among men who have sex with men (MSM) at 63% of new infections and nearly half of all persons living with HIV. Furthermore, HIV not only affects MSMs at an alarmingly disproportionate rate, but new infections are overwhelmingly among blacks who make up 44% of all new infections and people living with HIV/AIDS while only accounting for 13% of the total U.S. population.

Much has changed since the discovery of AIDS in 5 White homosexual men in the summer of 1981. The face of HIV in America is now Black America. The Black AIDS Institute reports that if Black America were its own country, it would rank 16th in the world in HIV/AIDS cases, ahead of Ethiopia, Haiti, and Botswana – a country that once had the highest prevalence of HIV on earth. This largely explains the United States’ position in the world as a leader in the number of people living with HIV. 4 key factors contribute to the epidemic among Black Americans:

  1. High prevalence of HIV: Blacks are more likely to be exposed to the virus because of the existing heavy burden of HIV in the Black community where intra-racial partnering is the highest among ethnic groups (Blacks are more likely to partner with other Blacks)
  2. High prevalence of Sexually Transmitted Infections (STIs): Blacks are more likely to be infected with other sexually transmitted diseases which increases the susceptibility of HIV transmission.
  3. Stigma: There is an innate distrust of the healthcare system among Blacks (Tuskegee Experiment) limiting the interactions between Blacks and access to HIV prevention, testing, diagnosis and treatment. Homophobia is pervasive in the Black community where MSM are 51% of new infections among blacks and 73% of new infections in black men, stigmatizing a key population from knowing their status and seeking treatment.
  4. Social determinants: High rates of poverty, lack of access to healthcare, racial discrimination, incarceration, and illiteracy persist in Black America and drive a raging epidemic throughout the American African diaspora.

How then was the West lost? The United States has been a leader in funding the fight against HIV globally, but has failed to take care of home first, before saving the rest of the world. One of the badges being distributed by activist groups at AIDS 2014 reads, “Save us from the savior;” in this case the United States. We are at a critical tipping point in the fight against HIV and AIDS worldwide, but whether or not the momentum tips backward or forward, hinges upon our ability to leave no one behind as stated by the IAC sub-theme. That also goes for the millions of people living with HIV/AIDS in the United States.

Words of wisdom from a flight attendant: “Secure your own oxygen mask first before assisting others.” Words to live, and die by.