Primetime special on HIV

[Hernandez]

Am I the only one who was taken about how ABC flat out blames the epidemic in the African American population on the government?

Of course, how could I not realize that it's the governments fault for not supplying crack addicts clean needles and not providing convicted criminals in prison condoms for their sultry prison sex.

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[mshheaddoc]

Oh and how men go on the downlow because black gay men shame their society and culture because nothing is "talked" about in African American society and they've been hushed and shunned since the times of slavery . All of this is tied into the fact that HIV is not talked about in the black community and why men go out and have relationships with other men while in commited relationships and don't tell their SO. *sigh*

 

[Puddintame]

Oh and how men go on the downlow because black gay men shame their society and culture because nothing is "talked" about in African American society and they've been hushed and shunned since the times of slavery . All of this is tied into the fact that HIV is not talked about in the black community and why men go out and have relationships with other men while in commited relationships and don't tell their SO. *sigh*

I have yet to see any solid documentation of the downlow phenomenon. Everything seems to trace back to the NYTimes magazine article of a couple years ago, that was based entirely on anectdotal evidence. It makes a good just-so story, but so far that's all it is. We have no real, solid basis for saying that closeted black men having unprotected sex are driving HIV infection numbers.

Right now I'd all the other socioeconomic factors afflicting black America (decades of double digit unemployment, the highest rates of incarceration, concomitant barriers to care, etc.) are a the best explanation for infection rates among African Americans we currently have available to us.

 

[twester]

Am I the only one who was taken about how ABC flat out blames the epidemic in the African American population on the government?

Of course, how could I not realize that it's the governments fault for not supplying crack addicts clean needles and not providing convicted criminals in prison condoms for their sultry prison sex.

Have you ever been poor? I'm not talking about "Oh, I can't afford to eat out until Friday and Oh, maybe I can mooch some beers off my buddy tonight." I'm talking about OMG-we're-starving-and-my-kid-really-needs-shoes-I-think-I'm-pregnant-again-and-winter-is-coming-again poverty. That kind of poverty drives people to do desparate things and your association of black people with crack abuse and incarceration are nothing short of racist stereotyping.

The government, contrary to popular opinion, exists to ensure the well-being of its people. Some of that responsibility does include defense, but the majority should be going to health and human welfare. We are a wealthy enough country that it's shameful that dire poverty exists at all. The sickest people in our society are the poorest - so the government does bear a lot of responsibility for that. Mismanagement of resourses is one of our government's biggest faults to date.

I didn't see the program, but when was the last time that you said to someone, "You didn't wash your hands and continually suck your fingers. You deserve influenza and should die ASAP!" HIV is a disease. Yes, it's a disease that's kind of difficult to get - but the flu is caused by a virus, HIV is caused by a virus.

We should be beyond "blaming" people for contracting HIV 25 years into a pandemic. I do think that people bear responsibility for their lives, but some people just can't do it. To leave them in the gutter as carrion is morally reprehensible, they should be guaranteed a bare minimum of services. People should never have to feel desparate enough to resort to prostitution, drug abuse or violent crime. I'm not talking about cell phones and Porsches for everybody, I'm talking about a life most middle-class people would see as hell, but that a destitute person would see as livable for the short-term (and, if they choose, for the long term).

 

[mshheaddoc]

The government, contrary to popular opinion, exists to ensure the well-being of its people. Some of that responsibility does include defense, but the majority should be going to health and human welfare. We are a wealthy enough country that it's shameful that dire poverty exists at all. The sickest people in our society are the poorest - so the government does bear a lot of responsibility for that. Mismanagement of resourses is one of our government's biggest faults to date.

Maybe you need to see the program and see why some of us are outraged at what their claims are. I'm all for the government helping people but exchanging used need programs and distribution of condoms in jail so men can (discretely) have sex with each other (the main breeding ground of HIV and STDs) should come under the gov't billing?

I guess I don't want my tax dollars used when these people can afford to PAY for the drugs but won't get new needles (or share needles KNOWING the risk THEY are taking).

These were some of the main points in the program last night. I didn't like the way they were portraying the african american population in the "I'm gay and I can't tell anyone" sense. Comparing black and white gays. Then claiming it harder for blacks to "come out" than white people because of social stigma. Last I checked, its hard on MOST people who come out of the closet.

I didn't agree with their view of making it seem like a race issue. Yes the proportion of HIV is higher in black men (and even MORE so in women) but they need to work on changing the behaviors and education because most of what is going on is simple educational issues in which the show led you to believe that IV users and men who were "swinging" or not being faithful to their female partners were the main causes. And to address one of the posts on the "DL" ... they had an interview with gay/swinger men to discuss this topic which most if not all of them stated they didn't tell their hetero-partner of their escapades.

Of course part of this issue of the spread of HIV boils down the BASIC issue that has been bashed over everyone's head if you know anything about HIV, use a condom.

I suppose I'm just upset that people CHOSE to make these decisions and now our government is supposed to be the ones that fix it. There is so much more I could argue right now but honestly, it gets me upset just thinking about. Innocent people and children are the victims here and their infections are so needless if people would just THINK before they acted. It has nothing to do with money. If you can afford the drugs, you can afford other things.


Oh and before you go off spewing crap about poor and racism like here:

Have you ever been poor? I'm not talking about "Oh, I can't afford to eat out until Friday and Oh, maybe I can mooch some beers off my buddy tonight." I'm talking about OMG-we're-starving-and-my-kid-really-needs-shoes-I-think-I'm-pregnant-again-and-winter-is-coming-again poverty. That kind of poverty drives people to do desparate things and your association of black people with crack abuse and incarceration are nothing short of racist stereotyping.

It was the PROGRAM that was stating this was the problem of HIV issues in the black community, not the poster.

 

[Hernandez]

Have you ever been poor? I'm not talking about "Oh, I can't afford to eat out until Friday and Oh, maybe I can mooch some beers off my buddy tonight." I'm talking about OMG-we're-starving-and-my-kid-really-needs-shoes-I-think-I'm-pregnant-again-and-winter-is-coming-again poverty. That kind of poverty drives people to do desparate things and your association of black people with crack abuse and incarceration are nothing short of racist stereotyping.

If you'd take a breath and actually read the bases of why I started this thread, then you might be surprised to find that it wasn't me making the associations and claims which I was referencing. In fact, I'm offended that you are doing "nothing short of" calling me a racist. I demand an apology.

It was the guests on the program and even the narrator who were saying that it was the governments fault for not providing clean needles to junkies and for not allowing condoms in prisons to prevent the spread of HIV and they were the ones giving statistics as to why these problems are even more so problematic in the AA community, not me. This is unacceptable, put the blame where the blame lies. With the junkies who shoot up and with those with risky life styles which lead them to make "desperate" choices with a man named bubba.

The government, contrary to popular opinion, exists to ensure the well-being of its people. Some of that responsibility does include defense, but the majority should be going to health and human welfare.

The term the Constitution uses is "general welfare." As far as I'm concerned, this means sanitation, emergency medical systems, this does not mean that we have to pay for clean needles for junkies to worried about getting high that they can't pay for clean ones.

We are a wealthy enough country that it's shameful that dire poverty exists at all. The sickest people in our society are the poorest - so the government does bear a lot of responsibility for that. Mismanagement of resourses is one of our government's biggest faults to date.

A government is a body of people usually notably ungoverned. And no matter where you go, and in any government, you're going to find mismanagement and bureaucracy (and I use bureaucracy as a curse word). So don't play shocked that this happens.

I do think that people bear responsibility for their lives, but some people just can't do it. To leave them in the gutter as carrion is morally reprehensible, they should be guaranteed a bare minimum of services. People should never have to feel desparate enough to resort to prostitution, drug abuse or violent crime. I'm not talking about cell phones and Porsches for everybody, I'm talking about a life most middle-class people would see as hell, but that a destitute person would see as livable for the short-term (and, if they choose, for the long term).

Desperate enough to resort to drug abuse? I find this laughable since it's often the other way around. It's the drug abuse that lead people to become desperate people. So we should fund rehabilitation programs, not programs to help them stay well while they're out to destroy their bodies. Call me cynical, but I'm sick of watching people continue in their self destructive ways and have the government bail them out time and time and time again. Hell, the latest craze I've seen in several of the HIV pts I've had is a resurgence in syphilis, and yes, it's from them sleeping around without protection with other HIV positive people, here is a group of people who we're paying un-tolds amounts of money for their meds and they go out and do the same act which got many of them there in the first place. I'm sorry, but I believe that at some point people are going to have to quit having their mistakes corrected by subsidies of people who don't screw up their lives.


I have much more to say about this, but I should be studying instead of typing out a thesis.

 

[chocomorsel]

Have you ever been poor? I'm not talking about "Oh, I can't afford to eat out until Friday and Oh, maybe I can mooch some beers off my buddy tonight." I'm talking about OMG-we're-starving-and-my-kid-really-needs-shoes-I-think-I'm-pregnant-again-and-winter-is-coming-again poverty. That kind of poverty drives people to do desparate things and your association of black people with crack abuse and incarceration are nothing short of racist stereotyping.

The government, contrary to popular opinion, exists to ensure the well-being of its people. Some of that responsibility does include defense, but the majority should be going to health and human welfare. We are a wealthy enough country that it's shameful that dire poverty exists at all. The sickest people in our society are the poorest - so the government does bear a lot of responsibility for that. Mismanagement of resourses is one of our government's biggest faults to date.

I didn't see the program, but when was the last time that you said to someone, "You didn't wash your hands and continually suck your fingers. You deserve influenza and should die ASAP!" HIV is a disease. Yes, it's a disease that's kind of difficult to get - but the flu is caused by a virus, HIV is caused by a virus.

We should be beyond "blaming" people for contracting HIV 25 years into a pandemic. I do think that people bear responsibility for their lives, but some people just can't do it. To leave them in the gutter as carrion is morally reprehensible, they should be guaranteed a bare minimum of services. People should never have to feel desparate enough to resort to prostitution, drug abuse or violent crime. I'm not talking about cell phones and Porsches for everybody, I'm talking about a life most middle-class people would see as hell, but that a destitute person would see as livable for the short-term (and, if they choose, for the long term).

You go girl/boy!!!! Couldn't have said it better myself. Very well spoken. Sometimes I can't believe the comments I see on this board. As sarcastic and judgemental as this board is I still get suprised at times.

 

[chocomorsel]

"

If you'd take a breath and actually read the bases of why I started this thread, then you might be surprised to find that it wasn't me making the associations and claims which I was referencing. In fact, I'm offended that you are doing "nothing short of" calling me a racist. I demand an apology.

It was the guests on the program and even the narrator who were saying that it was the governments fault for not providing clean needles to junkies and for not allowing condoms in prisons to prevent the spread of HIV and they were the ones giving statistics as to why these problems are even more so problematic in the AA community, not me. This is unacceptable, put the blame where the blame lies. With the junkies who shoot up and with those with risky life styles which lead them to make "desperate" choices with a man named bubba."




Sorry, my apologies. I thought that you were the one who was actually making these claims and the associations. Because it does sound really racist. But if it was the show, then I apologize for thinking you a racist prick. I do agree that some people are on a path to self destruction and do not necessarily have to get government assistance to aid in their self destruction. But we have to sit back and think that we really don't know the circumstances that drive people to these self destructive paths. It's most likely due to ignorance, desperation, lack of better resources or whatever. We don't know. But helping with condoms will likely help innocent people whose lives are unknowingly placed in jeopardy. As for the drug users and the brothas on the DL, only Jesus can help them really. Anyway, just my two cents.
As a black woman it is difficult to take care of young black women in my hospital who are stricken with HIV/AIDS most likely due to bad decisions and ignorance. It's tough to see so many black men in jail. I cannot begin to understand where they come from and how they got there, but I wish we could come up with a long term solution to help with these racial disparities. Definetly a better educational system from a young age. I heard on the radio that 700 students from lousiana who transferred to texas schools got held back this year so we know that the education the poor kids get is not up to par to other educational systems. Anyway, I don't have evidence or research to back any of this up it's just opinion. It's very sad for the black community thought. Are we ever gonna measure up to our white counterparts?

 

[8744]

duplicate sorry

 

[8744]

The government, contrary to popular opinion, exists to ensure the well-being of its people. Some of that responsibility does include defense, but the majority should be going to health and human welfare....

Another person who either skipped or slept through his civics classes in high school....or maybe they don't teach civics.

Governments are instituted among men to secure their inalienable rights which come from the creator and consist of...and I'm just free associating here...life, liberty, and the pursuit of happiness. See the subtle but important point? Your well-being is your own business, not the governments.

And I don't think the founding fathers meant food stamps, socialized health care, and free rent when they spoke of promoting the general welfare.

Unfortunately, it is the popular opinion that the purpose of government is to steal from one group of citizens to give to another.

 

[8744]

duplicate again

 

[8744]

seriously.

 

[Lindyhopper]

Without getting involved in the wider theory of government agrument, limiting the spread of infectious disease is a valid & important use of government power.

 

[twester]

I admitted that I hadn't seen the program and I probably won't since I have no respect for sesationalistic, commercial journalism. I'm a media snob. If it was the program that made the racist allegations, then I apologize for pointing the finger at Hernandez.

With regard to condoms to prisoners - aren't prisoners wards of the state? Is it right to sentence everyone who enters the prison system to possible HIV infection? If we, the people, are going to lock people up then I think we have to assume responsibility for them. (And before some nitpick claims that I want to shut down prisons - stop now.)

I've found the pervailing tone on this thread to be self-centered. Societal problems happen "over there" to "those people". The standard seems to be that substance abuse happens only to yuppie thrill-seekers rather than to desparately miserable people. Those seemingly remote problems ripple through society. It's the middle class that gets hit first. By the time the wave reaches the upper class, it's been diffused. It's in our own best interests to insist that our government help out with these problems.

I take the position that the government should pay for condoms in prisons and for clean needles as well as for substance abuse counseling for its citizens. Addiction is a social and biological disease, not a moral failing. I do advocate for personal responsibility but not all people have the finely tuned moral compasses that "we" do.

 

[McDoctor]

Perhaps the government should fund clean needles and condoms for all in lieu of providing lifelong medication for new cases contracted after initiation of these programs. This would certainly be more cost effective. Of course it would never happen.

I reluctantly support needle exchange programs for their cost effectiveness and widespread (albeit minor) contributions to improving public health, however, there is absolutely nothing compassionate about enabling somebody to feed a heroin addiction. I don't care how you look at it.

 

[8744]

Without getting involved in the wider theory of government agrument, limiting the spread of infectious disease is a valid & important use of government power.

I think everyone agrees that this is part of "promoting the general welfare." Same with building roads and other things that could not easily be accomplished by individual citizens.

 

[DoctaJay]

Here are some facts, for those people that are completely disconnected with the black race:
* In the black race GAY is bad. Its not normal, you weren't born with it, you're considered soft, and a special kind of sinner (since alot of blacks are religious)
* More black men are on the DL then you really think. Many popular rappers are
* There is a revolving cycle, which is the real cause of this HIV spread. Edcation is significantly worse in black neighbors, therefore most kids in those schools are never pushed to suceed, therefore school is more of a bore than a means to "make it"; these kids drop out of high school, or just never go to college; with a high school education they take on low paying jobs that only require high school degrees; those that don't want to work for low wages sell drugs; those that don't want to sell drugs sell their body; those that don't do either are the homeless ones; to compensate for the depression & stress that comes along with selling drugs or your body, or being homeless, people take drugs and drink massive amount so alcohol; all of these people end up having children, and the cycle starts again. That is what is going on in most of the black community. Do you see anyplace where the govt could step in?
* There are more black men in prison, than in college
* There are more black women than black men in every post-secondary school in the U.S. except Morehouse I guess

Please don't ask me to post links to these facts. I dont' have them..just trust me on this. I do believe that people need to own up for their own responsibilities, but when you look at how absolutely horrible education is in black communities starting in kindergarten, you can only guess that they will fail. Babies are having babies, and the cycle continues. Also, more so than drugs...has anyone thought about just how many HIV transmissions are due to alcohol? No one ever seems to talk about how many problems come from alcohol consumption.

I did see the show on ABC, and although I missed the part about needle exchange programs, I did learn that there really aren't any AIDS advocates in the black community, which is a problem. If it is really opened up to everyone in the black community, some change may take place. But it needs to start from kindergarten up, and that is where the government comes in.

 

[Hernandez]

If it is really opened up to everyone in the black community, some change may take place. But it needs to start from kindergarten up, and that is where the government comes in.

If there ever was a realistic solution, it is education and a change in the status quo. These attempts to help are not the cure, they are merely fingers in the ****.

 

[mshheaddoc]

First I want to say thanks for sharing what you know. I completely agree with your outlook about the lack of education and the facts that more black men are in prision and there are lack of outreach programs.

But I guess I really have issues with claiming the "blacks" are more religious than others. There are plenty of whites who condemn gay actions as well. I personally know white and black gay couples and I really find it hard to play this argument.

Also, there are advocates in black communities but not ENOUGH to get the word out to everyone.

My question is, where were they the past 15 years when everywhere there was the "safe condom" ads as well as ads about IV drug use? The government highly advertised in various venues over the past 15 years especially concentrating in urban areas (I know many areas in rural communities might not have the resources, but that doesn't make up for all of the population).

its just a sad state overall but there is only so much that one person can do for themselves.

If these people condone the DL lifestyle, then why are they doing it? It just comes back to the whole "responsibility" issue that people aren't taking care of themselves or their families and being irresponsible. Mostly the blame falling back on the men of the african american community for the "DL" and prison phenomenons.

Here are some facts, for those people that are completely disconnected with the black race:
* In the black race GAY is bad. Its not normal, you weren't born with it, you're considered soft, and a special kind of sinner (since alot of blacks are religious)
* More black men are on the DL then you really think. Many popular rappers are
* There is a revolving cycle, which is the real cause of this HIV spread. Edcation is significantly worse in black neighbors, therefore most kids in those schools are never pushed to suceed, therefore school is more of a bore than a means to "make it"; these kids drop out of high school, or just never go to college; with a high school education they take on low paying jobs that only require high school degrees; those that don't want to work for low wages sell drugs; those that don't want to sell drugs sell their body; those that don't do either are the homeless ones; to compensate for the depression & stress that comes along with selling drugs or your body, or being homeless, people take drugs and drink massive amount so alcohol; all of these people end up having children, and the cycle starts again. That is what is going on in most of the black community. Do you see anyplace where the govt could step in?
* There are more black men in prison, than in college
* There are more black women than black men in every post-secondary school in the U.S. except Morehouse I guess

Please don't ask me to post links to these facts. I dont' have them..just trust me on this. I do believe that people need to own up for their own responsibilities, but when you look at how absolutely horrible education is in black communities starting in kindergarten, you can only guess that they will fail. Babies are having babies, and the cycle continues. Also, more so than drugs...has anyone thought about just how many HIV transmissions are due to alcohol? No one ever seems to talk about how many problems come from alcohol consumption.

I did see the show on ABC, and although I missed the part about needle exchange programs, I did learn that there really aren't any AIDS advocates in the black community, which is a problem. If it is really opened up to everyone in the black community, some change may take place. But it needs to start from kindergarten up, and that is where the government comes in.

 

[Puddintame]

Once again, I question the appropriateness of treating the so-called down low phenomenon and its connection to the rate of HIV infection among African Americans as an established fact. Doctajay's post is extremely thoughtful and well intentioned, but nevertheless offers absolutely nothing but an assertion and vague reference to anecdotal evidence having to do with this connection. I have not seen any systematic study of this issue yet (although I've no doubt there are some in the works) and until that such time as I do I'd argue it's best to view with great skepticism anything that offers "down low" as a significant causal factor for the relatively high rates of infection among African Americans. I also have concerns beyond the simple lack of supportive evidence, as referring to down low seems to work very well for people who prefer to blame the victim, which is not as uncommon as it ought to be with respect to HIV-related issues.

As an aside, I will note that there was a study published earlier this year (I'm sorry I don't have access to here) that suggested that the high rate of imprisonment among AA males was an important contributor to AA HIV infections, as the infection rate in prisons is generally higher and risk behaviors (voluntary and involuntary) are prevalent.

My question is, where were they the past 15 years when everywhere there was the "safe condom" ads as well as ads about IV drug use? The government highly advertised in various venues over the past 15 years especially concentrating in urban areas (I know many areas in rural communities might not have the resources, but that doesn't make up for all of the population).

Having just finished working on a long-term, behavioral, HIV-related study focusing on AA urban populations I can only say that your are significantly underestimating the barriers to both care and health-related outreach that confronts this community.

 

[Hernandez]

Once again, I question the appropriateness of treating the so-called down low phenomenon and its connection to the rate of HIV infection among African Americans as an established fact.

Why is that? The connection with HIV transmission and male homosexual acts have a well documented relationship. While it may not explain all of it, I don't see how you can argue on one hand that there is no relationship but then reference transmission for those in prison as a prevailing factor (is sex in prison not of the homosexual variety?). So how can you have it both ways? If they're having sex only with men in prison and are not "on the down low" (meaning they won't latter go out and have unprotected hetersexual sex) why is there such a disproportion increase in AA female HIV contraction rates between other ethnicities? But you're right, prison does seem to be a breeding ground for this, even Primetime referenced a study which states up to 60% of prisoners have sex while incarcerated.

While not in the strickest sense is this on the down low I guess, it's still the same behaviour pattern which is causing an increase in infection rates.


While there is not data which clearly connects the facts of HIV and the down low phenomenon, there are enough data to make this a logical conclusion.

1) HIV risk differences between African-American and white men who have sex with men. Journal of the National Medical Association. 91(2):92-100, 1999 Feb

African-American men who have sex with men remain at disproportionately greater risk for contracting human immunodeficiency virus (HIV) infection. While high HIV seroincidence has been documented among homosexual African-American men, behavioral research has rarely studied the HIV risk issues confronting these men. This study assessed a sample of 253 men who have sex with men to determine if African-American (n = 79) and white (n = 174) men report different rates of HIV risk behaviors and differ in characteristics indicative of risk. African-American men who have sex with men were more likely to be HIV-seropositive, to report past treatment for gonorrhea and syphilis, and to have a recent unprotected sex partner known or believed to be HIV-seropositive. Multivariate analyses of covariance, controlling for group differences in age, education, and income, revealed that African-American men who have sex with men were less open about their sexual orientation, scored lower in HIV risk behavior knowledge, had more female sexual partners, and more frequently used cocaine in association with sex relative to white men who have sex with men. Human immunodeficiency virus prevention programs tailored to the needs and risk issues of African-American men who have sex with men are needed.​

2)Seroprevalence of human immunodeficiency virus type 1 and sexual behaviors in bisexual African-American and Hispanic men visiting a sexually transmitted disease clinic in New York City. Source American Journal of Epidemiology. 147(3):269-72, 1998 Feb 1.

A cross-sectional human immunodeficiency virus type 1 (HIV-1) serosurvey was conducted between January 1988 and January 1993 at a New York City sexually transmitted disease clinic serving predominantly African-American and Hispanic patients. Overall, 14% (415/3,069) of participating men reported having sex with men; among these, only 52 (13%) were classified as "homosexual" (having had sex with men exclusively since 1978). Most men (87%) who reported having sex with other men also reported having sex with women. These included 147 (35%) "bisexuals" (sex with more than one man and at least one woman since 1978) and 216 (52%) "heterosexuals" (sex with women since 1978 and sexual contact with men before 1978 or only once thereafter). Although HIV-1 seroprevalence was highest among "homosexual" men (70%, 95% confidence interval (CI) 55-81), it was also high among "bisexual" men (35%, 95% CI 27-43) and "heterosexual" men (17%, 95% CI 13-23), and was lowest in men who reported having no male sex partners in their lifetime (9%, 95% CI 7-10). It is possible that transmission of HIV-1 from bisexual men to female sexual partners plays a greater role in heterosexual transmission than was previously recognized.​

There was also a more recent article which quantified somewhat the bisexual behavior AA men, I believe the number was 2% of all AA males, which was much higher than any other ethnicity, I'll see if I can find that article.

 

[fantasty]

Chiming in (haven't read everything, but hern's articles are fairly consistent with other research I've seen)...

In HIV / STD literature (especially in AA and Hispanic communities), it's important to ask about behaviors rather than self-identity. Because of the stigma in those communities, men will be much less likely to identify themselves as gay or bisexual, which necessitates the use of Men who have sex with men (MSM) as the label, since that focuses on behavior.

 

[Puddintame]

Why is that? The connection with HIV transmission and male homosexual acts have a well documented relationship. While it may not explain all of it, I don't see how you can argue on one hand that there is no relationship but then reference transmission for those in prison as a prevailing factor. So how can you have it both ways? If they're having sex only with men in prison and are not "on the down low" (meaning they won't latter go out and have unprotected hetersexual sex) why is there such a disproportion increase in AA female HIV contraction rates between other ethnicities? But you're right, prison does seem to be a breeding ground for this, even Primetime referenced a study which states up to 60% of prisoners have sex while incarcerated.

While not in the strickest sense is this on the down low I guess, it's still the same behaviour pattern which is causing an increase in infection rates.


While there is not data which clearly connects the facts of HIV and the down low phenomenon, there are enough data to make this a logical conclusion.

1) HIV risk differences between African-American and white men who have sex with men. Journal of the National Medical Association. 91(2):92-100, 1999 Feb

African-American men who have sex with men remain at disproportionately greater risk for contracting human immunodeficiency virus (HIV) infection. While high HIV seroincidence has been documented among homosexual African-American men, behavioral research has rarely studied the HIV risk issues confronting these men. This study assessed a sample of 253 men who have sex with men to determine if African-American (n = 79) and white (n = 174) men report different rates of HIV risk behaviors and differ in characteristics indicative of risk. African-American men who have sex with men were more likely to be HIV-seropositive, to report past treatment for gonorrhea and syphilis, and to have a recent unprotected sex partner known or believed to be HIV-seropositive. Multivariate analyses of covariance, controlling for group differences in age, education, and income, revealed that African-American men who have sex with men were less open about their sexual orientation, scored lower in HIV risk behavior knowledge, had more female sexual partners, and more frequently used cocaine in association with sex relative to white men who have sex with men. Human immunodeficiency virus prevention programs tailored to the needs and risk issues of African-American men who have sex with men are needed.​

2)Seroprevalence of human immunodeficiency virus type 1 and sexual behaviors in bisexual African-American and Hispanic men visiting a sexually transmitted disease clinic in New York City. Source American Journal of Epidemiology. 147(3):269-72, 1998 Feb 1.

A cross-sectional human immunodeficiency virus type 1 (HIV-1) serosurvey was conducted between January 1988 and January 1993 at a New York City sexually transmitted disease clinic serving predominantly African-American and Hispanic patients. Overall, 14% (415/3,069) of participating men reported having sex with men; among these, only 52 (13%) were classified as "homosexual" (having had sex with men exclusively since 1978). Most men (87%) who reported having sex with other men also reported having sex with women. These included 147 (35%) "bisexuals" (sex with more than one man and at least one woman since 1978) and 216 (52%) "heterosexuals" (sex with women since 1978 and sexual contact with men before 1978 or only once thereafter). Although HIV-1 seroprevalence was highest among "homosexual" men (70%, 95% confidence interval (CI) 55-81), it was also high among "bisexual" men (35%, 95% CI 27-43) and "heterosexual" men (17%, 95% CI 13-23), and was lowest in men who reported having no male sex partners in their lifetime (9%, 95% CI 7-10). It is possible that transmission of HIV-1 from bisexual men to female sexual partners plays a greater role in heterosexual transmission than was previously recognized.​

There was also a more recent article which quantified somewhat the bisexual behavior AA men, I believe the number was 2% of all AA males, which was much higher than any other ethnicity, I'll see if I can find that article.

A fair question.

It has to do with the specifics of what's entailed by the label and the lack of any rigorous documentation for the behaviors being attributed. The down low pattern is supposed be this: There are AA men who have sex with men but see this as an offshoot of their own hypermasculinity, and who consequently reject any identification with a Gay identity. A consistent aspect of this pattern, we're told, is that this sex is highly anonymous and highly spontaneous (thus preparation by way of carrying and using condoms is rare and even contradictory). Again, according to the stated pattern, men on the down low also have heterosexual relationships and because of the deeply closeted nature of their MSM activity, they neither reveal their homosexual activity to their female partners nor do they take appropriate precautions.

"Down low" was first widely publicized 2-3 years ago via a short article in the NY Times magazine that referred to, at most, a handful of putative practitioners but suggested without evidence that the pattern was much more widespread. It was immediately picked up and has become firmly established in the common wisdom as one of the reasons, if not THE reason, that HIV rates among AA are so high. This is despite the fact, as I've said, that there is no study that indicates that closeted, unprotected MSM are any more common among African Americans than any other US sub-population. This is an important distinction, because if we are to address the issue and the chief cause is, in fact, men on the down low, the strategies employed would be radically different than those employed if the primary causal factors are poverty, incarceration, poor access to care, etc.

I do not for a moment (nor, upon rereading my earlier posts, see any reason for thinking I have) question the relationship that unprotected sex in general and unprotected homosexual sex in specific has with HIV transmission. I simply wonder at the speed with which the down low story has come to be accepted and the importance it's been given absent the basic kind of documentation we would demand for other claims in different contexts. I also am concerned about the role such an accusatory story might have in shaping policy and funding for both prevention programs and research.

Speaking specifically to your question about incarceration, I think there's an important difference. This is because incarceration rates are causally connected to larger socio-economic factors, while the down-low pattern, as it's been described for us, is depicted as a product of individual choice, however influenced by specific cultural factors that choice might be. The articles you've cited do not speak to this difference because they do not speak to the behavioral roots of the risks described.

 

[Puddintame]

Just as an F anybody's I, here's a synopsis of the study relating prison time to HIV rates among African Americans. Note that much of the characterization of what the study says comes from the WaPo columnist, not from the study itself.

Science & Medicine | Prison Time Among Black Males Might Account for Rise in Number of HIV/AIDS Cases Among Blacks, Study Says
[Mar 09, 2006]
The recent increase in the prevalence of HIV/AIDS among blacks coincides with an increase in the proportion of black men who are incarcerated, according to a study released last year, the Washington Post reports. Rucker Johnson and Steven Raphael from the University of California-Berkeley's Goldman School of Public Policy examined U.S. census information and a federal database containing detailed information about 850,000 HIV-positive men and women who contracted the disease between 1982 and 1996. According to government data, in 1982 about 40% of prisoners were black, and in 1996 more than 50% were black. The researchers found that the increase of HIV/AIDS cases among blacks since the 1980s, most notably among women, corresponds with the increase in the proportion of black men in prison (Morin, Washington Post, 3/9). The researchers write that the "higher incarceration rates among black males over this period explain a substantial share of the racial disparity in AIDS infection" (Johnson/Raphael, "The Effects of Male Incarceration Dynamics on AIDS Infection Rates Among African-American Women and Men," July 2005). "So powerful is the relationship between race, prison and [HIV/]AIDS that it almost completely explains why half of all new AIDS patients in 2002 were [blacks] even though only 12% of the population is black," according to the Post. The Post reports that other studies show about half of all inmates have sexual relations with members of the same sex, and programs needed to help control the spread of HIV/AIDS in prisons are not allowed in many prisons. "t's illegal to distribute condoms in prisons in all but one state," Johnson said, adding that lawmakers fear it would encourage same-sex relations (Washington Post, 3/9).

 

[8744]

* More black men are on the DL then you really think. Many popular rappers are..

Well, that explains why he calls himself "Puff Daddy."

 

[lpressley130]

Am I the only one who was taken about how ABC flat out blames the epidemic in the African American population on the government?

Of course, how could I not realize that it's the governments fault for not supplying crack addicts clean needles and not providing convicted criminals in prison condoms for their sultry prison sex.

That's why I didn't watch it. I knew they would pull crap like that.