A new study from the Centers for Disease Control and Prevention (CDC) showed Black and Latinx gay and bisexual men continue to be more affected by HIV/AIDS than white members of the LGBTQ+ community.
Howard Brown Health Chief Medical Officer Dr. Maya Green said the medical community has been aware of this disparity since 1984—less than 3 years after HIV/AIDS became widely known in the U.S —but addressing the issue still requires systemic change and a commitment to ending the stigma associated with the disease.
"These inequities didn't develop yesterday," Green said. "They developed over centuries of systems doing their part to keep racial inequities or create greater gaps. People need to get up every day and fight against these systems and commit to undoing them."
While new HIV transmissions decreased for white men who have sex with men (MSM) from 2010 to 2019, HIV transmissions for Black MSM remained about the same. Transmissions for Latinx MSM increased, according to the CDC's study.
These disparities exist in HIV treatment as well—74% of white MSM with HIV are virally suppressed while only 67% of Latinx MSM with HIV and 62% of Black MSM with HIV are virally suppressed, according to the study. Viral suppression indicates a person is being effectively treated for HIV.
The CDC study found that, across the board, less than 50% of MSM take PrEP—an intervention, usually in the form of an oral medication, that protects the user from HIV transmission—with Black and Latinx MSM even less likely to take PrEP than white MSM.
Despite the development of effective medical treatment for HIV/AIDS—such as viral suppression and PrEP—many members of the Black and Latinx LGBTQ+ community don't have access to adequate, consistent health care due to long standing inequities in the city.
"If I replace HIV/AIDS with high blood pressure, diabetes, COVID-19, its Black and Latinx communities bearing the brunt," Green said. "The issue isn't the disease. It's not like all these diseases know each other and are collaborating. It's the system."
Green explained there are multiple "barriers," including a lack of healthcare facilities in Black and Latinx neighborhoods, less access to health insurance and stigma surrounding HIV/AIDS treatment.
Another aspect of the healthcare system that makes care inaccessible is the prevalence of medical experts who don't understand day-to-day life for Black and Latinx people in the city, Green said.
This could look like a doctor recommending a daily pill to prevent HIV/AIDS to someone with inconsistent housing or suggesting running to alleviate high blood pressure to someone who lives in an area plagued by gun violence.
"Part of it is coming to the table as a healthcare provider with an understanding of a specific patient's background so you can apply it to their care," Green said. "The healthcare provider a person finally accesses needs to understand the context of the environment the people they serve are living in."
To address this, Howard Brown Health ensures medical staff and those who work at the front desk are familiar with the neighborhoods their offices are located in.
"I'm 44, so I have a lifetime of context that I approach my patients with, but it's not something you can teach in medical school," Green said. "What you can do is make sure there are people on your team who have the context and listen to them."
To increase the number of Black and Latinx men who receive treatment and information about HIV/AIDS, Howard Brown Health "customized its outreach," Green said.
This means that the communications Howard Brown Health sends out to Chicago's white population includes different language than what's sent out to Black and Latinx populations, to meet people where they are.
"The medicine works, it's been working for a long time," Green said. "Screening works. But there's a gap somewhere, and we can't just say, 'We have the medicines, we have screening.' We have to deliver communication about medicine in the context that each individual community and individual person can receive it."
Green said everyone needs to work to end the stigma surrounding HIV/AIDS because it's a major reason people hesitate to seek treatment or prevention resources.
"The biggest disease of all is stigma—it's killing people," Green said. "Conversations about HIV/AIDs need to be happening in people's communities, in their tribes, because those conversations are more impactful than what I can say in 15 minutes at the doctor's office."
To read the full study, visit www.cdc.gov/vitalsigns/hivgaybimen/index.html.
