Black, gay and proud: A USA-based man’s and a Uganda-based organization’s quest to thrive;Parallel stories between Uganda and USA

The good intentions behind strategic litigation are inadvertently suppressing strategic emotional health support. This story was inspired from different events including one by Daniel Driffin of Atlanta GA. 

Most At Risk Populations’ Society in Uganda (MARPS in Uganda) curved out the following niches: HIV Prevention and care practices targeting MARPs; Providing Shelter to address housing needs for LGBTIQQ in Uganda; running a resource center with Gender Neutral bathrooms; Income Generating activities as an empowerment to community integration by LGBTIQQ in Uganda; Media Advocacy work; Documenting Activities and abuses; addressing stigma and discrimination; building an advocacy network.

MARPS in Uganda has been providing services since 2004 and in all these years we have come across these recurring issues: higher proportions of young Transgender increasingly report higher HIV and other STIs; followed by gay bottom men; more LGBT reported engaging in exchanging sex for subsistence money including seasonal rotational respite housing at sex-partners for a few days;  there are those who reported being unaware of the fact that anal sexual intercourse is a route of HIV or any STI; some reported a long span between the first HIV Prevention and testing message to actual testing (kept on postponing HIV testing debut); stigma of HIV and homosexuality which hinder utilization of HIV prevention services including meeting to discuss HIV were reported; limited access to health care, HIV testing and treatment; linking sexually transmitted diseases to how they can facilitate HIV transmission; reports of displacement, eviction, expulsion as a result of being outed as gay; healing by touching; and we have witnessed a deliberate tendency for funders to provide money for strategic litigation, contexts for litigation and less for strategic emotional health support over a span of more than 10 years.

MARPS in Uganda has come up with a report covering 2004-2009: 67 young Transgender reported STIs; 300 gay bottom men reported STIs; 92 reported and were tested for HIV; 25 living with HIV needed transport support; 400 LGBT reported engaging in exchanging sex for subsistence money including seasonal rotational respite housing at sex-partners for a few days;  1,200 reported being unaware of the fact that anal sexual intercourse is a route of HIV or any STI; 1,700 reported a long span between the first  HIV Prevention and testing message to actual testing; 1,800 reported stigma of HIV and homosexuality hinder utilization of HIV prevention services including meeting to discuss HIV; 1,000 reported limited access to health care, HIV testing and treatment; 600 reported lack of awareness on how sexually transmitted diseases can facilitate HIV transmission; 870 reported displacement, eviction, expulsion and family abandonment as a result of being outed as gay; 76 were provided short term shelter support;  we placed in 28 proposals and in all situations were not accepted. We  have witnessed a deliberate tendency for funders to provide money for strategic litigation, contexts for litigation and less for strategic emotional health support.

In a report covering 2010-2017: 52 CBOs have reported need for Organization Development support; 190 LGBTIQQ accessing the online suicide support reported need for anti suicidal support; 330 reported living with HIV and 100 needed monetary support to go to/fro clinics during ARV refill days;  620 young Transgender reported STIs; 550 gay bottom men reported STIs; 1,400 LGBT reported engaging in exchanging sex for subsistence money including seasonal rotational respite housing at sex-partners for a few days;  1,200 reported being unaware of the fact that anal sexual intercourse is a route of HIV or any STI; 1,700 reported a long span between the first  HIV Prevention and testing message to actual testing; 3,860 reported stigma of HIV and homosexuality hinder utilization of HIV prevention services including meeting to discuss HIV; 2,000 reported limited access to health care, HIV testing and treatment; 1,600 reported lack of awareness on how sexually transmitted diseases can facilitate HIV transmission; 900 reported displacement, eviction, expulsion and family abandonment as a result of being outed as gay; 16 were provided short term shelter support; we placed in 18 proposals and in all situations were not accepted. Uganda has what is called an invisible council to whom funders "refer" all proposals. It is a pity these ones lock out any other organizations except those they have worked with.  Organizations that  were originally provided money for strategic litigation and contexts for litigation over so many past years, can now afford better offices and better facilitation. Those dealing with case-based issues and strategic emotional health like ours are not supported. So, we cannot provide attendant services although we have remained invested in providing some form of interventions including media advocacy. We deliberated on this in: http://kampalagaynews.blogspot.com/2017/09/kampala-uganda-open-letter-to-funders.html.

There are advantages in supporting LGBTIQQ-friendly organizations and creation of support spaces where tailored services are provided. We have a case from Atlanta we want to share with you too.

Daniel Driffin, 31, is co-founder of the non-profit THRIVE SS. He was 22 when he was diagnosed with HIV.  Driffin is HIV-positive, diagnosed in the summer of 2009, when new HIV infections among black gay men 13 to 29 years old exceeded new infections among white men who have sex with men aged 13-29 and 30-39 combined.

According to the Centers for Disease Control and Prevention, black gay men like Driffin were the only population group in the United States to experience a statistically significant increase in new HIV infections between 2006 and 2009. While HIV incidence was relatively stable among men who have sex with men overall, new HIV infections among black gay men ages 13-29 increased 48 percent. The HIV infections for those men rose from 4,400 HIV infections in 2006 to 6,500 in 2009.

Although the analysis did not examine the factors driving the trend, other studies suggested a range of possibilities, including: higher proportions of young, black gay men unaware of their infection than other ethnic groups; stigma of HIV and homosexuality, which can hinder utilization of HIV prevention services; limited access to healthcare, HIV testing and treatment; and higher rates of some sexually transmitted disease that can facilitate HIV transmission.

These are all the things Driffin is waging war against.

Although the analysis did not examine the factors driving the trend, other studies suggested a range of possibilities, including: higher proportions of young, black gay men unaware of their infection than other ethnic groups; stigma of HIV and homosexuality, which can hinder utilization of HIV prevention services; limited access to healthcare, HIV testing and treatment; and higher rates of some sexually transmitted disease that can facilitate HIV transmission.

Thirty years ago, none of this may have mattered. During the darkest days of the epidemic, 1980s and ’90s, AIDS was almost always fatal. Now, not only are more people learning their status, but people are also living longer thanks to updated treatment guidelines in 2012 that recommend treatment for all people with HIV infection.

That was not the case in 2009 when Driffin received his diagnosis.

Driffin had been getting annual HIV tests since his 17th birthday, the year he had his first sexual encounter.

But when the April 25, 2008, date rolled around, Driffin didn’t notice until nearly two months later.

“One day in June, I thought to myself I should go get tested,” he said. “I walked into the agency, pricked my finger and 15 minutes later, I was told I was preliminary positive.”

Driffin was shocked.

“Well, you know what this means?” the prevention specialist asked.

Driffin told him that he didn’t. He was confused. If someone just walks into an agency to get tested, how would he know what it means, Driffin thought.

“It’s like your doctor showing you an X-ray and expecting you to know how to decipher it without any medical education,” Driffin remembered.

That ended the conversation.

Driffin walked out and called a friend, a nurse practitioner who is also black and gay. For the next hour, he listened to Driffin. His was a beatable diagnosis, he told him, but he would have to decide what he wanted to do.

Driffin called more people that night, subconsciously building his support network and re-emerging from the closet he’d retreated to on the day his parents sent him off to Morris College in Sumter, S.C.

It wasn’t easy.

Driffin had known he was “different” since elementary school. But it wasn’t until 2002, while in middle school, that he began to accept that he was gay.

“I started working at a library in the eighth grade and one day putting books away, I started reading different ones, especially those with homosexual themes,” he remembered. “I borrowed a couple of the books and took them home.”

When his grandmother and legal guardian found one, she asked if he was gay.

“I said, ‘Yes,’ and she said, ‘Regardless, I want you to be the safest, and I love you,” Driffin said. “I was lucky to have my grandparents not throw me out on the street.”

He was also lucky to attend a high school — Wilson Magnet in Rochester, N.Y. — that made it easy for him to come out, to be in a place that was affirming for LGBTQ students and encouraged them to be themselves.

Now, he was leaving that for a Baptist-owned historically black college.

“To be from the North was one thing,” he said. “To be gay at a religious institution was another. ”

Driffin retreated to the closet. Revealing his sexual orientation, he believed, would disqualify him from joining the fraternity he’d dreamed of pledging since the early days of Rochester Step Off, a black Greek competition.

Despite his fears, Driffin excelled both socially and academically at Morris. He consistently made the Dean’s List. For three years, he was captain of the Honda Campus All-Star Challenge. He was a member of the Science Club and Show Choir.

“That allowed me to be with students for whom sexuality wasn’t the first thing they worried about,” he said.

In 2008, he graduated at the top of his class, earning a bachelor of science degree in biology.

He was traveling back to Rochester with his grandmother for a job interview when his grandfather suffered a stroke. They immediately returned to South Carolina.

It was there that Driffin received his HIV diagnosis.

“It was scary and daunting,” Driffin said. “I decided I wasn’t going to be sexual again because it was easier not talking about HIV than to go through the disclosure process every time.”

Three weeks later, Driffin returned to the same clinic for a confirmation test. It came back positive.

He was 22, one of the thousands of young black gay who made up the 48 percent increase in HIV diagnosis from 2006 to 2009.

The news was numbing.

“I felt like a statistic,” he said.

By 2012, he said, his viral load had dropped but his white blood cells had started to decline. Doctors finally prescribed a single dose regiment.

Driffin was sure now that there was something amiss within the medical system.

“I wasn’t the only one who didn’t get medication to suppress the virus,” he said. “More times than not, doctors are not recommending medication for black gay men immediately after testing positive. If someone is not in care, can’t afford care or have poor experiences with medical providers, they are more at risk for transmitting HIV.”

These are the biggest drivers of the continued increase in HIV infection among black gay men, Driffin believes.

According to a Lancet study, black gay men are six times more likely to have an undiagnosed HIV infection and 60 percent less likely to receive treatment. That, in turn, means their condition is more likely to deteriorate, and they’re more likely to pass on the virus to other black men they date because of smaller sexual networks.

In 2009, Driffin began working at a Florence, S.C., community health center, providing HIV tests to black gay men. When a CDC testing grant ran out 18 month later, Driffin moved to Atlanta where he continued work at a community-based organization.

He left there to manage a 670-person research study for six years examining new approaches to HIV testing.

“While doing that, I was still seeing more than 100 people yearly who were either testing positive for HIV or sexually transmitted disease,” Driffin said. “I began thinking about different approaches to assisting brothers to stay negative or, if they were positive, how to get them in care.”

So he and a group of friends co-founded the Young Black Gay Men’s Leadership Initiative and later the support group THRIVE SS or Transforming HIV Resentment into Victories Everlasting Support Services. Currently, there are some 700 black men living with HIV in the THRIVE SS network in Atlanta. Other networks, including one for women in Atlanta, are located in Oakland, Calif., Nashville and Washington, D.C.

He hopes to create non-traditional ways to solving HIV in the black community by “beefing up research capabilities and support systems here and across the country.”

Driffin, who is currently working to complete his master’s degree in public health at the Morehouse School of Medicine, wants black gay men to know they don’t have to live in isolation with HIV.

“You live in systems created against you, and you have the power to change it, he said. “Involve yourself in the policy structures. Place yourself on boards and agencies that decide healthcare in your community. Ask questions. If something doesn’t make sense, say it doesn’t make sense. Speak up when you hear inaccuracies about black gay men.”

For more read: http://specials.myajc.com/black-men-HIV-4/

Daniel Driffin inspired inspired this story