Hunted by the State: How HIV Advocacy Has Failed Black Folks

"The Negro death rate and sickness are largely matters of condition and not due to racial traits and tendencies.” – W.E.B. Du Bois

I think I am suppose to start with a story, right? I mean, that is how this goes, correct? I was closeted. I didn’t think anyone loved me. My family is Black, therefore homophobic, therefore incapable of offering me safety. He was five years older than me. I was eighteen and lonely. I loved him. He humored me. I didn’t wear a condom because I felt little reason to protect myself. If only I had someone to confide in. If only I loved myself more. I know better now. I would never want anyone to follow my same path. I am living through my mistakes. I am not my HIV. We can live long lives too. I won’t let this stop me. I will not let this stop me. This will not stop me.

Above I have positioned myself as the protagonist in some teenage redemption series and you (my audience) are left wet, waiting to hear what happens next. Do I find love again? Does my family ever become a site of comfort? Did my partner know he was HIV positive and give it to me maliciously? These are some of the questions that landed lily white, former Who’s The Boss character turned P.F Chang’s manager Danny Pintauro an interview on The View. These are the questions that make Charlie Sheen’s HIV “outing” national news. These are the very questions that currently has Michael “Mandingo” Johnson sitting in a cage serving a 60 year prison term. But, most importantly, it is these questions that systemically distract us from the “matters of condition” that W.E.B. Du Bois so graciously warned us about.

You want to hear another story? The moment after the nurse told me my results were positive, instinctively, in a way only Black folk would understand — a warm current flushed throughout my entire body chanting, “They got me.” And in that moment I did not need a book to teach me who the “they” were I was referring to. I did not have any groundbreaking analysis to unearth the significance of the word “got” in that sentence. No, all I had was “me,” and what I know to be true after living twenty-one years in this country and in this skin — I am being hunted. This fact was made ever more present in that room as I looked up, past the nurse, to a poster behind her head that read, “1 in 3 Black men will contract HIV in their lifetime.”*

In the book Anti-Black Racism and the AIDS Epidemic: State Intimacies, author Adam M. Geary highlights the two prominent modes of analysis implemented within HIV/AIDS discourse: Biomedical Analysis vs. Materialist Analysis. Currently the analysis framing all of our conversations around disease is that of the biomedical. What the Biomedical Analysis does is center “risk” around individuals. biomedical analysis asks us how many sexual partners have we had. It asks us when was the last time we were tested. It asks us if we took our pills this morning — or rather, have we considered PrEP? Largely, the Biomedical approach wants to know what you did, what you didn’t do, what you are doing, and how you plan on fixing things.

The materialist analysis (contemporarily known as the political economy of health or social medicine or social epidemiology) on the other hand asks an entirely different set of questions. Instead of asking what you did, the materialist analysis asks, “Where do you live?” It asks, “How much income does your family bring in each year?” It asks, “What access do you have to health care?” The materialist analysis understands “risk” begins within the societal structure and not within the individual.

“In this way, the socially produced conditions of urban despair fulfilled their historical function in being the incubators of epidemic, with the HIV epidemic being only the more recent example rather than something exceptional.”

– Adam M. Geary

The best and most telling example of how biomedical analysis perpetuates a victim blaming, anti-Black ideology can be cited in the remarks of our very own Centers for Disease Control and Prevention. Though on the CDC’s website they make a point to implicate poverty as one of the deterrents for Black people in the fight against HIV — in a data reporting the CDC doesn’t fail to herald their Biomedical, white-supremacist, racist fuckery. This reporting begins by stating, “While the overall number of HIV cases has dropped in the U.S., two groups are seeing a sharp increase.” The report then proceeds to explain that HIV cases have increased by 87 percent among gay and bisexual Black and Latinx men. The most telling aspect of this entire report is the CDC’s take on the reason for such an occurrence, “part of the problem is many in that community do not use condoms.”

To say a critical reason Black people account for only 12 percent of the U.S. population yet nearly half of all newly infected HIV cases each year, is simply something Black people are doing — is anti-Black. However, this isn’t the first time “Black behavior” is blamed for Black suffering. If only he wasn’t wearing a hoodie. If only she listened and didn’t keep running her mouth. If only he didn’t take his hands out his pocket so fast. If only he didn’t shoot himself — while handcuffed in the back of a police car.

It is also important to note that this sort of rationale isn’t only particular to “them” but we, Black people, also tend to cite such anti-Black logic ourselves. When we say statements such as, “HIV/AIDS is God’s reckoning for the deviance of the gay community,” we actively participate in a white supremacist agenda, that in turn kills us and resurrects a bolder, whiter, more resilient Jesus.

Dictionary.com defines epidemic as “a widespread occurrence of an infectious disease in a community at a particular time.” The word I wish for us to pay most attention to in this definition is “community.” The greatest advances in population health, especially in the twentieth century, were predicated on raising the general health of populations through social investments in drinking water, nutrition, safe housing, sanitation, and environmental safety, among other social investments. With this in mind, we can not properly have a conversation about HIV within the Black community without also having a conversation about gentrification, or minimum wage, or food justice, or gender justice, or climate change, or poverty, or most importantly prison.  

“The effect of mass incarceration on Black-White health disparities is greater than the effect of access to healthcare and may even be greater than standard measures of socioeconomic status associated with health, including employment.”

– Health Sociologists Michael Massoglia

Soon after I became more and more comfortable telling people about my status, I began to feel a shift. I found myself being called upon to speak on panels, at schools, and other HIV/AIDS related events. All of this before I really began to do my own research and discovery. The only thing I had to offer to these different spaces was my “story.”

If it is true that one in two gay Black men will contract HIV in their lifetime, what then happens to our other brother when we are only invested in the story of the one who got “it”? What then happens to our Black women, or our trans and gender non-conforming siblings still at risk? Before I was captured — I was the one hunted. Which is to say, no matter which half of the two a Black person represents in that statistic (or if they’re directly represented at all) — we are still all implicated.

When we base how we organize around HIV off the leadership of only those with a positive status we once again play into the biomedical agenda to individualize this disease. HIV is state-sanctioned violence, similar to police brutality. Both operate as a means of mass subjugation by the state. Both desire to reach towards the control or end of our living bodies. Both occur most frequently in populations that experience high structural vulnerability. However, rarely do we question why police brutality affects us all as Black folk, whether a cop shoots us personally or not. It is largely understood that whether or not you, or your brother, or your sister, or any other relative was the one brutalized — it is still an issue that implicates us all. This is how we must begin to think when we talk about HIV or more importantly the greater Black health crisis.  

In the words of Geary, “HIV isn’t anything exceptional” — other than the fact that it garnered the Black queer community visibility as well as funds. However, visibility in correlation with capitalism once again fulfills its primary function of distracting us from the bigger picture. Moving forward in our advocacy we must center Black health in all HIV/AIDS discourse, and not just positive folks — that is if we’re truly interested in raising the health and well-being of all Black people facing health disparities and not just the one’s wearing a red ribbon.

All of the most effective organizing and advocacy work around social change begins by centering the community most affected. In this case, the community most affected when we talk about HIV disparities is that of the impoverished who have the closest proximity to experiencing life in prison. Recently the World Health Organization, who analyses data from 15 countries, found that Black transgender women are nearly 49 times more likely than the general population to contract HIV. This is no surprise given that trans people are nearly four times more likely to earn less than $10,000 a year.

However, where the World Health Organization as well as all of these data collection groups fails in their research — and in turn fails Black people — is that it doesn’t account for our gender non-conforming community. The reason that perceived trans women are 26 percent more likely to lose a job due to bias, or 50 percent more likely to be harassed on the job, or 20 percent more likely to be denied housing, is because their very gender is being read as illegitimate — in that it doesn’t conform neatly into the standard of white femininity.

It is this “non-conformity” which is the root of transphobia and transmisogyny.  It is this “non-conformity” that we must allow to empower our liberation/resistance movements given that — much like religion, language, and disease were enforced upon Black people during colonization — so was the gender-binary as well. In this case, the act of me still only being able to perceive my body as “male” or “man” contributes as much to the strengthening of this prison that is HIV, as does poverty. Which is why for the sake of my life, the future of my people, and the credibility of my work — I can no longer continue to do so.

“The tragedy of illness at present is that it delivers you helplessly into the hands of a profession which you deeply mistrust.”

-George Bernard Shaw

Iatrophobia is defined as an abnormal or irrational fear of doctors or going to the doctor. However, this commonly used definition doesn’t accurately account for the fact that this word was first birthed from the interactions of the Black community and the medical industry. This definition also fails when it chooses to use a word such as “irrational.” Such a fear cannot justifiably be deemed irrational when historically this country’s medical industry has used Black people as test subjects (often times to their determent) for the advancements of western medicine. When all the state has shown you is its desire for your demise and disenfranchisement, how then could one’s distrust of it be deemed irrational? Which brings me to my final question: What are we talking about when we’re talking about “the state”?

It has become all too common practice in “social justice” spaces to replace critical analysis and critical thought with popularly used and easily digestible “buzzwords.” A few examples of such terms are: intersectionality, transformative justice, and respectability politics, just to name a few. I bring this up to say I see a common trend arising around the use of the term “the state” as always an abstract with very little effort to unpack what one actually means. In an effort to undermine this trend I wish to clarify what I am saying when I say “the state” in reference to HIV/Black Health advocacy.

When I say the state I am referring to the cultural pathology that positions Black people as disposable therefore worthwhile specimens for experimentation, yet unworthy of proper care and sustainability. When I say the state I am referring to the Tuskegee Syphilis Study in the 1970s to the 1996 jailing of poor Black mothers who were unwitting research subjects in South Carolina, to the 1998 infusion of poor Black New York City boys with the cardiotoxic drug fenfluramine. When I say the state I am referring to a history of bigotry and patriarchy shrouded in anti-Blackness. However, more supremely, when I say the state I am referring to a prison I rededicate myself each and every single day, to abolishing!

Timothy DuWhite  (pictured above) is a Black, queer, poz-writer/artist/nigga based out of Brooklyn, NY. A majority of his work circles around the intersections of state & body, state & love, and state & mind. All Timothy desires is a different/newer world for his sha-daughters, and believes the written word is one tool that could be used towards achieving that goal. This originally ran onRaceBaitR.

[*Editors note: According to the CDC, one in 20 Black men will become HIV-positive in their lifetime. For gay and bisexual Black men, the number rises to one out of every two.]