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Anti-HIV Drug Could Help Reduce Infection Rate Disparity

Mandie Trimble
A year ago, Jeremy Brown (r) told his family he is gay. Brown said the decision eventually led him to learn about a drug that could help protect him from an HIV infection.

The Federal Centers for Disease Control recently published a startling prediction. The CDC estimates 1 in 2 African American gay men will contract HIV during their life. Cultural and socioeconomic challenges remain top reasons. WOSU sat down with a young, gay black man who says his coming out propelled him to take steps to protect himself from getting HIV.

Jeremy Brown, of Columbus, has a beaming, broad smile. The six foot five, 24-year-old goes by Jay Artist. He’s an aspiring singer/songwriter.

"I’ve already been in two musicals, and I’ve been working on recording my first EP, if you will, my first album. I’m in the writing process right now.”

Brown is HIV negative. But like other black gay men, Brown has a 50 percent chance of contracting the virus in his lifetime, according to the CDC. Compare that to 1 in 11 white gay men. 

Brown decided four months ago to get on a daily regimen called PrEP. PrEP stands for Pre-Exposure Prophylaxis. Simply put, it prevents an HIV infection when someone is exposed to the virus if they’re on the pill. Studies show it’s up to 99 percent effective.  

Recently, Brown met with a nurse practitioner at the ARC Ohio Medical Center and Pharmacy in the Short North where he gets his medicine.

“So basically no missed doses in the last week. How many in the last two weeks? In the last two weeks, maybe one or two. Not going to lie about it. Like we said last time, from going to not taking any medication at all to taking a medication everyday it can be kind of weird.”

“Growing up as a black gay man, it’s kind of like it’s easier to tell your family that you have cancer than tell your family that you’re gay," Brown said. 

Brown’s is a common sentiment in his community. Many face stigma, homophobia and violence within their own race. Brown, who grew up a preacher’s kid, was taught “abstinence only.” These concerns can discourage men from seeking testing and treatment.

“There are a thousand Jays in this city," said MimiRivard. 

Rivard is an ARC-Ohio nurse practitioner who works with Brown. 

“Young men in this demographic come in and they see the post about PrEP on the wall and they say, ‘What is that?’ They’re here for their first HIV visit. We’re too late.”

CDC figures show HIV diagnoses in young gay and bisexual black men increased 87 percent in the past decade. The youngest – 13 to 24 year olds – remain most at risk.

Here in Franklin County, black gay men made up about a third new HIV diagnoses, last year, according to the state health department.

Rivard blames the numbers on the failure of the public health system and institutional racism.

“What we’re seeing is the way that most infectious diseases have moved in our country to disenfranchised poor populations with lack of access to health care," Rivard said. "We have examples of this over time, like tuberculosis. We’re seeing it now in HIV.”

Andrew Delollo oversees programs at the Greater Columbus MPowerment Center, an outreach group devoted to HIV prevention among young gay men of color.

Delollo describes the black gay dating community as “tight knit,” which he says contributes to the higher HIV rate.

“So it’s not that they’re having riskier behaviors or having a lot of unprotected sex, but the pool of individuals is smaller, so it increases their chances of getting HIV.”

But Ryan Hair, who works with Delollo and is an HIV counselor, said many people are not practicing safe sex. And for that reason, Hair said PrEP should be at the forefront of prevention plans.

"People don’t use condoms. Obviously we’re seeing that if you look at the numbers and see that the infection rate is still going up," Hair said. "So, instead of preaching condom use, they should’ve been preaching PrEP or trying to figure out PrEP a lot faster.”

While some medical experts say PrEP discourages condom use, others say it is the answer to slowing the spread of HIV.

For Jeremy Brown, he said facing potential persecution by coming out may have saved him from an HIV diagnosis down the road.        

“I thank God that I did have a chance to meet Mimi [Rivard] and get on PrEP.”

Now, Brown has made it his mission, his duty to tell others how to keep themselves healthy and HIV free.