Why Limiting and Labeling Won’t Work to Reduce HIV Infection


An interesting interview with Lisa Bond, PhD, of Public Health Management Corporation, discussing the results of a study on men on the down low, or men who do not identify as men who have sex with men: “Not all black men on the so-called down low are having sex with women, and some men who don’t identify with the term down low do have sex with women—and these two findings really underscore the limited utility of using a label like down low for targeting HIV prevention efforts” (“The Low Down on the Down Low“). It has always been very common to pin the blame for the spread of HIV on various groups: at first, gay men, then injection-drug users, and recently, men who openly identify as straight but who have sex with other men in secret (down low, or DL). Bond’s study, which looked at HIV infection rates among both men who consider themselves on the down low and men who do not, found that there was no significant difference in the spread of HIV between the groups — in other words, we cannot make the assumption that men on the down low spread HIV at a greater rate than men not on the down low.

What can be taken away from this study is the finding that there is a great deal of unprotected sex occurring among both DL and non-DL men. Bond strongly emphasizes this, and states further that:

It’s important to point out that this rate of condom use is not unique to bisexual black men. This is a problem we see across populations and different racial and ethnic backgrounds, among women and men. This is an ongoing struggle in the fight to stop the spread of HIV, and that is: How do we increase the use of condoms in populations where there is significant risk for infection or transmission? … We need to shift our focus away from the down low. It’s been used quite extensively to demonize black gay and bisexual men, and we need to shift our focus on to more meaningful issues that do drive the HIV epidemic among HIV communities of color and particularly among black gay and bisexual men.

Studies like this are extremely important in addressing how to reduce new HIV infection rates. This type of research, which helps identify patterns and behaviors, is critical to addressing the spread of HIV. It is not enough for us to treat those who are infected; we must address the risks of infection and look at transmission with a clear, nonjudgmental eye. There is no way to reduce the rates of infection if we assign blame to certain populations while ignoring the facts: that any person may be at risk for HIV infection. By ignoring the universal dangers of HIV infection and not taking adequate steps to protect ourselves and others, we put our communities at greater risk. And by assuming that HIV infection only occurs among certain groups of people, we remove our own agency and responsibility for educating and taking care of others.

To read the entire interview, please see Trenton Straube’s POZ column.
To learn more about the study, please visit the American Journal of Public Health [subscription required]

-Until There’s A Cure

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