Black Men at High Risk for HIV Suffer From Knowledge Gap

Demonta Reed, 21, is a Black male who is also a member of the LGBTQ community. He is unfamiliar with the vast number of resources in Milwaukee that address the HIV epidemic in the gay Black community. Reed’s understanding largely comes from his cisgender older brother, who learned about HIV from other family members. Reed’s views on HIV transmission illustrate the knowledge gap within the most vulnerable community.

“We don’t want to wrap it up, honestly,” Reed said. “We are just so quick to want to have sex with somebody or not ask somebody about their health.”

However, Black men are more likely to use condoms than their gay white counterparts. Stigma and socioeconomics play a larger role in why HIV rates affect the gay Black community more prevalently.

“Gay Black men are more likely to live at the intersection of financial instability, racism, lack of education, mental health issues, substance abuse, and being ostracized from their family,” Executive Director of the LGBT Community Center, Ritchie Martin, said. “Addressing socioeconomic factors along with stigma is paramount in addressing the HIV crisis in the city.”

One in two gay Black men in the city of Milwaukee are HIV positive. Several different community-based organizations (CBOs) are tasked with addressing this issue. Lorenzo Rivas, Manager of Prevention and Care Services at Diverse and Resilient, is working to tackle this.

“We offer free comprehensive testing here, at all three sites, not just the urine sample,” Rivas said. “If you’re engaging in oral or anal sex, then a urine sample will not suffice.”

Rivas is referring to rectal and oral swabs that are used to test for sexually transmitted infections (STIs) at those sites. A negative urine sample ignores whether there may be a positive oral or rectal sample for those who engage in different types of sex. Some people, like Demonta, who say that they are taking care of their sexual health, may not be aware they are potential carriers for STIs, despite being tested.

This type of comprehensive testing is vital in stopping HIV experts say.

According to Rivas, HIV-positive people who are unaware of their status are two to five times more likely to contract other STIs. HIV and STI transmission go hand-in-hand. But CBOs seem to struggle with effective messaging.

“I see the television ads and the billboards on the sides of the buses, but it doesn’t really connect with me,” Reed said. “I trust my brother more.”

Martin admits that the messaging is struggling to reach both younger demographics and LGBTQ individuals who aren’t completely immersed in the community.

“New people coming in to get tested is hard to come by,” Martin said. “They trickle in with their friends here and there, and they are hard to retain. The ones we do retain usually do so on the strength of knowledgeable friends.”

Failed social media campaigns with low engagement and funding, which is being cut by the Trump administration, is also making attracting new people difficult. While Martin admits that CBOs would like to do more, even when funding is abundant, it’s restrictive.

“We can’t just do whatever we want,” Martin says. “We have guidelines we have to follow to make sure funds are appropriately allocated.”

According to Rivas, whose organization has the same restrictions, what the community can do is work on HIV stigma inside out.

“HIV stigma within the community doesn’t seem to be as pertinent as it is outside of it,” Rivas said. “With half of the community being positive, it’s hard to have a stigma around something that is almost unavoidable.”

Adherence to medication allows HIV-positive individuals to reach undetectability, meaning the viral load is so low they cannot sexually transmit the virus. Reaching this status means that there is so little virus in the body of the positive person that they cannot pass it on to partners sexually. CBOs launched a U=U campaign several years ago, which stands for Undetectable = Untransmittable. This knowledge seems common within the community, even among those who may not know as much as they should.

“I would date someone who was HIV positive,” Reed said. “I know that as long as they take their medicine and go to the doctor when they are supposed to, then everything will be alright. I am willing to be there for them to make sure they are okay.”

Although messaging is difficult, CBOs aren’t giving up. And they acknowledge their successes and downfalls equally.

“We see what works and what doesn’t,” Martin said. “We understand community members trust their friends and family, but that is why we still must make attempts to reach those willing to come into our organizations so they can reach the people we can’t.”

For Reed, his brother remains his primary, albeit potentially flawed, source of information, highlighting the power of word-of-mouth. It underscores the crucial role of individuals within these networks, echoing Martin’s point about the necessity of reaching those who do come to the clinics. By empowering those who seek resources, CBOs are working to indirectly reach individuals like Reed, using trusted community connections to spread accurate information and combat Milwaukee’s HIV epidemic.