The Underlying Truths of HIV in Our Black and Brown Communities

[Music]

i’m

only human how many of us have ever

heard or said this phrase before

do we think about what this phrase is

actually saying

you know as a noun the word human is a

human being especially someone is

distinguished from an animal

or in science fiction an alien

this phrase gives us room to be patient

with ourselves as we acknowledge that as

humans we’re still whole and valuable

even in unfortunate situations

today join me in a journey as i walk

through the three underlying truths of

hiv in our black and brown communities

now i’m a guy who forgets a whole lot no

honestly i know you’re probably at home

thinking to yourself how is this guy

giving a tedx talk if he forgets so much

and trust me if i told you about all my

forgetful adventures you’ll probably

fall off your seat laughing at home

but if you’re like me a guy who forgets

a lot

i try to remember the three underlying

truths of hiv by putting them in an

acronym

s m h now i already know what you’re

thinking

shaking my head right all right well

you’re close

all right not really the smh stands for

stigma

minority stress and health disparities

and it’s important that everyone knows

about this acronym because hiv is not

just an issue for some people

it’s your issue it’s the community’s

issue

it’s the world’s issue and while this is

an issue that we’ve been combating for

years on end

hiv still is not as black and white as

we all hope it would be

many times hiv is mistakenly thought to

be interchangeable with aids which is

far from the truth so today we’re going

to comb through some of that together

the first letter in hiv stands for human

human human immunodeficiency

virus this virus compromises one’s

immune system

while interfering with the body’s

ability to fight off organisms that

cause disease

aids or acquired immunodeficiency

syndrome

is the most advanced stage of hiv that

leaves the body vulnerable for

life-threatening infections

now i know this sounds confusing trust

me because i’ve been there before

but try thinking of it like this without

being in care

and adhering to medication hiv can

progress to aids

and as it’s important to know the

difference between the two it’s

just as important to know about the data

behind it and how it’s affecting our

communities that we live in

in the state of wisconsin one in three

or 35 percent of black gay men are

estimated to be living with hiv

in their lifetime compared to ten

percent of

gay latino men and four percent of the

white counterparts

this trend of black gay men being

disproportionately affected goes all the

way back to the beginning of the aids

epidemic

and according to the wisconsin hiv

surveillance annual report

during 2019 ethnic and racial minority

groups made up just

18 percent of the state’s population

while accounting for 68 percent of new

hiv diagnosis

but why is that black men know what hiv

is

we know what condoms are we’ve been

conditioned to look at this data

and hold it at its face value instead of

thinking of the data as if it’s a

as if it’s an onion with multiple layers

of findings that give us a true scope

into how to really truly alleviate the

problem

now don’t get me wrong i’m not bashing

data we need data

it’s our starting point but i think it’s

imperative that we pull back those

layers to truly identify and capture

the why so let’s lean forward a little

bit

how do you define the disapproval or

discrimination against someone based on

their sexuality or the characteristics

the first word that comes to my mind out

of many is homophobia

because we see it every day but this is

not the word i’m looking for

second word that comes to my mind is

racism the suppression and oppression of

a people from generation to generation

and as that word is important to know

and understand

that’s still not the word i’m looking

for the word

less described and that best fits this

description

is stigma also known as the silent

killer

see stigma serves actively throughout

our everyday ways of life

it’s the stain of ignorance that

includes two other components

prejudice and treating others in ways

that disadvantage the already

stigmatized person

in the part that is the most important

to remember in respects to this

conversation

is the fact that many health conditions

are associated with stigma

including hiv stigma creates pathways to

unfavorable social conditions

hiv transmission and health consequences

for same-gendered loving men of color

a stigma fuels discrimination that

creates unfavorable social conditions

and when an individual is faced with

these unfavorable social conditions

that increases the risk of risky

behavior which then in turn

increases the risk of hiv transmission

for example due to stigma and anti-gay

discrimination

many same gender loving men of color

hold negative internalized ideas and

expressions about

their sexuality due to their family and

or friends

we call this internalized homophobia

being that these men have been

conditioned to view hiv in such a

stigmatizing way

they may not feel safe or comfortable

having conversations about safe sex and

getting tested with their partners

thus increasing the chance of hiv

transmission so picture it

living in a world where you combat

society’s ideology in which

you are not normal and often treated

differently because you have the

audacity to be

well you

what internal discomfort would you bring

on to yourself

would you be able to grow and prosper

and thrive to your fullest capacity

this is the example of millions of

people in our country today

is best measured by the minority stress

model

this model by dr ian meyer proposes that

sexual minority health disparities

can be best explained in large part by

stressors caused by a hostile and

homophobic culture

which then can lead to a lifetime full

of maltreatment

harassment discrimination and

victimization

now stress is an inevitable feeling that

we have throughout our lives

at one point in our lives or another we

look for that new job or

look to move our family into that new

house some of us have babies while the

others

we have puppies this is dahlia

this is my baby and she’s adorable

but she also could be very stressful

these are all examples of positive

stressors that we

encounter all the time throughout our

everyday ways of life

but we also encounter negative stress

also known as distress

throughout our lives as well and while

my dolly here is adorable as a positive

stressor

i’m pretty sure we don’t look at our car

breaking down or a recent death in the

family and think to ourselves oh that’s

adorable

so try to think about how stress can

look for someone who looks differently

than you

not as able as you or even love

differently than you

think of your everyday stressors now

imagine a lifetime of a burden of stress

added to that balance due to your sexual

identity

imagine going to the doctor and bearing

the embarrassment because they

automatically assume

outcomes due to who you love imagine

inquiring about safer sex practices and

getting that gut-wrenching feeling when

they mistake your sexual identity

or imagine wanting to try out for the

football team

and not doing so because you’re scared

of the ridicule and judgment that will

come behind it

those are the experiences of millions of

people

around the world but when i get to

peeling that onion

i start asking myself important

questions one of them being i wonder

what gateways this opens for same gender

loving men of color

what disparities does minority stress

produce for same 211 men of color

health disparities are differences that

are preventable in respects to the

burden of different diseases

you know we hear of these disparities

all the time black women have the

highest infant mortality rates in the

country or

african americans having the highest

rate of diabetes in the country

these differences range from

opportunities for primary health

to access of resources for disadvantaged

populations

when assessing this more we see how this

could ultimately impact one’s

access to medical care due to medical

mistrust and other factors

and throughout the history of our

country it’s no secret that people of

color have been oppressed and suppressed

in many different ways systematically

now imagine how that is for someone who

is of color and identifies as gay

bisexual or queer that’s two strikes

and in 2017 a sample of us adults found

that lgbt people of color were twice as

likely to report discrimination based on

their identity

when applying for jobs and when

encountering the police

now this may seem intolerable to the ear

because these are people’s lives we’re

talking about

real actual lives

and as a way to alleviate this factor

many people rely on their close

relationships where they find love and

comfort

how many of us find love and comfort and

voice of reason within our families

okay friends

religious institutions

now what if i told you these same places

where you found love

support and guidance were the very

places where you face

exile ridicule and judgment

and so many homes around this country

there are millions of young gay men

especially of color who face this

treatment

the society’s norms that we’ve been

conditioned to champion just are not

conducive to the very lives that they

affect

so today we have millions of young gay

black men walking this earth beautifully

designed as is

not only to face ridicule from a larger

society

but to come home to a mirroring image of

what society perceives them to be

now i ask you again when looking at the

data

do we look at these things

working in public health i’ve met so

many amazing people that brought so much

joy to my life many of these people have

been impacted by the stigma minority

stress and health disparities that we

just talked about

but while thinking about everyone that

i’ve met one person sticks out to me the

most

his name is tyrell

terrell grew up in oak creek wisconsin a

suburban city outside of milwaukee just

about 25 minutes away from here

when getting to know terrell he told me

about his story of his younger years and

how he didn’t feel safe and comfortable

in his classrooms

from being teased in school to being

called a at home tyrell just

didn’t feel like he belonged anywhere

then terrell started telling me about a

story about how his adult years evolved

and how he

navigated through dropping out of school

losing his job his car

and battling the then toxic cycles of a

relationship

i remember thinking to myself how is

this young 27 year old man so resilient

after all his turmoil but then it got to

the point of his experience that i was

not expecting

after terrell got out of his toxic

relationship he went to his doctor to

talk about a pill called prep

prep short for pre-exposure prophylaxis

is a pill that people without living

with hiv take once a day to prevent them

from contracting the virus

tyrell said all he did was have to go to

his doctor and have an important

conversation about the pills for him and

do some simple blood work

but i just couldn’t believe that there

was actually a pill this effective at

protecting people from contracting hiv

that’s when terrell found out something

that would change his life forever

terrell waited a couple days to get his

lab results and the doctor called and

said that everything was

negative except for one thing terrell

tested positive for hiv

as i watched terrell spiral down a deep

depression he told me that a lot of

things contributed to his outcome

hiv stigma played a huge role in how

terrell felt about having important

conversations about getting tested in

safe sex with his partner

he also felt like other factors like

lack of inclusive sexual education

due to minority stress living out of

survival

due to health disparities all played a

role in this outcome

that was the last of bad news for

terrell

see terrell started working for a

community-based organization that

focuses on

equity and health for the same gender

loving men of color just like him

here is where terrell learned about

personal and professional development

while learning of many safe sex

interventions

it became a place for terrell to be

himself

a place for guidance a place

to be alive and whole

those words since that day have been

engraved in my heart

to be alive and whole

well today i’m alive and whole standing

in front of you all

not only because i know tyrell because i

am tyrell

my name is stacey tero clark and i’m

only human

just like you but it always didn’t feel

this way

one day around the time of my diagnosis

i was visiting my mom

and she could tell that my morale was at

an all-time low due to my recent

diagnosis

so she told me to go outside and ask me

what i felt

i said mama i don’t feel anything

standing out here in 10 degree weather

with snow on the ground

then she told me to close my eyes and

feel the small gusts of wind

and ask me if i felt weak of course i

said yes because at that point i felt

like i had nothing left

but then she said something that would

eventually turn

my pain into my purpose

she said baby that wind is like your

strength

just because you don’t see it does not

mean it doesn’t exist

have faith with that faith

i am now in a position to provide so

many same gender loving men of color

where opportunities that i did not

have but i can’t do this work alone

how many of you have heard of the

butterfly effect

this theory suggests that with a change

as small as a grain of sand that you

could create

change in a different part of the world

the example best used is when a

butterfly flaps its wings

it creates a natural disaster on the

other side of the world

when i thought to myself this is the

craziest thing i ever heard in my life

who would actually believe that when a

butterfly flaps their wings in kansas

they would create a hurricane all the

way in the atlantic ocean

just from flapping its wings so you know

what i started doing

i waited

i continued to wait

then it all came so simple and small to

me

me being intentional in how i respond to

stigma was me flapping my wings

me educating my family and friends of

the true

facts about hiv is me flapping my wings

and well what i’m doing here in front of

all of you today

well i’m flapping my wings only to know

that

somewhere somehow someone is receiving

this information that they would not

have received

that’s the power that we all have

you don’t have to be living with hiv to

fight the fixed notions of stigma

suppress the actions of minority stress

or alleviate health disparities for same

gender loving men of color

in this world little by little we create

the change

that we want to see so in this moment

right now being man or woman

cisgendered or transgender gay or

straight

black white or brown you have the

ability to either

fan the flame of stigma or quench the

flame

so i ask will you flap your rings with

us

because hiv is not just the issue for

some it’s your

issue too in fact when we look at the

root of the acronym smh

we see how communities treat and see

people who are living with hiv

and so we say in solitude with the many

shades of us

i am strong

i am resilient

i am human so will you join us

will you flap your wings because hiv is

your issue too

thank you

[音乐]

i’m

only

human 在科幻小说中,外星人

这句话给了我们对自己保持耐心的空间

,因为我们承认,作为

人类,

即使在今天不幸的情况下,我们仍然是完整的和

有价值的 黑人和棕色人社区

现在我是一个忘记很多事情的人,不,

老实说,我知道你可能在家里

想自己,如果这个人

忘记了这么多,他是如何进行 tedx 演讲的

,如果我告诉你所有事情,请相信我 我

健忘的冒险,你可能会

在家里笑着从座位上掉下来,

但如果你像我一样是一个健忘很多的人,

我会试着记住 HIV 的三个基本

真相,把它们放在一个

首字母缩略词中

smh 现在我已经知道你是什么了 ‘回覆

想着

摇头 好吧 好吧

你很接近

不是真的 smh 代表

耻辱

少数人的压力和健康

差异 重要的是每个人都

知道这个首字母缩略词 因为 HIV

不仅对某些人来说是一个问题

它是你的问题 它是 社区的

问题,

这是世界的问题,虽然这是

我们多年来一直在努力解决的问题,但

艾滋病毒仍然不像

我们所希望的那样黑白分明,

很多时候艾滋病毒被错误地认为

可以与艾滋病互换,这是

与事实相去甚远,所以今天我们

将一起梳理其中的一些内容,

艾滋病毒的第一个字母代表

人类人类免疫缺陷

病毒,这种病毒会损害一个人的

免疫系统,

同时干扰人体

抵抗导致疾病艾滋病或艾滋病毒的有机体的能力。

获得性免疫缺陷

综合征

是艾滋病毒的最晚期阶段,它

使身体容易

受到危及生命的感染,

现在我知道了 听起来很困惑相信

我,因为我以前去过那里,

但试着

在没有照顾

和坚持服药的情况下这样想,艾滋病毒可能会

发展为艾滋病

,因为了解两者之间的区别很重要,所以了解

两者

同样重要

它背后的数据以及它如何影响

我们生活

在威斯康星州的社区,据估计,三分之一

或 35% 的黑人男同性恋者

一生中感染了艾滋病毒,相比之下,

只有 10% 的

拉丁裔男同性恋者和 4% 的

这种黑人男同性恋者受到

不成比例影响的趋势

可以追溯到艾滋病流行的开始

,根据威斯康星州艾滋病毒

监测年度

报告,2019 年少数族裔和种族

仅占该州人口的 18%,

而 占新

诊断艾滋病毒的 68%

但为什么黑人知道什么是艾滋病毒

我们知道什么是避孕套 我们已经习惯了

看待这些数据

并保持其表面价值,而不是

将数据

视为好像它是一个具有多层发现的洋葱,这些

发现为我们提供

了如何真正真正缓解

问题的真实范围

现在不要 误会我的意思,我不是在抨击

数据,我们需要数据,

这是我们的起点,但我

认为我们必须撤回这些

层以真正识别和

捕捉原因,所以让我们向前倾斜一点

,你如何定义反对或

歧视 某人基于

他们的性取向或特征

,我脑海中浮现的第一个词

是恐同症,

因为我们每天都看到它,但这

不是我要找的

词第二个词是

种族主义,压制和

一代又一代对一个人的压迫,

因为这个词很重要,要知道

和理解

这仍然不是我正在

寻找的词,

描述较少,最适合这种

描述的词

也是耻辱 被称为沉默的

杀手

看到污名在

我们的日常生活中积极发挥作用

这是无知的污点,其中

包括其他两个组成部分

偏见和以

不利于已经被

污名化的人

的方式对待他人,这是最重要的

要记住的部分 这场

对话的事实是,许多健康状况

都与耻辱有关,

包括艾滋病毒耻辱为

不利的社会状况创造了途径

艾滋病毒传播和

对有色人种的同性别爱人

的健康后果 由于

这些不利的社会

条件增加了危险行为的风险

,进而

增加了艾滋病毒传播的风险,

例如由于污名和反同性恋

歧视,

许多热爱同性的有色人种

他们的性行为持有负面的内化想法和表达,原因是 他们的家庭 和/

或朋友,

我们称之为内化的同性恋恐惧症

,因为这些男人

已经习惯于以如此污名化的方式看待艾滋病毒,

他们可能

在谈论安全性行为并

与他们的伴侣接受测试时感到不安全或不自在,

从而增加了艾滋病毒传播的机会

所以图片 它

生活在一个与社会意识形态作斗争的世界中,在这个世界

中,

您不正常,并且经常受到

不同的对待,因为您有

胆量变得

健康

您会给自己带来什么内在的不适

最充分的能力

这是

当今我国数百万人的例子

最好用少数族裔压力模型来衡量

这个模型由 ian meyer 博士提出,

性少数群体的健康差异

可以在很大程度上

由敌对和恐同文化造成的压力源来解释

这会导致一生

充满虐待、

骚扰、歧视和

受害

现在压力是

我们一生

中不可避免的感觉 在我们生命中的某个时刻 我们正在

寻找新工作或

希望将我们的家人搬进新

房子 我们中的一些人有婴儿而

其他人

我们有小狗 这是 大丽花

这是我的宝贝,她很可爱,

但她也可能压力

很大 虽然

我这里的多莉作为一个积极的

压力源

很可爱,但我很确定我们不会看到我们的汽车

抛锚或家人最近的死亡,

然后对自己想,哦,这很

可爱,

所以试着想想压力是如何

寻找某人的 谁看起来

和你

不一样 没有你那么有能力,甚至爱的

方式与你

想象的不同 你的日常压力源现在

想象一生的压力负担

由于你的压力而增加了平衡 性

身份

想象去看医生并

承受尴尬,因为他们会

自动假设

结果是因为你爱的人

不这样做是因为你

害怕随之而来的嘲笑和评判,

这些都是世界各地数百万人的经历,

但是当我开始

剥洋葱时,

我开始问自己重要的

问题,其中一个是我想知道

这为爱同性别的有色人种打开了

什么大门 少数族裔压力

对相同的 211 名有色人种产生了哪些

差异

该国婴儿死亡率最高

非裔美国人死亡率最高

该国的糖尿病发病率

这些差异范围从

初级卫生保健的机会

到弱势群体获得资源的机会。

在评估这一点时,我们更多地看到,

由于医疗

不信任和其他因素

以及在我们的整个历史中,这最终会如何影响一个人获得医疗保健的机会。

国家

有色人种受到

多种不同方式的压迫和压制已经不是什么秘密了

现在想象一下对于

有色人种并认为自己是同性恋

双性恋或酷儿的人来说是怎样的,这是两次罢工

,在 2017 年,我们成年人的样本

发现 lgbt

在申请工作和遇到

警察时,有色人种报告基于身份

的歧视的可能性是

现在

两倍 这个因素

很多人依靠他们的亲密

关系找到爱和

安慰 我们中的许多人在我们的家庭中找到了爱、安慰和

理性的声音

好吧朋友

宗教机构

现在如果我告诉你这些

你找到爱

支持和指导的

地方 正是你面临

流放嘲笑和审判的地方

以及周围有这么多家庭的地方 这个国家

有数以百万计的年轻男同性恋者,

尤其是有色人种,他们面临这种

待遇

我们习惯于拥护的社会规范

利于他们影响的生活,

所以今天我们有数百万年轻的同性恋

黑人男子走在这条路上 地球

设计精美,

不仅是为了面对更大社会的嘲笑,

而且是为了回到

社会对他们

现在的看法的镜像我在查看数据时再次问你,

我们是否会看到这些

在公共卫生中发挥作用的东西? 遇到了

很多了不起的人,他们给我的生活带来了如此多的

快乐

我们

刚刚谈到的,

但在想到我遇到的每个人时,

一个人最让我

印象深刻的是,他的名字是 tyrell

terrell,在威斯康星州橡树溪长大,是密尔沃基郊外的一个

郊区城市,

离这里大约 25 分钟路程。

知道特雷尔,他告诉

我他年轻时的故事,以及

从在学校被戏弄到

在家里被称为娘娘腔,

他在教室里是如何感到不安全和舒适的。

告诉我一个

关于他成年后如何演变的故事,以及他

如何通过辍学、

失去工作、失去汽车

以及与当时有毒的关系循环作斗争。

他所有的动荡,但后来到

了他的经历,我

没想到

在特雷尔摆脱了他的有毒

关系后,他去看医生

谈论了一种叫做 p 的药丸 rep

prep 暴露前预防的缩写

是一种药丸,没有

感染艾滋病毒的人每天服用一次,以防止

他们感染病毒

泰瑞尔说,他所做的只是去看

医生,并

为他就药丸进行重要的交谈 并

做一些简单的血液检查,

但我简直不敢相信

实际上有一种药丸能如此有效地

保护人们免受艾滋

病毒的

感染 医生打来电话

说,

除了一件事特雷尔

的艾滋病毒检测呈阳性外,

一切

都是阴性

的 与他的伴侣

进行了关于接受安全性行为测试的重要对话,

他还觉得其他因素,例如

由于缺乏包容性性教育

少数族裔

因健康差异而无法生存的压力都

在这一结果中发挥了作用,

这是特雷尔的最后一个坏消息。

特雷尔开始为一个以

社区为基础的组织工作,该组织

专注于

热爱同性的有色人种提供公平和健康 就像他一样,

这里是特雷尔学习

个人和职业发展的地方,

同时学习了许多安全的性

干预措施。

它成为了特雷尔成为

自己

的地方 一个指导的地方 一个活着的地方

今天我还活着,身体健康,我还活着,全身心地

站在你们面前,

不仅因为我认识泰瑞尔,因为

我是泰瑞尔,

我的名字是 stacey tero clark,我

只是和你一样的人,但它总是没有

在我确诊的那天,我没有这种感觉,

我去看望我的妈妈

,她可以看出我的士气

由于我最近的诊断而处于历史最低点,

所以她让我出去 一边

问我感觉如何,

我说

妈妈,在 10 度的天气里

,地上有雪,我感觉不到任何东西,

然后她让我闭上眼睛,

感受一阵阵风

,问我是否感到虚弱 当然,我

说是的,因为那时我觉得自己

一无所有,

但后来她说了一些话,

最终将

我的痛苦变成了我的目标,

她说宝贝,风就像你的

力量,

只是因为你没有看到它并不

意味着 它不存在

有这种信念

我现在有能力提供这么

多热爱同性的

有色人种我没有

机会但我不能独自完成这项工作

你们中有多少人听说过

蝴蝶效应

这个理论表明,

只要一粒沙子的变化,你

就可以

在世界的不同地方创造变化,

最好的例子是当

蝴蝶拍打翅膀时,

它会在地球的另一边造成自然灾害

我想的世界 我自己,这是

我一生中听过的最疯狂的

事情,谁会相信当一只

蝴蝶在堪萨斯州扇动翅膀时,只要扇动翅膀,

它们就会在大西洋上制造一场飓风,

所以你

知道我开始做什么

我 等待

我继续等待

然后一切对我来说变得如此简单和渺小

我有意识地回应

耻辱是我扇动翅膀

我教育我的家人和朋友

关于艾滋病毒的真实事实是我扇动翅膀

,以及我是什么 我

今天在你们所有人面前做得

很好我拍打着我的翅膀只是

知道在

某个地方有人正在以某种方式收到

他们不会收到的信息这

就是我们所有人都拥有的力量

你不必活着 与艾滋病毒

对抗耻辱的固定概念

抑制少数压力的行为

或减轻这个世界上

同性爱好有色人种

的健康差异,我们一点一点地

创造我们想要的改变 o 看到这一刻

现在是男人或女人

顺性别或变性同性恋或异性恋

黑人白人或棕色你有

能力

煽动耻辱的火焰或熄灭

火焰

所以我问你会和我们一起拍打你的戒指

因为艾滋病毒是 不仅仅是

某些人的问题,这也是您的

问题事实上,当我们查看

首字母缩略词 smh 的词根时,

我们会看到社区如何对待和看到

感染艾滋病毒的人

,所以我们在孤独中说,

我很坚强

我有韧性