49th place goes to Philadelphia County

49th place goes to Philadelphia County

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As a Black gay man who came out in 1994, I remember how the AIDS epidemic cut short so many lives.  These days, Philadelphians worried they have been exposed to HIV have access to post-exposure prophylaxis (PEP). People who do contract HIV can access effective treatment plans. And for anyone who thinks they are high risk (me!), pre-exposure prophylaxis (PrEP) is increasingly available in Philadelphia. In the 1990s, these treatments were unfathomable to so many friends I lost.

So, why doesn’t this encouraging picture of HIV apply everywhere? Or to everyone?  According to the Centers for Disease Control, African-Americans accounted for 44 percent of HIV diagnoses in 2016, despite comprising only 12 percent of the population — and the disproportion seems to be growing. That year, HIV diagnoses among African-American gay and bisexual men aged 25-34 increased by 30 percent. If you are a young gay Black man in America, you have a 1-in-2 chance of contracting the virus — compared with a 1-in-11 chance if you are a white gay man.

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This is not good for gay men and trans women of color in the wealthiest country in the world. It is time for Philadelphia’s Black LGBTQ community to do what lawyer and advocate Randall Robinson says: develop a “crowd-sourced understanding of what a community needs.” As a collective, we need to come up with 10 demands for our nonprofit organizations, public health officials and medical providers, who continue to make millions of dollars off the backs of Black and Brown gay men and trans women.  It is time we start judging these institutions by how our community is impacted due to their decisions.

This means we can no longer wait for federal, state and local systems to tell us what we need. Out of 3000 counties in the U.S., Philadelphia County has the 49th highest rate of HIV infection. The standards and programs here are not working for our communities. Philadelphia’s LGBTQ community is hyper-segregated and has a lot of health inequality, which is why activists are searching for ways to address this disparity in our city.

We need to create an equity-assessment program for the city of Philadelphia, ensuring every city agency assesses its programs, policies, procurement, leadership and hiring practices. Moving forward, we need to demand ALL  health programming is executed through a lens of equity.

Our lives depend on it! 


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