What does it take to support a young black or Latino gay man who may be at risk of contracting HIV? A few years ago, a national phone company produced a commercial in which one man on his phone turned around and saw hundreds of employees behind him, supporting him with his phone service. Wherever this one man went, they followed him for the long term. Ideally, HIV prevention programs would want to consistently follow young men of color who have sex with men (YMSM) as they negotiate intimacy, safety from potential violence, safer sex and more – providing them similar support to that phone service. There is a looming myth that HIV prevention can occur in a moment, but actually this process takes a long time of following and engaging.
Many young gay men face homophobia in the communities in which they live. They also face poverty, looking for shelter (if they have been kicked out of their homes), lack of jobs and education, lack of support from families, and not enough mentors with whom they can have difficult discussions. As an example, who can talk to a gay youth of color about negotiating foreplay, anal and oral sex, and then counsel him about school and jobs? Where are they supposed to find the support they need? What makes the situation worse is these youth are too often considered forgettable and dispensable—unless they have a sexual service to provide. These factors, plus other complexities, place YMSM at the epicenter of the HIV epidemic with disproportionately high transmission rates – not just in NYC, but nationally. As such, programs which seek to engage young men, help them stay healthy and invest in their future are critical.
At GMHC, Outstanding Beautiful Brothers (OBB) is one program serving YMSM that has been highly effective. OBB is structured like a typical black fraternity - one that creates a family while also offering these young men a variety of services that emphasize wellness and empowerment. The program provides opportunities to build social support networks, experience a sense of brotherhood and family, and improve their self-esteem (in part by connecting to others with similar histories in the group). Speakers regularly lead discussions on topics such as domestic violence, suicide prevention, gender identity, and the risks of sex work. Nearly 50% of these young men in this program stay connected to GMHC for 6 months or longer, which helps staff to follow them as they help to build their life skills.
OBB staff members go to nightclubs, parks, churches, adult video stores, and bus stations to first talk to YMSM and encourage them to join the program. Once the young men feel safe to visit GMHC, OBB staff can address the deep-rooted issues of homophobia, which deeply stigmatizes young men, and causes them to be susceptible to depression, substance use, abuse and violence – all of which can lead to engaging in risky behavior that can result in HIV and other sexually transmitted infections.
The tragic part of this story is the city and federal funding for these programs are being cut—which is “penny wise, pound foolish.” In September, the five-year federal grant that funds OBB expires. Jeremy Ortman, Coordinator of Young Men’s Prevention at GMHC, expressed hope that people will understand the impact of these critical programs, especially OBB, “Without new funding, this HIV prevention program, which is crucial to YMSM in NYC, is in serious jeopardy – despite the success of the program, and despite our target demographic being one of the groups at greatest risk of contracting HIV.”
While it is true we are losing money, we must not lose our commitment to young gay men. We can partner with other community-based organizations, faith communities, schools and other group to continue our work. We must continue to search for new funding sources as we raise awareness about decreasing funds of prevention programs. The world needs to be safer, promising and hopeful for young gay men. The investment ultimately pays off as we work to decrease new HIV infections and young gay men can move forward and make fruitful contributions to their communities.
Dr. Marjorie Hill is Executive Director of the Gay Men's Heath Crisis (GMHC) in New York City.