Black Leaders Confront CDC on AIDS

By Keith Boykin, in sexuality
Thursday, September 1 2005, 1:30AM

Atlanta, GA -- More than 70 black gay, bisexual and same-gender-loving community leaders from across the country emerged on Atlanta this week, where they challenged and confronted top officials of the U.S. Centers for Disease Control and Prevention (CDC) and began the process of creating a new national AIDS organization specifically for black gay and bisexual men.

In three days of intense meetings held in Atlanta about HIV/AIDS among black men who have sex with men, the leaders developed and then presented a list of specific recommendations for CDC and other government agencies to implement. The meetings, which followed the announcement of a CDC study in June that found 46 percent of black men who have sex with men (MSM) in five U.S. cities were HIV positive, included a tense 90-minute session with CDC Director Dr. Julie Gerberding on Tuesday.

In a series of recommendations, the group called on President Bush to focus his December 1, 2005 World AIDS Day speech on the crisis among black MSM with HIV. They also called on U.S. Secretary of Health and Human Services Mike Leavitt to convene a summit of African-American stakeholders to develop solutions and raise attention to the issue of HIV among black gay and bisexual men. And they recommended that the CDC set a goal to reduce HIV incidence among black MSM by 50 percent in the next five years.

Participants Take Over CDC's Agenda

The community leaders were called to Atlanta for a standard "consultation" with CDC officials, but unlike previous consultations, the leaders rejected CDC's scheduled agenda. In a move that might be described as a friendly coup d'etat, the participants created their own agenda specifically designed to address what the CDC, state and local health departments, and the community itself should do to reduce the HIV rates among black MSM.

On a day spent coordinating the CDC's relief efforts for victims of Hurricane Katrina, Dr. Gerberding met with the group and answered numerous questions from the African American leaders, who included AmASSI Health and Cultural Centers CEO Cleo Manago, Gay Men of African Descent Executive Director Tokes Osubu, Houston-based activist and consultant Steven Walker, and Black AIDS Institute Executive Director Phill Wilson.

Before Gerberding spoke, most of the participants had already pasted red signs on the meeting table that read "46% is unacceptable," a reference to the high HIV rates reported among black MSM in the June CDC study. Facing an audience that ranged from stoic to skeptical, Gerberding acknowledged the CDC's failures in the past. "Whatever we're doing right now, it is not enough," she said, and she admitted that the CDC's current five-year-plan, which ends in 2005, had failed to reach its goals to reduce HIV infection. Despite the past failures, Gerberding said that her goal is "zero incidence" of HIV.

Some were pleased that Gerberding came to the consultation, as the leaders had requested, while others were still dissatisfied. Roosevelt Mosby, executive director of Oakland's Sexual Minority Alliance of Alameda County, challenged the CDC for its failure to provide specific numbers of funding amounts targeted at black MSM and said that white men would never stand for it. In response, CDC's Director of Divisions of HIV/AIDS Prevention Robert Janssen argued that he could not tell how much money is going to the white community or the Asian community either.

Several participants expressed frustration about the lack of statistical information and data available about black men who have sex with men. UCLA Professor Vickie Mays said we don't have a lot of very basic information on this population, such as number of doctor visits and access to health care. CDC officials seemed to acknowledge the lack of information, but Dr. Gerberding asked, "What percent of the problem is not knowing what to do and what percent of the problem is not doing what we know?"

Passion and Policy

The meetings were marked both by passionate speeches and technocratic policy work. GMAD Executive Director Tokes Osubu made a plea for more passion, anger and vision from the community and likened the situation to a "war." But the leaders also presented an extensive list of policy recommendations for the CDC and its partner agencies.

Among the recommendations, the group called on the HHS Secretary to convene an inter-agency task force on black MSM by December 1, 2005, and they called on CDC to develop trainings for CDC staff to educate decision makers on the realities affecting black men who have sex with men.

The meetings also brought out new terminology to the discussion. In addition to the clinical term "MSM," which has been widely used by activists and researchers for more than a decade, Cleo Manago coined two new abbreviations to add to the AIDS alphabet soup. The first, BMSR, referred to "black men at sexual risk," and the second, MSMPC, referred to "men who have sex with men in particular circumstances." Steven Walker, President of SLW Consulting in Houston, also used the phrase "AIDS industrial complex" to refer to the professional HIV/AIDS community.

When asked about the "lack of leadership and urgency" from the CDC, Gerberding vowed to use her podium to talk about HIV prevention as often as possible and pledged to incorporate HIV prevention messages in non-HIV discussions.

Mental health issues were all discussed. George Bellinger, Jr., a New York-based consultant who took part in the meetings, criticized current government programs that include mental health components but fail to provide adequate funds to address the need. He also urged the CDC to study HIV negative men to find out what keeps them negative.

Several of the leaders expressed the importance of focusing on what the community itself could do instead of relying on or depending on CDC or the government. The group debated a series of community action steps, including promoting increased HIV testing, changing community norms about safe sex and HIV, holding their own organizations accountable for performance, building healthier relationships among organization leaders, and developing mentoring programs for young people.

Some participants at the meeting also worked into the late hours of the night developing plans for a new national organization for black men who have sex with men. The group tentatively chose the name Black Men Organized for Victory in the Epidemic (BMOVED) and drafted a letter to be sent to President Bush and HHS Secretary Leavitt.

The new group would be the first national organization for black men who have sex with men to deal with HIV/AIDS. An earlier organization, the National Task Force on AIDS Prevention, focused on HIV/AIDS among men of color, but the group has since closed down.

Internal Divisions Among Leaders

Several participants noted a history of divisions and personal animosity that had prevented some of the leaders from working together in the past, but many of them pledged to do a better job of separating their personal disagreements from their work in the future.

But in an email sent out at the end of the three-day meeting, Cleo Manago called some of the AIDS activists "an unprofessional field, with an intense resistance to accountability, excellence, integrity and reasonable vision -- based on Black culture." He also characterized the leadership as competitive, non-cooperative, deceptive, opportunistic and unskilled.

Manago made reference to a statement by CDC's Robert Janssen, who said on Monday, "In order to fund proposals for Black MSM we had to lower our score system. We had to fund [bad] proposals." Manago criticized the leaders themselves for this failure. "It's really too bad that Black MSM heads aren't rolling among its opportunistic and incompetent ranks," he wrote.

It is still too early to tell if Manago's critique will generate a response, but before the meeting ended, one participant seemed to suggest that disagreement need not paralyze the community. "We need to be unified, but we don't have to be uniform," said Steven Walker.

Other community participants at the event included former Whitman-Walker Clinic Director Cornelius Baker (DC), National Black Justice Coalition President Keith Boykin (NY), Healthy Black Communities CEO Lamont Evans (GA), National Black Leadership Commission on AIDS President Debra Fraser-Howze (NY), San Francisco AIDS Foundation Directors Ernest Hopkins and William Bland (CA), Us Helping Us President Ron Simmons (DC) and Addiction Research and Treatment Corp. Executive Director Beny Primm (NY).

Government participants included Ronald Valdiserri, Acting Director of the National Center for HIV, STD and TB Prevention, Acting Director of Health and Human Services Office of HIV/AIDS Policy Christopher Bates and CDC Deputy Director of Divisions of HIV/AIDS Prevention Janet Cleveland. Several black openly gay and bisexual men from CDC, including Rashad Burgess, Kenneth Jones and Dr. Greg Millet also participated in the discussion.

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