9/19/2013

Shonda M. Craft, Ph.D., LMFT September 19, 2013

Every nine minutes, someone in the United States is infected with HIV

Presentation Overview
HIV in the African American community HIV stigma and homophobia HIV myths & misconceptions/Barriers to prevention
HIV and men on the DL

Levels of prevention (primary, secondary, tertiary) How to be a resource

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HIV in the African-American community

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HIV in Minnesota

HIV Infections* Diagnosed in Year 2012 and General Population in Minnesota by Race/Ethnicity

Data Source: Minnesota HIV/AIDS * HIV or AIDS at first diagnosis Surveillance System

Population estimates based on 2010 U.S. Census data.

n = Number of persons Amer Ind = American Indian Afr Amer = African American (Black, not African-born persons) Afr born = African-born (Black, African-born persons)

HIV/AIDS in Minnesota: Annual Review

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HIV Infections* Diagnosed in Year 2012 by Gender and Race/Ethnicity

* HIV or AIDS at first diagnosis

HIV/AIDS in Minnesota: Annual Review

Data Source: Minnesota HIV/AIDS Surveillance System

n = Number of persons Afr Amer = African American (Black, not African-born persons) Afr born = African-born (Black, African-born persons) Amer Ind = American Indian Other = Multi-racial persons or persons with unknown race

Number of Cases and Rates (per 100,000 persons) of HIV Infection* by Race/Ethnicity Minnesota, 2012

* HIV or AIDS at first diagnosis; 2010 U.S. Census Data used for rate calculations.

African-born refers to Blacks who reported an African country of birth; African American refers to all other Blacks.

Estimate

72,930 HIV/AIDS Source: Retrieved from MNCompass.org on 3/22/12. Additional calculations by the State Demographic Center. Data Source:of Minnesota System ^Surveillance Other = Multi-racial persons or persons with unknown race
HIV/AIDS in Minnesota: Annual Review

Sexuality and the (Black) church

African Americans, as a group, are also the most religious and have the most religious participation than any other group. Within the AA community, the majority of those that have a religious affiliation that is Christian, the predominant denominations being various types of Baptist and Pentecostal. Sectarian Protestant denominations such as Southern Baptist and the Church of God in Christ value a literal translation of the Bible and these translations not only are exclusively homophobic but are also devoutly sexnegative and reserve sex for heterosexual married couples exclusively.

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Sexuality and the (Black) Church

Belonging to sectarian Protestant denominations is also correlated with believing that homosexuality is morally wrong and being considerably less tolerant (Sherkat, Mattias de Vries, and Creek, 2010).

HIV Stigma in the Black Community

HIV is particularly affective as the HIV virus has been historically associated with being gay, or that it is a gay mans disease (Mays & Cochran, 1998; Zamboni, Robinson, & Bockting, 2011). While heterosexual AA men that are HIV+ may feel less internalized stigma about being or disclosing their HIV status, AA MSM that are HIV+ often report feeling numerous types of social stigma because of their sexual/romantic identity and their HIV status (Radcliffe, Doty, Hawkins, Gaskins, Beidas & Rudy, 2010).

HIV Stigma in the Black Community

Some research also suggests that HIV + AA men also experience greater stigma than Whites and Latinos (Goffman, 1963). Sexual minority stigma is associated with sexually risky behaviors (Presont, DAugelli, Kassab, Cain, Schultze & Starks, 2004), and HIV+ stigma is also associated with higher frequency of unprotected sex, and unprotected sex while using drugs or alcohol (Radcliffe et al., 2010; Rao, Kekwaletswe, Hosel, Martinez & Rodrigeuz, 2007).

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HIV stigma in the Black Community

There are also factors that must be considered when examining sex and HIV stigma in the AA community.
AAs are most likely to live in the South where LGBT acceptance is less popular (Ellison and Musick, 1993). Many popular and influential AA figures have been vocally homophobic, espouse violent and hateful rhetoric, and actively fight against Queer rights Popular AA thinkers and literary figures have also asserted that to be AA is to also and exclusively be heterosexual (Collins, 2005).

Men on the Down Low

http://www.oprah.com/oprahshow/Living-on-the-Down-LowVideo

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Men on the DL
HIV prevention and education efforts have typically focused on knowledge, attitudes and theories of rational behavior and have paid little attention to the context of engaging sexual risk behaviors, particularly among men who self-identify as heterosexual, are involved in relationships with women, but secretly engage in sexual behaviors with other men. Concordance between sexual identity and sexual behavior may be mediated by numerous cultural factors. These men may downplay their sexual identity in order to appear more masculine and straight out of fears of violence or negativity. Furthermore, these men may continue to engage in partnerships with women due pressure to conform to heterosexist ideals of family and relationships.

Men on the DL
Men who have sex with women fall into two broad categories: heterosexual and bisexual.
Heterosexual men are those who only engage in sexual contact with women while bisexual men engage in sexual contact with both men and women. Because female to male transmission of HIV is rare, most heterosexual men contract HIV from injection drug usage (IDU).

Men on the DL
Men are increasingly becoming more comfortable self-identifying as bisexual and research has shown that they retain these behaviors and identity over long periods of time. Openly bisexual HIV-positive men are an understudied population and more data is needed to understand their role in HIV transmission.

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Primary prevention: aims to prevent the disease from occurring. So primary prevention reduces both the incidence and prevalence of a disease. Secondary prevention: aims to find and treat disease early. Tertiary prevention: targets the person who already has symptoms of the disease
prevent damage and pain from the disease Slow down the disease prevent the disease from causing other problems (These are called "complications.") give better care to people with the disease make people with the disease healthy again and able to do what they used to do

Levels of HIV prevention

Keys to prevention
Get tested Ask partner to test Talk about safe(r) sex strategies Educate yourself about ss strategies Implement doable strategies Know your limits Know your body "Relate not isolate"

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Acknowledge your own stereotypes about HIV, sexual identity, and sexual behavior Educate yourself about the lives that people living with HIV lead and how they may be the same or different from your own.it could be your mother/father/sister/brother/cousin/best friend/etc Address issues of cultural differences from the beginning.

How to be a resource

Lets Stop HIV Together Source: CDC

http://www.youtube.com/watch?v=FRF5p96JD9k

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