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Aids research in the United States has often focused on gay white men because the virus was identified early in that group and they developed an effective lobbying voice.
But a clinical trial by the Aids Research Consortium of Atlanta, Georgia, is focusing on gay black men, who are not as well organised but have a higher incidence of the disease. The trial aims to determine whether an Aids drug is safe for people who are negative for HIV, the virus that causes Aids. It has stirred debate among participants and researchers about gay sexuality within the black community and its attitude to safe sex. "The black gay community has become complacent about HIV and STDs (sexually transmitted diseases) as a whole," said Duncan Teague, recruitment co-ordinator for the project. "A lot of people in the black gay community are looking for love, so they have sex because they think that means that that person loves them," Teague said. Blacks make up around 12,8% of the US population but comprised 50% of new diagnoses of HIV in 2003, according to data from the Centres for Disease Control and Prevention and the US Census Bureau. In Georgia, 78% of people diagnosed with Aids and 81% of people diagnosed with HIV in 2005 were black, as were almost all of the women who were newly diagnosed, said Melanie Thompson, the trial's lead investigator. "African-American men are disproportionately affected by HIV and underrepresented in clinical trials. We're testing in order to know whether a drug is safe for the people who will ultimately use the drug," she said. "While the study is open to men of any race, we are working hard to enrol as many men of colour as possible." The trial involves giving daily doses of the drug tenofovir, an anti-retroviral drug and marketed as Viread, to men. Participants, who could also be given a placebo, complete a computerised questionnaire about their sex lives and get risk-reduction counselling and condoms at every visit. As a control, half the group don't receive the drug for the first nine months to see if taking a pill that might potentially make them less likely to contract HIV might encourage men to take more sexual risks. It's part of a long-term project that includes similar studies in Botswana, Thailand and elsewhere to determine whether a drug that suppresses the Aids virus could one day be used as a prophylactic to prevent people from contracting it. Researchers said one reason for the reluctance of blacks to participate in the study is the legacy of the notorious 40-year-long Tuskegee experiment, which was exposed in 1972 and led to an apology by then president Bill Clinton on behalf of the government. In that experiment, the US Public Health Service, starting in 1932, told 400 blacks with syphilis in Alabama they had "bad blood", leaving the syphilis untreated to study its long-term effects on the body. Some 43% of men enrolled in the Aids drug study are black but many others were reluctant to take part because of misunderstandings about what the study entails and fear within the black community about clinical trials, Thompson said. "My first question was 'wait, are you going to inject me with the HIV virus?'," said Dorrington Poitier, who is now taking part. Atlanta is considered by some the gay capital of black America and gays organise an annual gay black pride festival on the Labour Day weekend. Despite the large numbers of at-risk men, researchers said lack of organisation within the gay black community had made it harder to promote awareness about Aids. Another underlying reason for the prevalence of HIV infection was the stigma still attached to homosexuality within some parts of the black community, which left gay men vulnerable to a degree of social isolation that made poor choices on safe sex easier. "People within the black community say 'It's fine to be gay but … don't wear it on your sleeve. They see black as something you can't really hide but they don't want you to be gay in public," said Anthony McWilliams, a project organiser. Source: thestar.co.za |
