Health : Follow-up: HIV and Black Gay Men

We received so many passionate responses to the last health post on the study, Back of the Line: The State of AIDS Among Black Gay Men in America 2012, that I felt it important to provide more information and insert other perspectives into the conversation.

There is a topic in public health called “Social Determinates of Health”, it is a topic that the World Health Organization (WHO) has been talking about since 2005 when they established the Commission on Social Determinants of Health in an effort to provide advice on how the conditions in which people are born, grow, work and age, including health systems, may help to determine their health.

The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention picked up the topic and in 2010 created a white paper called ‘Establishing a Holistic Framework to Reduce Inequities in HIV, Viral Hepatitis, STDs, and Tuberculosis in the United States’.

The WHO commission on Social Determinants of Health, 2005-2008 generated a report that concluded: “This ends the debate decisively. Health care is an important determinant of health. Lifestyles are important determinants of health. But… it is factors in the social environment that determine access to health services and influence lifestyle choices in the first place.”

There are reasons that help to explain our “lifestyle choices” and why the infection rate is so high for gay men, and for gay black men in particular, that go to the very core of our society and, in my opinion, they have more to do with topics like social isolation and loneliness, self-esteem, discrimination, religion, distribution of wealth, access to health care, and the horrid history that public health has and the reputation they have earned in the name of research, prevention and disease intervention activates.

I also want to say a little something about Adam4Adam, and hook-up sites in general. One of the consistent arguments that I have heard over the past 12 years is centered around blaming sites for everything from the rise of HIV to decline of gay society.

What is Adam4Adam without our members? A blank space with some adult ads.

What fills and makes Adam4Adam what it is, is us, gay men. We gay men are Adam4Adam, it is what we make it though the content we provide and the products we purchase.

Hook-up sites exists because there is demand, the ads are what they are because they sell products, it is simple: supply and demand rule, especially as a free site, that does not charge a membership fee.

We as Adam4Adam have no control over what men do in bed and, even after decades of spending billions of dollars on research, programs and some of the most intelligent minds in the country, organizations such as the Centers for Disease Control, also have no control over what men do in the bed room. I also  wonder how much influence public health has on lifestyle choices. Can anyone be motivated to consistently wear a condom through a campaign or program?

If it is true that: “it is factors in the social environment that determine access to health services and influence lifestyle choices in the first place.” Then we, as society, that must take responsibility and it is we, as individuals that make up our society, that must work towards creating the change in the social environment that can improve the social determinants that influence health and therefore improve the health of all gay men.

Yours in good health,


There are 38 comments

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  1. wootownman

    I, for one, am glad for your thoughtful follow up. I think this shows how volatile race in the gay community is. We may be trending toward a “post-racial America” but it is far from true in the gay community. It would be cool to see some posts about that.

    We know the solution to the HIV/AIDS crisis seems simple–just wrap it up. However, human behavior is never simple, and rarely logical, especially in the heat of a sexually charged environment, or in the light of depression, fantasy, drug use, alcohol use, etc.. Getting people to change their behavior across different cultural norms will be difficult. And although this study focused on black MSM, one could replicate the study in other groups and come to interesting conclusions. For those who are interested in the topics at hand, I would recommend a couple of books: “Without Condoms: Unprotected Sex, Gay Men and Barebacking” by Michael Shernoff. You may find the reading interesting.

  2. Rolando

    I just want to say that there is no excuse for any gay male to put themselves in a situation to get infected. Nowadays you can get condoms for free. As positive as it is for researches to have been able to create medicines that weaken the HIV virus, it seems to embolden men to be more promiscuous if living with HIV doesn’t come with the stigma and side effects as it used to. In my personal opinion I believe most gay men have an emptiness, a void, that they try to fill. One of the ways they do so is through empty sex. By no means am I an angel. I’ve had my share of one night stands. But with time I’ve found a happiness within myself and do not find a need to fill that void any longer. If you believe your body is valuable then treat it like it is valuable. With care and respect.

  3. Cedric

    I wanna know when is that “Stephan” guy will stop trying to male HIV/AIDS epidemic a black and poor issue? I am sick and tires of these racist blogs about black men. You have nothing nice to say don’t say it at all! Why is all your attention focused on black men? To paint a negative picture? This is 2012 and its so sad to racism is running rapid in the gay community. This author is BIAS in my opinion! For example in a recent post about discrimination he points out profiles that says “Blacks only” when in fact majority of the racism comes from WHITE men saying “No blacks, No Asians” which the author failed to mention. All I’m saying is let’s be honest and fair when deciding the topic of discussions with this blogs. Its getting out of control and I would like to read about the statistics of GAY WHITE MEN since you guys run this website! Let those skeletons out the closet!

    P.S. I’m not angry or bitter I just hate that my race is always singled out in a negative light. Its about EQUALITY isn’t it?

    Thanks 🙂

  4. Scarpien

    Well said Rolando. I was going to comment on the original blog but decided against it as, judging by some of the responses, many might not have been quite ready to hear it.

  5. GayMaleLA

    Some people forget to understand that just because you have HIV doesnt mean you go around sleeping with random guys unprotected. You can get it from a lover you have been with for years and they just so happen so slip up. Also from women. These bi-men think if a women is on birth control he doesnt need a condom. I contracted HIV while in a relationship and was very young, so was it my fault for trusting the person I loved at that time?

  6. Stephan

    Cedric – please read this post again. In this post I am pointing out that it is possible that the infection rates for black gay men are higher than other races as a result of things like racism – things called Social Determinants of Health.

    Here are the CDC statistics for the Estimated Number of Diagnoses of HIV Infection, 2009 by Race or Ethnicity

    American Indian/Alaska Native 189
    Asian 470
    Black/African American 21,652
    Hispanic/Latinoa 7,347
    Native Hawaiian/Other Pacific Islander 34
    White 11,803
    Multiple Races 516

  7. ton

    ok well i for one am very offended by this as a black american considering its not wat every statistic says because no matter wat color you are you we all can be nasty ass people but wd choose not too every black person aint tryin to effect anyone thats steroeotyping people over a study like be forreal there are pLenty of other races out there that alobg hiv let alone other diease!!!!

  8. Eternal Dawn

    I saw the title and was intrigued because i did not find the previous blog on the matter helpful to me (i knew the study, but was incensed by the underlying effects the post carried with it). However, upon reading this i was slightly underwhelmed because the post didn’t really discuss much. There was a general overview of dominant-submissive relations in this country and how that may affect health, however, there were no actual in-depth dialogues surrounding them. It seems like this post will fly over the heads of many who read it.

  9. Tibor

    I found the comments about this blog post interesting, not for what they illustrate about race, but for how they speak to a deeper issue; the stigma that is associated with HIV. The fact that anyone would view HIV infection statistics as an attack of any kind speaks volumes. HIV is a virus, period. It is not a judgement or an indication of moral values anymore than HPV or HSV or Hep or a cold. Unfortunately, the fear that persists around the subject of HIV and STDs in general leads to a lot of blame and shame, both of which are counterproductive to what should be the common aim of eliminating these conditions. I love my gay brothers, positive or negative, black or white, young or old. We all pulled together in the 80’s and 90’s before there were effective treatments. It was the silver lining in an otherwise horrific time. Let’s not lose that now.

  10. Alex

    I can appreciate what Stephan wrote and also understand exactly where a lot of the other people are coming from, but for me, a young black male who is predominately attracted to white men, its very disheartening to see this at the bottom of the “Members Online” page. It’s bad enough when you read profiles and they say white men only, but now having this listed as a blog just seems like their reasoning is validated. In no way, shape, or form am I saying that this issue is not important, but why couldn’t the article or subject be about gay men in general. HIV/AIDS is an epidemic amongst all of us no matter what race you are, but it comes across as now it’s has been given a face which is Black.

  11. jace

    the steciets tend tell the truth that also ando grope that asd rsi aswell that spresding to tis laitono men tow reall i do have agree there no excluce for any gay men out black white asson ect to wiling put them self in harms way boys if you goung to have sex with some orftct your selfs were a condrom eever time

  12. Me

    I think its sad that ppl can focus on one ethnicity instead of focusing on the issue at hand, which is hiv as a whole and how to prevent it. I think that It is ignorant for ppl to single out one group of ppl. The thing to focus om Is that ppl have it and we need to educate everyone on prevention. And it is a ahamw that ppl make it seem like black ppl are just nasty ppl when we are the ones to except ppl the way they are. But you have ppl that have some prejudice judge us based on what they call statistics. My thing is the same amount of time your using to try to continue to make black ppl look bad spent some damn time out on the streets educating every damn body. But hey this Is America an you are going to have some ignorant ass prejudice ppl everywhere so u have to deal with their dumb asses. Such is life. Be encouraged EVERYBODY. JUst because u see some statistics don’t cause ppl to make u think Black ppl r nasty cause there are some nasty ppl in all ethnicies. OUT!!!!!!!!

  13. RJ

    Information-wise both this blog and the other are very interesting. But personally as a bi guy of Black and Mexican descent they both seem like they are scaring others of different races away from the black community. I understand that the author wants to educate, I just feel like the post can and is being taken the wrong way. Although there may be many black males that are HIV+ there are many who are not as well. I don’t know, I guess I’m basically saying don’t be afraid to date the next black guy that messages you on this site because he might one of the 3.

  14. Osei

    Stephan, you are missing the link so that those who want to check out the data for themselves may do just that. Here is the link:

    If anyone knows one person who is HIV+ then I guarantee you that the idea of Six Degree of Separation counts, and you could be the Sixth person down the line just away from becoming HIV+. It is important for us as African/Black American men to develop monogamous relationships with substance, rather than jumping from one night stand to another night stand thinking that we have accomplished anything good. Since many individuals tend to be attracted to people of similar race and social background, it is very likely that since there are approximately 20% of gay African/Black American men currently living with HIV+/AIDS, then there is a likely chance that if you are consistently changing sexual partner that you will eventually have sexual intercourse with 2 or 3 HIV+ men out of a possible 10. If you are at a sex party, the same rule applies that 2 or 3 of the men at this party will be HIV+ for every 10 in the room. And you may never be aware of the status of anyone, but yourself.

    There is nothing wrong in trying to develop relationship with someone on Adam4Adam, since unlike many heterosexuals we do not always get to meet our partners in social gathering like church, high school, college, work related situations. We meet our partners at gay social gathering, so you need to learn how to make A4A become a place to meet A LIFE PARTNER that you may grow with.

    It is your life, choose wisely. And should you be HIV+, tell the person you are about to have a sexual encounter with. Give the person the chance to make an enlighten decision (if you have a heart).

  15. Lee

    I can see why African Americans would be offended by this. Aids does not discrimminate against race people. We’re even divided in the gay community…(smh)

  16. Lee

    how would you feel if the title blog said……
    Blog: Health : Follow-up: HIV and White Gay Men
    I would be offended if I was white.

  17. James

    While I am not African-American, I can say as an white gay man who is also HIV+ that this is a huge, complex issue to overcome. We as a gay community have allowed ourselves to become more divided over the last decade or so regarding the HIV issue and ignorance and an “I don’t care” attitude is the general rule of thumb for many within the M2M sexual acts, regardless of race or age, regardless of gay/bi or curious. I have been shut down/shout out so many times just because I am a poz guy, and while I do understand the choice of each individual to be intimate or not with a poz guy, the same ones the majority of times are out in adult bookstores or hooking up in other places where anonymous sexual acts occur, more times than not, without the use of condoms. Also, we as a gay community should and must demand that the porn industry clean up their acts and stop brain-washing us with porn full of bareback sex. While I agree that each person is entitled to their own privacy behind closed doors, I feel it sends a wrong message to the younger men who may either have self-esteem issues, suffer from depression, or who feel that because of the advances in HIV treamtments, HIV is no longer a serious threat and in fact, have heard several guys talk about there being a cure for HIV…so why should I worry about it. Myself, I am an honest guy, always state within my profile about my HIV+ status, along with asking questions to make sure a guy is comfortable and able to handle the matter in a mature and respectful way before I ever meet. I also have made changes within my personal sexual life to reduce the risk of infection to my sexual partners and within the last couple of years, even swore to abstain from anal sex penetration altogether. Yes, it’s my choice, be we as gay men need to wake up and realize that there is so much more to do with another man than just who is going to be top or who is going to be bottom. We, the gay community, need to wake up and realize that we are already being discriminated against by so many extremist Right wing and religious groups, so we should find ways to unite our cause for equality and social justice and stop being so ignorant, full of hatred and bigotry and show our pride of ourselves and our wonderfully rich gay history.

  18. TA

    Racism and white privilege are the gay community’s dirty little secret. I have white gay friends who are honest enough to clue me on the things that are said about other races behind closed doors. Nasty 1950s type stuff.

    Black guys can be very racist too, so let’s not let them off the hook. Although I have a sneaking suspicion part of it is a defensive measure to avoid being hurt.

    Yes, studies like this single out black men, because they make someone’s “blackness” the determinant factor when it is not. Why not a study showing the infection rate for drug users? Or guys between ages 20 and 30? Or single guys as opposed to those who are partnered? Or guys who are under or in-employed?

    Seems like those factors could play a role, but the sole factor that is singled out for study is blackness. Black is not a behavior; it would be nice if these studies singled out behaviors instead of races, but that’s asking too much from our race-obsessed culture.

  19. kevstar

    You made a very good point when you said we all must take responsibility for our actions. d there was some heated debate on whether gay men should look up to porn stars and treat them like gods. Some people were saying gay men should look at his death as a wake-up call that having the hottest body and lots of sex didn’t make him happy. Trying to party like a porn star certainly makes for an early death. Just look what happened to most of the stars of the 80s.
    . At least they looked like men you might have met in a bar. Now they all look like caricatures of masculinity with tattoos all over their bodies and steroid enhanced biceps! All from trying to not look sick and having no trace of feminity. It’s ironic that bareback videos are so popular! And the majority of these muscle Marys are white! I did an impromptu survey and 90% of the people on A4A with the words “party “, “pig “

  20. kevstar

    Continued … bareback only and cumdump I’m their profits are HIV positive and white! I guess they hope the AIDS money will just keep pouring in. Nowadays if I give money to AIDS organizations, I will give to those who help women and children. Otherwise, I feel that money is just going to waste on those who refuse to take responsibility and change their behavior. If you aren’t a porn star, stop trying to live like one!

  21. Peoplecannotbetrusted

    Usually, the people that protest the most are usually guilty. Take that however you like. Everybody of every race needs to take responsibility for what they do. Nobody wants to hear anyone else blame someone else for becoming infected when the truth is you were thinking with your dick and not your brain.

    Stop gambling with your health and you won’t have to worry about becoming infected. Grow the fuck up, be a man and don’t blame someone else because you were too stupid to keep your fucking dick in your pants. Have some self-respect and control yourselves.

    Also, I’m so tired of hearing about infected people that intentionally infect other people. Those people know they’re doing wrong but they don’t care because they are angry that they became infected. Sounds kind of childish, doesn’t it? Anyone guilty of that deserves all of the bad shit that happens to them.

    You know who you are.

  22. biracial-boy

    plus it would help if people would stop being cowards and get tested… and I don’t know why grown ass man and young men are afraid of getting condoms it means that you’re protecting yourself from contracting anything DUH

  23. Trousersdown

    If there are other statistics out there…post them. I can understand how easy it is to get into mis understandings when discussing a delicate subject, such as race.

    I think what is important though is that it be understood that no one is trying to blame anyone by talking about the rising numbers, or where they are rising…it’s all an attempt to understand why they are rising.

    When AIDS hit the scene it was a gay white man’s disease, and the African American as well as the female body count was ignored, by the media, the medical community, and basically the world at large. That was racist then, and that lack of consideration and public comment caused a whole lot of damage and suffering.

    I don’t think it is fair to say that it’s racist now when the discussion is raised that the numbers are rising among the African American demographic. I can see how it seems racist, or like all members of that group or race are being stigmatized or somehow being labeled as disease carriers but I don’t see that as what is actually happening here.

    Established institutions are releasing figures. This blog shared that information. That isn’t racist. It sucks, but it really just sucks that the numbers are rising and we’re all a little bit complicit in that. We aren’t all actively working toward a solution, nor are we all advocating a better course of action, or demanding a healthier representation of gay sexuality within our culture. We’re all just rolling the dice and hoping that we’re lucky enough to avoid misfortune all the while assuring ourselves that we’re taking precautions or maybe that the consequences aren’t bad enough to outweighthe enjoyment of the moment. Or maybe that’s just me, I’m really not trying to speak for anyone else.

  24. E

    This info is not so surprising. HIV/AIDS my be universal and affect all of us equally, however when black men start acting responsibly and stop living on the DL maybe things will change.

  25. Niko_in_Richmond

    Rolando, it is easy to caste a stone when you are living in a brick house. For many within the gay community, there are a host of issues that these people deal with that have an affect on the decisions that they make. Unless you have walked in someone else’s shoes, and understand what is going on in his mind, you are in no place to judge by saying “there is no excuse for any gay male to put themselves in a situation to get infected.” The same could be said about the suicide rate among gay men–“there is no excuse for any gay male to [commit suicide].” Just as we don’t understand why someone commits suicide, we don’t fully understand why someone “puts himself in a position to be infected.” As someone who is positive, I don’t know anyone who consciously put themselves in that position. That’s not to say that there aren’t people who do it–we know that there are bug chasers. However, most people end up positive for a host of reasons, not just one reason. I am a highly educated man who barebacked my way through the toughest portion of the HIV/AIDS epidemic only to get it from someone I was dating. (I was depressed, lonely, had low self-esteem and, in a quest for intimacy, found that I did things that I shouldn’t have done. I never intentionally put myself in that position; however, based upon my needs at the time, thinking rationally took a backseat to getting my needs met.) Instead of judging people, you need to learn to be sensitive to the fact no one wants to get HIV, but have enough to deal with already when they do test positive that they don’t need you looking down upon them.

  26. Beigeu

    Facts or just a group of targeted males in this lifestyle that have unprotected sex. Sad to hear of this and my race of men, its not to my surprise. Be advised i would love to see a topic on what the statisic would be on how white america enjoys penial pumps or toys verses or racail backgrounds and how strong the markets are n that area.

  27. Anthony

    I for one don’t really care who’s feelings are hurt by the facts. But this makes sense. The ideas of insecurity and how they play into how gay men have sex. Maybe black gay men are more insecure because of all the percieved racism against them on these websites and are therefore more likely to not use a condom.
    Come to think of it, how many profiles of black guys are on there that you remember said they were HIV positive? How many white guys are on there said they were HIV positive? Im saying the statistics indicate there should be a lot more hiv infected african americans of the african americans on there. It’s disproportionately higher than the amount of caucasians who are positive or don’t know. You bet there’s a stigma in their community against it. Everyone should get tested frequently and the rest of the community must reach out to the black community.

    There are also more factors at play here. Blacks may also be more susceptible upon the same exposure than other races to HIV infection and less resistent. There are some people who are immune to a certain strain of hiv. They are descendants of a northern european viking tribe which also had resistance to the bubonic plague.

    It’s just biology. More motivation for young research scientists like myself to unravel the code of this disease and smash it out.

  28. Steve

    Response to Cedrics post! You can only view things through your eyes and make judgements based on your opinions and life experiences. However when you make comments about all the “white people” who’s ads state “no blacks” there are an equal if not more than ads from black men that state “no whites” or “no ghosts” !!! Racism is a two way street and I don’t think that in any way Stephan was being racially bias! That being said, it is statistically proven that the HIV rate in african american men is higher than any other ethnic group. Why do you find it necessary to make it into something other than what it is, which is someone stating a fact! And everytime you make a comment about “white people” you are being just as prejudice as the CAUCASIAN people you are commenting about. Thats a huge problem with society today!

  29. Golden Boy

    Did you all know that AIDS does not discrimnate.. I hate this .. Race should not be a factor here it does not matter … what is important is that we all need to be responsible.. and lets stop putting stats out there by Races its so ignorant

  30. TJ

    First, Stephan, a very informative, thought provoking piece. Next, to my fellow black men who so quickly and negatively responded to the post: Please read the piece again and this time without the preconceived notions. This piece illustrates, accurately I feel, the issues that make these statistics what they are, the disparages between them, as well as the barriers to solutions.
    The reality is that society in general and the gay community in particular still attach a stigma to those who contract and are living with hiv. Doubt that this is still true? What is the first assumption made when someone becomes hiv positive? “Oh, that person was promiscuous or slutty.” When all intelligent, clear thinking individuals realize that it only takes one instance of unprotected sex to become an addition to the statistics.
    The unfortunate reality is that the stigma still exists, just as racism still exists.
    Those two issues along with economic, social and maybe most importantly cultural differences are major factors determining the disproportionate rise in hiv cases in black and latino gay men, & also why the seemingly simple idea of “safer sex” appears to be falling on deaf ears in recent years.
    Let’s stop being so touchy, defensive and most definitely so judgmental, start and keep the dialogue going and do what we need to do to fix this problem. We all win in the end!

  31. seriously

    As a black male I will say this all of u need to grow up and worry about youself as a person versus race. Protect yourself as a gay person instead of what you read in todays news the better off you would be! Truth be told no race is perfect from your ghetto to the home depot right on up to the trailer park! The fact of the matter is that us as gays are weak we are already shunned by what society is suppose to be we do anything and hurt anyone just to once feel like we belong it really sadens me to see minority against minority and for you who are blind arizona should be proof enough for you. Its not a race disease but more of a laziness issue and a self pitty one if u can’t get off because of a condome then check your equipment the shit feels the same! So again grow up stop being so judgmental and try to live life to the potential you are given versus the color of dick or ass you think is going to help you live a better life only you can change your situation and no one can love you the way you can oh and yeah don’t confuse preference with preprejudice because its a fine line. Oh and if you are prejudice be a man about it lol and stick with it lol don’t me any favors show me the man that don’t use the restroom like you and then let’s talk about who’s better than who this site is so sad and statiscs and adam are not the issues just accept who you are and

  32. seriously

    Oh and for the ones this pissed don’t worry I’m f’ed up too I’m black been with a mexican for 7 years and hold pampered chelf parties for the causians love every moment and cultural interaction so chill out queers Which includes all gays! Which means different! Lol own it! Don’t alter it! And stop ready statistics because they if you get your fact straight are public based and its unfortunate minorities depend on public heath care so their records are free game don’t believe the hype because most non minority are insured and private physicians don’t release that type of info for public study I know mine better not give any of my info to anyone so you see

  33. Hmm?

    Given the immaturity of so many in our community, perhaps this topic should not have been raised. This is Adam 4 Adam, keep it simple.

  34. Nope

    Sorry Steve I have never seen more black men putting “no whites” and I have definitely never seen anyone post “no ghosts”. You were doing some major projection and it is pure BS. The fact of the matter is, with the statistics they are making it appear as if black men are naturally HIV+. You talk about how racism is a two-way street but youre the only racist here. This sudden explosion of black men and HIV is suspect and definitely not designed for a purely benevolent purpose.

  35. Robblee

    Truly I don’t think it’s the gay man putting the stuff out there. We are just reading it and reacting. What needs to happen is we as a whole stop them from composing reports of different races it a waste of money that could go to finding a cure. Also for those who are on soapbox telling us we need to be in a 1 on 1 relationship i was and he still gave me hiv because he would go out and sleep with others. So 1on 1, sex parties, etc everyone is still at risk.

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