To commemorate World AIDS Day, the JSI Atlanta office opened its doors to He Is Valuable, Inc., a local community-based organization for “Chit, Chat, and Chew: World AIDS Day Edition.” Chit, Chat, & Chew (CCC) is an open forum for conversation and engagement to increase the social capital of the black, gay/queer community and the overall health status of those living with or affected by HIV in Atlanta. During the event, over 20 attendees shared candid experiences of how HIV shows up in their relationships, families, and communities.
HIV in Our Relationships
Creating and maintaining relationships can be difficult, especially if you are living with HIV. And often even if you’re not. Some men in Atlanta are opting to contract HIV to feel included in their peer groups and to feel connected to their friends or partners who are living with HIV. Jayl Jackson, Chit, Chat & Chew moderator, who is openly living with HIV, highlighted the importance of being affirming of where people are in their lives, regardless of serostatus.
Jackson chronicled a time when potential partners, friends, and colleagues would approach him about intentionally becoming HIV positive. He said, “I don’t want this life for you. I want you to be comfortable where you are. I want you to see your value as an [HIV] negative person but not take away the value of an [HIV] positive person.”
Chit, Chat and Chew members feel the way HIV is portrayed in national campaigns and the media is partly to blame for this way of thinking. One CCC member shared that he’s never seen images of healthy, magnetic/serodiscordant relationships freely expressed where black, gay/queer men congregate in places like bars, clubs, and other social scenes. It’s always a poster of, ‘This guy is living healthy with HIV’ while neglecting to mention that he is in a magnetic, healthy relationship.
Another CCC member shared how he participated in a national campaign, as an HIV-negative man, with other black gay/queer men who are living with HIV. Off camera, the men participating in the campaign would share their experiences living with HIV. When it was his turn to share, sadly he said, “I don’t have anything to contribute to this conversation.” The moderator skipped him and went to the next person. This experience resulted in feelings of isolation and guilt because he did not know how to move forward. He felt that being HIV positive was inevitable for him and that he hadn’t reached the same level of inclusiveness as his peers because of his negative status.
Opting to contract HIV is not a new trend.
Young black, gay/queer men are seeking out HIV through transactional sex in exchange for stable housing, food, or other necessities. One CCC member felt this was prominent in black gay men who live in rural communities where stigma and discrimination about being gay is extremely high. Some gay men intentionally seek out big cities, like Atlanta, and make a plan to start a relationship with someone without knowing their serostatus or disregarding safer sex practices altogether.
A Florida native described these geographic disparities as ‘alarming’ and suggested that gay men enter into these relationships because HIV services aren’t as abundant in places like Jacksonville compared to larger cities like Atlanta. These experiences reinforce the importance of recognizing the gaps in HIV prevention and care, examine how and why black gay men engage in this risk-taking behavior, and how black/gay queer men are portrayed in campaigns and other media.
HIV in Our Families
Romantic relationships are not the only relationships affected by HIV; familial relationships also present challenges for black gay men.
“When I first came out to my mom, HIV was the first thing she brought up,” said Richard Hutchinson, founder of He Is Valuable, Inc. Several black, gay men who have come out have endured accusatory, shameful, and combative dialogues between themselves and families related to HIV transmission. Many men view disclosing their HIV status to family as a “second trauma” following heated discussions about their sexual orientation.
One CCC participant recalled a time where he disclosed his status to his mother and received drastic mistreatment when it came to using household items. He was instructed to only use certain bathrooms, utensils, and other items. “That situation created self-hate and internalized oppression in me,” he lamented. “There is a certain type of fear that I feel when [I have to] talk about my status. It prevents me from being open to other people.”
Due to situations like these, some black gay/queer men are choosing not to have the conversation with their families at all. A participant shared that he had been living with HIV for nearly 20 years and has never told his mother about his serostatus. He felt that “for her [and his] emotional stability it was best for her not to know.”
We often forget that when we engage in conversations about topics such as HIV or sex with family members or friends, we may be dealing with individuals who have unchecked trauma. We all have experienced some type of trauma in our lives and when talking to others we may unintentionally trigger something in that individual. CCC members agreed that if you are dealing with someone who has unchecked trauma, boundaries are essential in protecting yourself and the other individual.
HIV is a family issue; everyone has a role to play in ending the epidemic. In the African American community, black women are often the leaders in their families and have remained disproportionately affected by HIV. In 2016, among all women who received an HIV diagnosis, 61% were African American women (HIV Among Women Fact Sheet, CDC, 2016).
One of the CCC members recognized the importance of educating black women in our families about (pre-exposure prophylaxis) PrEP and HIV. An even smaller amount of black women are engaging in PrEP care.
We have to address everyone’s HIV risk in the family unit and equip them with the tools to make decisions that empower them and their sexual health. It’s not all bad. Familial relationships, in relation to HIV, are starting to become more prominent in mainstream entertainment. TV shows like “How to Get Away with Murder”, “Pose”, and “Empire” are exploring serodiscordant relationships and its impact on personal and familial relationships. Positive Spin, a digital storytelling series created by HIV.gov, briefly touches on these issues as well.
HIV in Our Communities
As healthcare professionals, we have a duty to continue to apply a social determinant of health framework to our HIV prevention and care efforts. HIV is a part of the person; not the whole person. CCC members want community leaders to invest in them beyond their status and take a look at how environmental and interpersonal relationships play a role in their individual and communal growth. Black gay/queer men want professional development, employment opportunities, and tools to improve their own self-efficacy for the health and wealth of their communities.
“HIV is surface level,” says Richard Hutchinson. “There’s [more to us than that].”
Chit, Chat & Chew member, Michael Chancley says, “[A lot of young black gay men] feel that becoming HIV positive is inevitable or that you’ll die or won’t be able to thrive with a [positive status]. Some don’t even think they’ll make it to 30 because they are victims of crime, poverty, and drug addiction. Why get a job? Why build your credit? Why focus on a career? In a tangible sense, how do [we] build value in people who look like us?”
Black gay/queer men, as well as other vulnerable populations, are in desperate need of consistent role models. One participant shared that by having positive role models, like her transmother, she was able to navigate life as a transperson and ultimately avoid HIV infection and engaging in commercial sex work.
For those who are acting as role models, Jayl insists that persistence is key. We can’t be selfish with our knowledge and experiences nor can we be deterred by the negative attitudes of inexperienced youth. We must push forward.
How do conversations like Chit, Chat & Chew inform our work at JSI?
As public health professionals, we are tasked with improving the health and well being of black gay men and other vulnerable populations. What if we are approaching the health of black gay men… backward? The majority of public health interventions developed for black gay men are for black gay men living with HIV. “We teach black gay men living with HIV that you have to be resilient. You have to have a good and working relationship with the healthcare system,” says Deontez Wembley, Chit Chat & Chew member.
“The interventions for HIV negative men are meant to keep them negative. [Providers] don’t teach the importance of resilience to patients, healthy relationships, or how to navigate the healthcare system until their HIV status changes. The only health [providers] are concerned about are [the patient’s] serostatus. I think that is a huge problem. My mental health is impacted by feelings of guilt for being HIV negative.”
The He Is Valuable, Inc. team is calling for interventions on the front-end. It seems that when it comes to the health of black gay men, we only spring into action when the proverbial crap hits the fan and not sooner. We think that HIV testing is enough, condoms are enough, hashtags are enough, and it’s not. There is an entire untapped culture of black, gay men who can benefit from the right messaging, interventions, and services that span the entire HIV care continuum and beyond.