As we grapple with the relentless Covid-19 outbreak, now in its second year, it may be easy to forget that we are already in the midst of another, older pandemic: HIV/AIDS. When it was first identified in the United States in 1981, the disease that would soon be named Acquired Immunodeficiency Syndrome, and then linked to the Human Immunodeficiency Virus, was seen mainly among gay men in cities like New York, San Francisco, and Los Angeles. In recent decades, however, the front line in the fight against AIDS in the United States has shifted to the South.
According to the Centers for Disease Control and Prevention, in 2017, over half of new HIV cases in the country were in Southern states. This should come as no surprise. The white evangelical Republicans who dominate state governments in the former Confederacy mix race-baiting and sexual moralizing with a fanatical commitment to “small government” and the free market, resulting in threadbare social safety nets and educational systems that preach the wonders of heterosexuality and abstinence. With few resources to safeguard public health and little in the way of sexual health education, HIV has spread like wildfire through the South in recent decades.
Even then, the burden of HIV/AIDS falls unevenly. African Americans account for more than half of new HIV diagnoses in the South—over ten thousand cases in 2017—a region where they make up less than 20 percent of the total population. And within Black communities, men who have sex with men (MSM), which includes self-identified gay and bisexual men, as well as those who are homosexually active but do not identify as gay, make up six out of every ten diagnoses. What’s more, in 2017, there were almost as many new HIV infections identified among Black MSM as there were among white and Latino MSM combined, 2.4 times as many among Black MSM as among Black women, and over five times as many among Black MSM as among Black straight men.
“I’m a Black gay man living with AIDS, and I didn’t get it from the warm confines of my mother breastfeeding me. I didn’t get it from a blood transfusion. I got it from loving another Black gay man.”
New treatments for HIV have done little to remedy these disparities; in fact, they have likely made them worse. Around the time that highly effective medications were introduced in the mid-1990s, the percentage of new AIDS diagnoses among African Americans surpassed those among whites. More recently, pre-exposure prophylaxis (PrEP) has changed the landscape of HIV prevention by allowing HIV-negative people to take a once-daily pill that dramatically reduces the risk of transmission from HIV-positive sexual partners. However, Black gay men have adopted PrEP at rates far lower than their white counterparts. Even as overall use of PrEP increased by 470 percent from 2014 to 2016, just 11 percent of PrEP users were Black, according to CDC data. In the South, where many states did not expand access to Medicaid under the Affordable Care Act, lack of health insurance only partly explains this gap, which is also driven by the relative scarcity of clinics that actually provide PrEP.
At the same time, HIV/AIDS has become less of a priority for the mainstream LGBTQ rights movement, which instead shifted its focus toward assimilationist goals, such as the right to marry and serve in the military. Against the narrative that the AIDS crisis is either “over” or “global” (i.e., someone else’s problem), we see a disproportionate number of Black lives, and particularly Black gay lives, that continue to be cut short by HIV.
Atlanta, which serves as a mecca for Black gay men from all over the South, has been hit especially hard in recent years: in some parts of the city, the rates of new HIV/AIDS cases are as much as eight times the national average. Grady Memorial Hospital, in downtown Atlanta, regularly sees patients who find out they are HIV positive at the same time that they receive an AIDS diagnosis, meaning that they likely contracted the virus years before. It’s a dramatic, devastating sign of the way the epidemic is driven by a lack of access to HIV testing, counseling, and regular health care among Black Southerners.
That’s not for lack of advocacy or activism on the part of Black gay men—not in the country as a whole, and not in Atlanta in particular. Since the earliest days of the epidemic, Black gay men in the city have struggled to save their own from HIV/AIDS. Doing so has meant nothing less than fighting, again and again, to assert their own humanity in the face of indifference and hostility. They’ve had to fight against both predominantly white gay AIDS agencies and mainline institutions within the Black community, both of which have often treated them as an afterthought. They’ve had to convince those holding the reins of power that the intersection of racism and homophobia makes them uniquely vulnerable to HIV, while also fighting to survive under the weight of dual oppression. More recently, Black gay men have grappled with a public health regime that finally takes HIV rates seriously—but tends to view them coldly as mere statistics or collections of pathological behaviors rather than as representative of individual human beings.
“Well, No Thank You”
When AIDS was first identified in 1981, it was largely seen by Black gay men as a “white boy’s disease.” The gay enclaves where AIDS appeared first were largely segregated, and the earliest AIDS advocacy groups, which grew out of the social networks of men in those enclaves, reflected their biases. According to Maurice Franklin, a Black gay man who was locally active in both AIDS and gay issues during the 1980s and 1990s, white gay Atlanta and its Black counterpart were like “two different countries,” and the “white gay moneyed community . . . didn’t see us.” At agencies like AID Atlanta, the city’s primary AIDS service organization, white gay men dominated leadership positions and volunteer structures. Not seeing themselves reflected in efforts to address the new disease, Black gay men believed themselves to be insulated from it. However, by 1983, over a quarter of people diagnosed with AIDS in the United States were Black, roughly double their share of the national population.
At the same time, Black gay organizing was slow to get off the ground in Atlanta. Duncan Teague, a Black gay man who moved to the city in 1984, recalls an “I-must-be-closeted milieu around Black gay identity.” In May 1986, Teague and his friend Crawford Jones wrote an article for the Journal of AID Atlanta titled “The Lack of Organization among Black Gays in Atlanta.” Black gays, they speculated, were largely silent because they had “never had a voice.” “Blacks have in the past been completely excluded from the affairs of the mainstream society,” they continued, and “being gay in the black community is viewed the same way it is in the larger society—with misunderstanding and contempt. Having been effectively silenced as blacks, black gays are even more silenced.”
The very same issue of the journal illustrated their point. The newsletter’s front page reported on a national conference on AIDS to be hosted by SCLC/WOMEN (Women’s Organizational Movement for Equality Now), an adjunct group of the Southern Christian Leadership Conference (SCLC), which had been founded by Dr. Martin Luther King Jr. and others just under three decades earlier as one of the pillars of the civil rights movement. The group had begun holding educational AIDS workshops in the local community several years earlier, but this would be the first time that a major Black organization hosted a national event to address the growing epidemic.
It was also clear that the group had no intention of addressing the disease among Black gay men. The late Reverend Joseph Lowery, then president of SCLC, remarked, “We have received information that AIDS has been spreading in the black community among heterosexuals and children at a disproportionate rate and that gave it a sense of urgency.” Dr. Lowery’s comment played on the popular understanding that some people with AIDS were innocent, including women who contracted HIV through monogamous sex with male partners, and children who contracted HIV from their mothers. Black gay men, so the thinking went, were guilty, and got what they had coming to them. So long as they were dying in outsized numbers, AIDS carried no “sense of urgency.”
Accordingly, no one among the initial lineup of conference speakers was both Black and openly gay. SCLC/WOMEN had drawn an impressive array of Black doctors and public health professionals from the region, along with Reverend Ken South, the executive director of AID Atlanta, who was also a gay white man. Gil Gerald, then executive director of the National Coalition of Black Lesbians and Gays, called SCLC/WOMEN’s office to protest the absence of Black gay men from the conference. He was added to the program at the last minute, but his affiliation was misprinted on the schedule as the “National Coalition of Lesbians and Gays,” omitting the fact that a national organization for Black gay men and lesbians even existed.
In his remarks, Gerald called on conference-goers to recognize that both racism and homophobia contributed to the growing AIDS epidemic in Black America. He challenged those who would disavow “lesbian and gay people, and then dare to celebrate the lives and contributions of James Baldwin, Audre Lorde, Langston Hughes, Bayard Rustin,” and others who “we love and appreciate for their contributions to community life.” By erasing the sexuality of these Black luminaries, community leaders signaled that, for Black gay men and lesbians, the price of inclusion was to deny a piece of their own humanity. The resulting shame and denial, Gerald insisted, kept Black gay men from learning about and protecting themselves from AIDS.
The SCLC conference showed that even when mainline civil rights organizations did speak out about the growing AIDS crisis, they could not be counted on to treat Black gay men as though their lives were worth saving. At the same time, neither could predominantly white gay AIDS service organizations, such as AID Atlanta. As a writer for Gay Community News observed, “some AIDS organizations appear to operate on a myth current in the straight media: AIDS only affects gay white men.” Gerald argued that Black gay men needed their own organizations, not just for predominantly white groups to revise their outreach efforts. “Outreach is a continuation of setting an agenda from the white perspective,” he told the newspaper. “Black people need to be involved before the agenda is set. And when the agenda is more inclusive, it is different. We have come as an afterthought. Well, no thank you.”
Around this time, Duncan Teague was growing frustrated in his own work as one of AID Atlanta’s three part-time peer educators. The agency was small and under-resourced—he recalls that the three peer educators shared a single desk—which meant that it was up to him to tailor programs that had been designed by white gay men for his Black gay audience. The fact that he “didn’t have a program on paper,” one that was developed by and for Black gay men, “was not helpful.” Some Black gay men, he says, were “detrimental” to his efforts because they “really wanted autonomous Black gay AIDS work” instead of outreach from a group that remained predominantly white.
Teague had complained that no out Black gay organizations existed in Atlanta; now it was up to him to start one. Together with other local Black gay and lesbian activists, including Ron Wilkins, Carolyn J. Mobley, Chuck Cummings, and Sabrina Sojourner, he formed the African American Lesbian/Gay Alliance (AALGA) in October 1986. The group marked a shift from the clandestine culture of the city’s Black gay community in more ways than one. AALGA’s first male cochair was Marquis Delano Walker, a member of the Atlanta Committee, which, according to Teague, was “an exclusive social network of gay black men who were closeted and very middle-class.” As an early leader of AALGA, Walker became publicly visible as a Black gay man and came out about his HIV status, writing a column for its newsletter about his experiences as a person living with AIDS. Although AALGA did not entirely focus its efforts on combatting the disease, its overall mission of fostering “greater cooperation and mutual support in our struggles as black people in a hostile country, and as lesbians and gays in a society that denies our existence” found expression in its efforts to develop affirming HIV/AIDS education programs targeted to Black gay and same-sex-desiring men.
AALGA filled the need for an “out” Black gay organization in Atlanta, but it was a small volunteer group and not yet ready to compete for the major AIDS funding that was finally being made available to minority agencies from the federal government. SCLC/WOMEN was a different story. In 1988, Evelyn Lowery’s group received a major grant from the CDC as part of the agency’s National AIDS Minority Information and Education Program to develop outreach efforts centered on the Black church.
People who don’t have access to food and safe, stable housing, much less adequate health care are unlikely to make HIV prevention a priority in their lives.
The grant to SCLC/WOMEN presented Black gay and lesbian AIDS activists with an opportunity as well as a challenge. Lowery’s organization could give a new kind of moral legitimacy to the fight against AIDS and send a clear message that all people with AIDS belonged in King’s beloved community. Federal funds would help SCLC/WOMEN amplify this message, as the group looked to develop a National AIDS Program spanning seven different cities across the country. At the same time, Black gay and lesbian activists knew that, if left to her own devices, Lowery might exclude or erase Black gay men from her group’s AIDS-fighting efforts.
With this in mind, Phill Wilson, the founder of the National Black Lesbian and Gay Leadership Forum, and Vicky Mays, a Black lesbian researcher at UCLA, conspired to put a Black gay man at the head of the National AIDS Program. They found their candidate in Maurice Franklin, a naval medic with experience counseling sailors and marines who had tested HIV positive. Wilson and Mays introduced Franklin to Evelyn Lowery, who promptly hired him. It wasn’t until later, Franklin says, that she found out he was gay.
As SCLC/WOMEN’s national program coordinator, Franklin worked with Black churches in Atlanta, Charlotte, Detroit, Kansas City, and Tuscaloosa to train their members as community AIDS educators. Franklin and others knew that there were plenty of men who slept with other men in the church already. Gay men sang in the choir and served as ushers or on the deacon board. Very often, the price they paid to be part of the congregation was to be silent while ministers condemned the sin of homosexuality from the pulpit.
Franklin and other SCLC/WOMEN staff found that churches were resistant to incorporating AIDS education into their ministry, in part because of the association between the disease and homosexuality. Franklin also found that women within the organization, from Lowery on down, were too invested in maintaining a respectable image to really advocate for Black gay men, who they saw as unworthy of care and concern. Likewise, Gerald later recalled that the group “was coming largely from a very middle-class framework” and “had real difficulties dealing with some of the issues like gay sexuality.”
When AIDS was first identified in 1981, it was largely seen by Black gay men as a “white boy’s disease.”
For Franklin, tensions within SCLC/WOMEN came to a head when the group collaborated in 1992 with AALGA on a proposal to develop an HIV prevention program targeting Black gay men. The latter group by that time had some funding experience, having received a small grant from Fulton County to develop an awareness campaign focused on the link between substance abuse and unprotected sex. Franklin insists that for the second grant, submitted the following year to the Georgia Department of Human Resources, SCLC/WOMEN was only supposed to be a “pass-through” organization for the funding, to help increase AALGA’s chance of getting the award. However, when the grant was made, Evelyn Lowery declined it, and AALGA never received the money. Franklin was furious and soon resigned from his post.
Nevertheless, Franklin is adamant that Lowery’s prejudices weren’t shared by other SCLC leaders, including her husband. Dr. Lowery, he says, was a strong ally to lesbians and gays. Working for SCLC/WOMEN also gave him the chance to meet veteran civil rights leaders, who gave him a “masterclass” in organizing. That experience, along with the clout that he derived from proximity to King’s legacy, would be invaluable to his own organizing work in years to come.
Franklin brought his experience to Second Sunday, a monthly discussion group in Atlanta for Black gay men that he helped found in 1992. In a room at City Hall East, in the Old Fourth Ward neighborhood (home to the birthplace of Martin Luther King Jr. and near the Ebenezer Baptist Church, where he preached), Black gay men could talk about HIV/AIDS and the myriad other issues that affected their lives. Second Sunday also hosted HIV and safer sex education workshops, including a live condom demonstration in which facilitators showed how to properly put a condom on a man’s erect penis. Beyond that, the group offered Black gay men their own space to find fellowship. Five years on, the group’s cochair Ulester Douglas reflected that Second Sunday “provides rare opportunities for us to build intimate relationships,” meaning “friendships and/or partnerships where there is trust, love and caring; where each person risks vulnerability and growth; where we respect ourselves and each other.”
Duncan Teague was also a fixture at Second Sunday events. He recalls that for almost a full year, his performance group Adodi Muse, “Atlanta’s only Gay Negro Ensemble,” performed at the monthly meeting. At the time, Adodi Muse consisted of Teague, Malik M.L. Williams, and Tony Daniels, who was HIV positive, “very much a radical,” and a member of Second Sunday’s Topics Committee. They performed original work, including Daniels’s poetry, which challenged notions of guilt and innocence surrounding the disease: “I’m a Black gay man living with AIDS, and I didn’t get it from the warm confines of my mother breastfeeding me. I didn’t get it from a blood transfusion. I got it from loving another Black gay man.”
Adodi Muse also performed “Burning for Your Touch,” a script based on interviews from the Young African American Men’s Study, a qualitative HIV prevention research project directed by Georgia State University psychologist John L. Peterson, for which Teague also served as a research coordinator. The script strings together the words of young Black gay men who participated in the study, their words forming a verbal collage that captures the breadth of their experiences and points of view. The script highlighted the problems with outreach to Black gay men that had existed since the start of the epidemic:
The funding for black education and prevention agencies is way too low and they are very understaffed. At AID Atlanta, the African American Outreach only has one person and the Gay African American Outreach only has one part-time person, neither of whom knows what the hell he is doing.
Respondents also made clear that homophobia remained a serious problem in the Black church:
The Black Churches do not embrace their gay children. They shun them. The churches have belittled them and made them feel less than—I guess—the culture at large. And considering that Black men are normally raised in a church until such a time as they can choose not to go; it adds to the self-hatred, the self-loathing that you find in many homosexuals or with men who have sex with men. They have this whole self-loathing kind of psychotic episode. Black churches have not helped Black gay men.
And they described, just as Gerald had a decade earlier, the toll that racism and homophobia together took on Black gay men’s well-being:
You need to pay attention to these men’s self-esteem. The root of the problem is this self-esteem issue. Being black and gay is not an easy thing to do. Many brothers see this in a very negative light and still live this lifestyle. If you can’t get them to improve on their own self-worth and help them to love themselves, then it is a lost cause.
Still others resisted what Darius Bost has described as the tendency to read “black gay social life . . . as wholly determined by (social) death” from AIDS:
I’m sick of people with AIDS shoving it down our throats. I am HIV negative and don’t plan on getting it anytime soon. People think that just because I love men that one day I will be positive.
Charles Stephens was one of those young men who very well could have been interviewed for Peterson’s study. He began attending Second Sunday in 1999 when he was a freshman at Morehouse College, before he “muster[ed] the courage to . . . reject my dreams of middle-class assimilation, safety, and respectability, and . . . devote my life to writing and activism.” The group, he says, “helped me come to a stronger sense of identity.”
As a young Black gay man growing up in Atlanta, he recalls that the first Black gay community he found was through books from the Black gay renaissance of the late 1980s and early 1990s. In that movement, men such as Joseph Beam, Essex Hemphill, and Assotto Saint wrote openly about being both Black and gay. In poetry and prose, they documented lives full of love, sex, and heartbreak; the stinging pain of racism and homophobia; and the sorrow of watching their brothers die of AIDS. Their sense of urgency is captured in Hemphill’s poem “For My Own Protection” from In the Life (1986), the first collection of Black gay men’s writing:
I want to start an organization
to save my life.
If whales, snails, dogs, cats
Chrysler and Nixon can be saved,
the lives of Black men are priceless
and can be saved.
We should be able to save each other.
“That generation of public intellectuals,” Stephens says, “understood the humanity of Black gay men, and they were able to connect to it in their work.” In Second Sunday, Stephens saw that affirmation of humanity reflected back to him through a new group of Black gay elders. These men came from the same generation as Beam, Hemphill, and Saint; some had even known and worked with them. They had survived not only AIDS but the many crises that threatened their lives. Second Sunday helped Stephens to see that the arts and culture could be used in the fight against HIV, to help Black gay men see that they are priceless and can be saved.
After graduating from Georgia State, Stephens took this mentality to work at AID Atlanta in 2006. There he designed and led HIV education programs “rooted in stories and connection and the humanity of Black gay men.” He brought Hemphill’s poetry, panel discussions with Black gay elders, and screenings of Tongues Untied, Marlon T. Riggs’s 1989 documentary about Black gay identity, into his work at the agency. “Black gay men were largely represented in public health discourse at the time largely through the lens of deficit and pathology,” he says. Instead of talking about HIV as the byproduct of what was perceived to be wrong with Black gay men, “our approach was to talk about joy, was to talk about pleasure, and center those things.”
In 2014, Stephens started an organization to save his life. That year he founded Counter Narrative Project (CNP), which uses storytelling to build grassroots power among Black gay men through panel discussions, film screenings, podcasts, an online magazine, and Twitter connections. In the Covid-19 era, their work has shifted entirely online; recent events include a virtual reading of Cheryl West’s play Before It Hits Home, which deals with the stigma surrounding bisexuality and AIDS in Black communities, and a webinar on the HIV activism of Mario Cooper, a Black gay man who worked in the Carter and Clinton administrations. Stephens insists that encouraging Black gay men to tell their stories and listen to one another is a critical step toward building the agency they need “to respond to the violence that we experience.” Doing that, he says, means “insisting upon the humanity of Black gay men in the face of so many narratives and discourses that seek to rob us of our humanity.”
Walk the Long Way
In recent years, however, groups like CNP that focus on movement building have attracted less and less support from funders, according to Stephens. Instead, funding has “enticed organizations to move full speed ahead . . . to a very narrow clinical approach, to a very biomedical approach” with discrete, measurable outcomes. As a result, money has been channeled to large bureaucracies in a system that Stephens refers to as “trickle-down public health,” where too little money gets to people in need and too little effort gets invested in building up the agency of those who have been marginalized.
If current infection rates persist, half of Black gay men will become HIV positive during their lifetime.
One prominent example of this approach is the Trump administration’s “Ending the HIV Epidemic” plan, which emphasized diagnosis, treatment, and prevention, with the latter primarily accomplished by increasing access to PrEP and syringe exchange programs. Without a doubt, these are important tools in the fight against HIV/AIDS. However, the almost singular focus on “magic bullet” medical interventions has failed to make a dent in the epidemic among those most affected: if current infection rates persist, half of Black gay men will become HIV positive during their lifetime.
Nevertheless, Stephens sees opportunity for change in the crises and movements of the last year. The disproportionate impact of Covid-19 on Black, Latino, and Indigenous communities has exposed deep racial inequities in public health and medicine. Of course, HIV and AIDS also exposed those same disparities. The difference is that, since Covid-19 has to some extent touched all of our lives, far more people are paying attention this time around. The Black Lives Matter protests that followed the murder of George Floyd and Breonna Taylor by police weren’t new either, but last summer’s protests put anti-racist analysis in the minds of millions of Americans. Out of all of the turmoil may come the political will for change—in Atlanta, in Georgia, and in the nation—that will allow us to make real headway against an epidemic that is now in its fortieth year.
What would it take to end AIDS in Atlanta, and in the United States? According to Stephens, we should start by mending the social safety net. People who don’t have access to food and safe, stable housing, much less adequate health care—“all of the things that folks need to have wellness”—are unlikely to make HIV prevention a priority in their lives. At the end of the day, condoms can’t put a roof over your head or clothes on your back, and PrEP isn’t going to end homophobia or white supremacy. These interventions, though useful in their own ways, fall short precisely because they fail to tackle the root causes of the epidemic’s trajectory, the brunt of which has been and continues to be borne by Black gay men. To be sure, recognizing HIV/AIDS as a structural problem makes the work of solving it much, much harder—but there is no choice but to try. The lives of Black gay men are priceless and can be saved. We should be able to save each other.