Guest Post: An Open Letter to Oprah Winfrey concerning the “Down Low”

The following was originally posted as a note on facebook by my friend and much respected colleague, Dr. David Malebranche. I watched the Oprah episode in question, and had many of the same concerns. There was some debate and responses to David written, which I may come back and answer this week.

An Open Letter to Oprah Winfrey concerning the “Down Low”

Dear Oprah,

On a beautiful, sunny October 7th afternoon in Atlanta, Georgia, I sat down to enjoy a rare occasion where I could come home early from work to catch a new episode of your daily talk show that I have watched on and off for the better part of the past 3 decades.  Upon pressing the info button on my remote, I learned that your show would be discussing a woman who “sued her husband for 12 million and won,” after finding out he had given her the HIV virus.  To say I watched this episode unfold in horror is a profound understatement – I was uncomfortably riveted and disgusted for the entire hour.

To be quite clear, I wasn’t horrified or disgusted by the fact that this unfortunate Black woman had contracted HIV as a result of her husband’s secretive “Down Low” infidelities with other men.  As a Black gay male, physician and public health advocate who has dedicated the past 12 years of my life to the behavioral prevention and treatment of HIV in the Black community, I have heard stories like your guest’s on this day more times than I would like to admit.  To the contrary, the acidic taste of bile that coated the back of my throat as I heard her story was in response to the superficial and sensationalistic manner in which you handled the topic, and how it was apparent that you and your staff have learned absolutely nothing in the 6 years since you originally interviewed J.L. King on your “Down Low” episode in 2004.

Yes, you can claim that for this updated version of your “Down Low” show, you actually included the fact that publically “heterosexual” White men and men of other races are equally capable of having secretive homosexual affairs as their Black counterparts.  And yes, this new version of J.L. King who again opportunistically sashayed onto your stage to promote himself now uses the word “gay” to describe his sexual identity (partly as a consequence of the fame and fortune he attained from appearing on your show).  However, everything else about the show remained stuck in a metaphorical time warp in which Black women are portrayed as simple victims with no personal responsibility or accountability when it comes to their sexual behavior, and Black men are projected as nothing more than predatory liars, cheaters and “mosquito-like” vectors of disease when it comes to HIV.

I felt like I was like watching a train wreck or an car accident about to happen: it was so awful that despite wanting to turn it off, I found myself transfixed and could not bring myself to pick up the remote or change the channel.  From the ominous background music and blurred images on the screen when discussing Black men being intimate with one another (God forbid!), to your declaration that reading your guest’s husband’s sexually explicit emails and messages on gay websites “blew your mind,” the way in which your show was staged did nothing to forward the conversation on the current facts or the social context that currently drives secretive same sex behavior among Black men and the current HIV racial disparity in the United States.  Instead, what came across was a clear, fear-mongering and hyperbolic message: “Black women, look out for your husbands, they could be lying and cheating on you with other men and putting you at risk for HIV.”  It was bad enough that 6 years ago, after your original “Down Low” show, you single-handedly launched a major media and cultural hysteria where Black women across the country were now searching for signs of how they could tell if their men were “on the Down Low” through stereotypical signs and ridiculously offensive generalizations about how homosexual men think and act.  Your show also helped J.L. King and other self-proclaimed “HIV experts” make a lot of money off this capitalistic, fear-based industry to promote their books, movies and narcissistic products on the so-called “Down Low.”  It did nothing, however, but open new wounds and put salt in the old scars caused by centuries of sexual exploitation and calculated pathologizing of Black bodies in the United States and internationally.  The way you and your staff have handled this topic has done nothing but widen the already irreparable rifts between Black men and women, as well as between Black heterosexual and non-heterosexual peoples.

While I realize that this is your show’s “final season,” let me give you and your staff some suggestions on how you can better address this issue of the “Down Low” and HIV in the Black community if you ever wish to revisit this issue during this year:

  1. Please do some research on the facts explaining why so many Black women in the United States are contracting HIV. I can guarantee you that what you find will surprise you, as the vast majority of cases are not due to so-called “Down Low” Black men.  Remember that in other countries like South Africa, India, Russia and China, there are millions of HIV cases attributable to heterosexual transmission.  Ask yourselves where is the proof, outside of anecdotal stories that are splashed on your show, BET and the pages of Essence magazine, that bisexual men are primarily accountable for this horrible disparity among Black women?
  2. If you are going to tell the story of HIV in the Black community, please give equal consideration to the social context and personal story/struggles of Black men who contract the virus, regardless of whether it is through IV drug use or sexual behavior.  I can tell you for certain that if you sit down and ask these men to tell their stories, you will undoubtedly have your eyes opened to the fact that there is much more to their lives than the “predator” labels you so easily ascribe to their actions.  And believe it or not, Black men can also be “victims” of this disease when exposed through their wives or female sexual partners who don’t tell them about the other people with whom THEY have been having sex.
  3. If you are going to talk about the so-called “Down Low,” then really talk about it.  That means, be prepared to discuss how Black men are socialized in this country to believe that our manhood solely exists in our athletic prowess, entertainment value, and the size and potency of the flap of skin that dangles between our legs.  Moreover, be prepared to talk about how these manhood expectations placed on Black man are in stark contrast to the stereotypical images and expectations of “gay” men we see in the media: White men who assume a gender performance of how women are traditionally expected to act.  And then talk about our society’s pervasive disdain, hatred and religious condemnation of anything that does not fall into a heterosexual “man-woman” norm of relationships and behavior, and how this puts pressure on men to deny who they truly are for fear of rejection and isolation.  Only when you begin to scratch the surface of these dynamics can you begin to rise above your current myopic and pathologic lens through which you view and project secret homosexuality and bisexuality as an “immoral act” on your show.
  4. Have your team do better research on the notion that just because men do not disclose that they have same sex relations to their female sexual partners DOES NOT automatically mean that they are irresponsible when it comes to condom use.  Simply put, “coming out of the closet” does not mean that a formerly “Down Low” brother will increase his condom use.  I can provide you team with numerous studies to support this statement if it goes against your preconceived notions of the so-called “benefits” of “coming out.”
  5. Withhold your judgment and disdain for explicit homosexual websites until you take time to explore websites like craigslist, nudeafrica.com, xtube.com and the many others that heterosexuals are just as freaky, raunchy and sex-crazed as homosexuals are.  If you really want to read  some conversations, pictures and videos that will “blow your mind,” check out these websites and do a show on how HUMAN BEINGS are sexual creatures – instead of suggesting that homosexually active people have a monopoly on that market.
  6. Finally, if you are going to have a discourse on homosexuality or bisexuality on your show in the future, please be bold and courageous enough to tell the various sides of men’s stories.  We are not all self-loathing, secretive, unprotected sex-having, disease ridden liars.  Surely in the work you have done in the entertainment field over the past 3 decades, you have interacted with enough same gender loving men to realize that sexuality is a fluid journey for anyone, and that there are many Black homosexual men who are well-adjusted, comfortable with who we are, and at peace with our lives.

Oprah, I was so disappointed with your show and treatment of this follow up to your “Down Low” episode 6 years ago that I don’t know if I really care to watch the remainder of this, your final season.  As a seasoned journalist, you have intricately described and explored the nuances of diverse topics such as eating disorders, mental health, spirituality, violence and criminality, cultural diversity and even the benevolent nature of human beings on numerous shows.  You have approached these topics with a sensitivity and attention to detail regarding the social contexts driving human behavior, that even the most skeptical viewer can understand why some people do the things they do.  So why is it with this topic (the so-called “Down Low”), particularly when it comes to the task of actually humanizing Black men, that you and your staff appear mentally, emotionally and intellectually incapable of creating a show that shows the rich, diverse and complex experience of being a Black male and homosexual in this country?   Is it really that difficult?

As one of the most powerful human beings this country has seen in the past 30 years, and someone whose show I grew up watching, it would be nice if you realized your influence and took more personal responsibility for the quality of your shows that address serious topics like HIV in the Black community.  The careless manner in which you continue to drive a wedge between relationships among Black men and women, between heterosexuals and homosexuals in this country through your one-sided analysis of Black sexuality in your shows is reprehensible.  And I for, one, refuse to sit by idly and say nothing while you spoon feed sensationalism and fear to our community who will all too willingly eat every last drop because it comes from your hand.  I need you to do better Oprah – the world is watching.

David J. Malebranche, MD, MPH

Assistant Professor

Emory University Division of General Medicine

49 Jesse Hill Jr. Drive

Suite 413

Atlanta, GA 30303

(404) 778-1630

(404) 778-1602 fax

dmalebr@emory.edu

Drug War Update: Global, National, & New York

This week,the world’s got drugs on the mind. Here’s what’s happening at the global level, nationally, and then here in New York State.

GLOBAL

Days after the President of West African country Guinea-Bissau was assassinated (rumored to have been supported by South American drug cartels), the new UN Political Declaration on Drugs was announced this week as a follow-up to the 10 year plan to reduce global drug use and trade (HAHAHAHA!). Many NGOs (including Human Rights Watch & the International Harm Reduction Association (IHRA)) and editorial pages across the globe concurred that it does not go far enough in moving UN members to adopt less punitive, and more public health approaches to drug abuse, which factors in the fight against HIV/AIDS. In fact, the Human Rights Watch (in a press release I received from the media department of the International AIDS Society) noted that:

“What is at issue is a series of measures known collectively as ‘harm reduction services,’ which have been endorsed by UN health and drug-control agencies, including the UN Office on Drugs and Crime, UNAIDS and the World Health Organization. These measures include needle and syringe exchange and medication-assisted therapy (for example, with methadone), both inside and outside prisons, as essential to address HIV among people who use drugs. The groups noted that a wealth of evidence proves harm reduction is essential to HIV prevention for people who use drugs. The action was taken against the direct advice of UNAIDS, the Global Fund to fight AIDS, Tuberculosis and Malaria, and the UN special rapporteurs on health and on torture.

Not only that, but The Economist published an editorial (which is also its cover story) detailing why a global war on drugs is a failed project to reduce drug use. The write:

Indeed, far from reducing crime, prohibition has fostered gangsterism on a scale that the world has never seen before. According to the UN’s perhaps inflated estimate, the illegal drug industry is worth some $320 billion a year. In the West it makes criminals of otherwise law-abiding citizens (the current American president could easily have ended up in prison for his youthful experiments with “blow”). It also makes drugs more dangerous: addicts buy heavily adulterated cocaine and heroin; many use dirty needles to inject themselves, spreading HIV; the wretches who succumb to “crack” or “meth” are outside the law, with only their pushers to “treat” them. But it is countries in the emerging world that pay most of the price. Even a relatively developed democracy such as Mexico now finds itself in a life-or-death struggle against gangsters. American officials, including a former drug tsar, have publicly worried about having a “narco state” as their neighbour.

The failure of the drug war has led a few of its braver generals, especially from Europe and Latin America, to suggest shifting the focus from locking up people to public health and “harm reduction” (such as encouraging addicts to use clean needles). This approach would put more emphasis on public education and the treatment of addicts, and less on the harassment of peasants who grow coca and the punishment of consumers of “soft” drugs for personal use. That would be a step in the right direction. But it is unlikely to be adequately funded, and it does nothing to take organised crime out of the picture.

National

It seems as though the US’ policy on the War on Drugs is going to somewhat shift to a conversation less about public health, and more about “national security.” Over the last week, media stories about the possibility of Mexico becoming a failed state due to the violent drug cartels that are wreaking havoc on the country, and that the government is failing to control. Fears, and what is somewhat true, that Mexican gangs that have ties to the drug trade are spreading across the US in major cities. The US government seems to be signaling a fear of the kinds of violence seen in Mexico spreading to the US, and with an increase in Mexican immigrants if drug cartels do succeed in rendering the existing government powerless. (There is evidence that many of the weapons are coming from the US, and we’re not likely to have an gun reform laws anytime soon.) Notice that Department of Homeland Security Chief Janet Napolitano’s recent appearances on television talking about this problem.

Secondly, yesterday, Obama nominated Seattle Police Chief Gil Kerlikowske as Drug Czar, while he removed the post as a Cabinet-level position. I don’t know much about this new Czar, but being a police chief doesn’t give me much hope of a real shift in policy. However, Drug Policy Alliance’s Ethan Nadelmann in a Huffington Post piece, remains cautiously optimistic based on what’s happened in Seattle during the police chief’s tenure:

What gives me hope is the fact that Seattle has been at the cutting edge of harm reduction and other drug policy reform developments in the United States over the last decade. The city’s syringe exchange programs are well established and harm reduction is well integrated in Seattle’s approach to local drug policy. Marijuana has been legal in Washington State for medical purposes for a decade. In 2003, Seattle voters passed a ballot initiative making marijuana arrests the lowest law enforcement priority. And the King County Bar Association has demonstrated national leadership in exploring alternatives to current prohibitionist policies.

While Kerlikowske has not spoken out in favor of any of these reforms, he is clearly familiar with them and has not been a forceful opponent. Given the high regard in which he is held by other police chiefs around the country, Kerlikowske has the potential to provide much needed national leadership in implementing the commitments that Barack Obama made during the campaign. He also surely recognizes that substance abuse or run-ins with the law can touch anyone, including his own family. He will hopefully advocate for treatment instead of incarceration for nonviolent drug law offenders.

New York State

Almost 2 weeks ago, the NYS Assembly passed a bill that would basically gut the Rockefeller Drug Laws, and after nearly 40 years, return discretion to judges for sentencing and not give these automatic stiff penalties for petty drug charges (although racist judges will still mean racial disparity in sentencing. That’s how we got talked into mandatory minimums in the first place.). Now the problem is what the NYS Senate and Governor Patterson is going to do with this bill. Will they leave it as written, or cut the scope of it so it becomes another whack reform that means nothing. Assembly Speaker Sheldon Silver wrote yesterday in an op-ed for The Daily News:

By now it should be beyond debate that these laws have failed. One serious consequence: massive racial disparity in sentencing. According to the U.S. Health and Human Services Department, the rate of drug use in America is generally 8.2% for whites, 7.2% for Latinos and 8.7% for African-Americans. Yet the Rockefeller laws have filled New York’s prisons with tens of thousands of drug offenders, 90% of whom are African-American or Latino.

The laws have also failed to curb drug abuse. According to statistics from the National Survey on Drug Abuse conducted by the Health and Human Services Department, illicit drug use among New Yorkers has not abated since the passage of the drug laws in 1973.

Finally, 35 years of unambiguous data make clear that the Rockefeller laws have had no appreciable impact on combating violent crime. All evidence shows no correlation between the Rockefeller laws and the subsequent increase, followed by an equally precipitous decrease, in crime in New York.

My Plenary Remarks at Creating Change

Hey folks, sorry  I been gone so long, but I was in Denver al last week for the 21st annual Creating Change conference, this year in Denver. Bilerico.com just published the speech I delivered at the HIV/AIDS plenary at Creating Change on Saturday, January 31, 2009. My other co-panelists, Marjorie Hill, PhD (Executive Director, Gay Men’s Health Crisis), Bishop Yvette Flunder (UCC Ark of Refuge, San Francisco), & David Ernesto Munar (VP of Development & Communications, AIDS Foundation Chicago), were quite brilliant!

Excerpt below. Go to Bilerico to get the full text:

First and foremost, the time where we can pretend that there is no viable, credible or visible Black (or other POC) queer leadership is over. While we certainly need to be developing leaders, leadership per se, is not the problem. We have lost of leaders, but leaders with no base that they’re accountable to. Because what little Black LGBT infrastructure that exists, is largely due to HIV/AIDS service delivery, we are able to reach lots of people in our organizations as “clients”, but are rarely engaged as potential leaders, organizers or members of our organizations. We need the investment of both progressive philanthropy and LGBT funders to help build the capacity and infrastructure of organizations to move from strict service delivery to doing community organizing, leadership development, and base-building.

Lastly, as long as the White-led mainstream LGBT movement is invested in seeing itself as the only credible leadership or it’s organizations the only ones doing “the real work” or having “real impact” we will continue to invisibilize the work that Black and other POC organizations are doing on the ground, in spite of real material obstacles. So every time the gay news media and organizations promote ideas of the gay community vs. the Black community, Black queers will continue to remain invisible, and assumes that Black queer people are not engaging in a battle against homophobia and transphobia in the Black community.

Here’s the last 3 minutes of the speech on Youtube:

Senegal Sentences 9 Gay HIV Activists to Prison. For Being Gay.

Despite my celebrating the recent Uganda high court decision in favor of several lesbians abused by police, we still obviously have a long way to go. This past week, a Senegalese court sentenced 8 gay men who worked for AIDES Senegal (an organization that provides condoms and HIV treatment, in a country that has one of the lowest prevalence rates on the continent) to 8 years in prison for “homosexual acts.” Ironically, the country just played host to a regional gathering of the International AIDS Conference. The BBC reports:

“This is the first time that the Senegalese legal system has handed down such a harsh sentence against gays,” said Issa Diop, one of the men’s four defence lawyers. Mr Diop said he would be appealing against the sentences.

The IGLHRC’s Cary Alan Johnson said he was “deeply disturbed” by the case.

“There have been pretty consistent human rights violations… in Senegal,” he told the BBC’s Network Africa programme from Cape Town in South Africa.

“But the extremity of this sentence [and] the rapidness of the trial all really shocks us in a country which has been moving so positively towards rule of law and a progressive human rights regime.”

According to the website Behind the Mask (which documents what’s happening to LGBT people on the African continent.), the law governing “homosexual acts” reads (in English) as follows:

“Without prejudice to the more serious penalties provided for in the preceding paragraphs or by articles 320 and 321 of this Code, whoever will have committed an improper or unnatural act with a person of the same sex will be punished by imprisonment of between one and five years and by a fine of 100,000 to 1,500,000 francs. If the act was committed with a person below the age of 21, the maximum penalty will always be applied”

Human Rights Watch has also issued a statement demanding their release.

New Study: 95% of HIV Positive Don’t Transmit HIV

Even though we’ve talked over the last year about the new HIV infections rate (incidence) in 2006, I haven’t given any thought to the issue of transmission–how many people actually transmit HIV to an HIV negative person every year? And what does the looking at the rate of transmission over the course of the epidemic tell us about what’s working or not working with prevention, testing, treatment or care efforts?

Well that’s why we have smarty pants like David Holtgrave, PhD at the Bloomberg School of Public Health at the John Hopkins University. His study, which JAIDS released online ahead of the publication date, looks precisely at HIV transmission rates over the course of the epidemic. They conclude that the highest rates of transmission occurred in the early years of the epidemic–in the early/mid 80s, and then began to drop off at several different points, particularly from 1985-1986 (31.4-17.4), and 1990-1991 (11.7-6.6). By 2006, the transmission rate declined to 5.0.

In other words, 95% of all people with HIV did not transmit the virus to people who are HIV negative.The study goes on to explain the possible causes for this drop in transmissions:

The general decline in HIV transmission rates over time could be considered a rough measure of prevention success, in that even as prevalence grew over time incidence did not grow proportionately. HIV diagnosis is known to significantly reduce HIV risk behavior, and in the past decade, there has been an increasing emphasis on prevention programs for persons living with
HIV that further reduce HIV risk behavior and 2006.

Another interesting thing they note is that AIDS drugs (anti-retrovirals) didn’t have a grand impact on transmission rates, as transmission was declining long before ARVs were on the market.

Could it be that marginalized communities with no access to treatment is where those transmission rates did not decrease or increased?

Could it be that the prison boom and/or Welfare Reform Act of 1996 (when prison construction peaked and we hit the 2 million prisoner mark for the first time) disrupted or changed sexual networks enough to create new HIV transmissions (and sexually transmitted infections in social networks where they had been stable?

Holtgrave doesn’t ask these questions, but notes that further research needs to happen to explain why ARVs do not seem to have significantly decreased transmission of HIV. But in a Q & A on Johns Hopkins’ website, he addresses the impact of housing stability on HIV risk, and also says what he would do if he was AIDS Czar in the Obama Administration:

I think it is critical to address unmet HIV prevention needs in the U.S. As I testified recently before Congress, my wish for a five-year plan would be for $1.3 billion in prevention funding per year. I might front-load that a bit, so maybe it’s $1.6 billion in the first year, and so on. Over that five-year period, I estimate that as a nation we could reduce transmission by half—but we’d need that substantial investment. And if we really saw a drop in new infections, that higher level of funding might sunset in several years, so we wouldn’t necessarily have to continue to fund it at $1.3 billion per year.

Let’s hope we’re as lucky to have this come to fruition.

UPDATE: The CDC has published a factsheet and podast on HIV Transmission Rates in the US, based on the release of this data.

World AIDS Day: We’re Still Living With AIDS

(originally written for the NGLTF Policy Institute)

December 1, 2008 8:40 am

Today, many of us will dust off those red ribbons, and “remember” to remember the people who we’ve lost, and who are currently living with HIV/AIDS.

Some of us may even donate money to an AIDS charity doing work in some far flung place. But red ribbons and prayer services that commemorate only hide the reality that here in America, we are still living with AIDS.

Despite major advances in treating the virus, the HIV/AIDS epidemic didn’t go anywhere and in fact, it seems to be getting worse for people in our community. At the International AIDS Conference, the Centers for Disease Control and Prevention (CDC) stunned the international AIDS community by announcing that the richest nation on earth had over 56,000 new infections in 2006. While this may not seem like a huge number, this revision also included a back-calculation revealing that, for the 15 years from 1991-2006, infection rates were approximately 25-50 percent higher than the long-held 40,000 annual estimate.

Not only have we been under-counting the growth of the epidemic, men who have sex with men (MSM — that public health category that includes gay and bisexual men, and transgender women) continue to bear the greatest increases in new infections. In 2006, 53 percent of all new infections were among MSM. More stunning, it found the number of new infections of black MSM ages 13-29 to be the highest of all MSM groups. Even though CDC officials are typically conservative in its public statements, CDC Behavioral Scientist Greg Millett has stated publicly that black MSM are the only group in the U.S. with HIV rates similar to Sub-Saharan African nations, despite similar or lower rates of risky sex or substance abuse than white MSM. While black MSM certainly bear the brunt of the virus, gay and bisexual men and transgender women of all races are disproportionately impacted by the virus.

Though many of us are celebrating a new administration, we are still living with HIV/AIDS policies that reflect the reactionary Reagan era, where politics, not public health science, dominates our approach to HIV prevention, treatment and care. We still fund abstinence-only sex education, ban federal funding for syringe exchange programs, and there’s no coordinated national AIDS strategy for the United States. This lack of concern for our lives shapes the ability of people with HIV to accessing quality services, but also makes many in our community more vulnerable to contracting the virus.

And the HIV negative still live with the virus — lovers, friends, relatives, are positive, have died, and the spectre of HIV still shapes our current sexual lives.

So instead of silently commemorating this World AIDS Day with a red ribbon, I urge of us to continue to fight the public policies that make us more vulnerable to contracting the disease or that prevent people who are positive from staying healthy. President-elect Barack Obama will be making key appointments in the coming weeks that will demonstrate whether his promises for policy change for the domestic HIV epidemic will put public health over politics. We have an opportunity to do something different. Let’s hold him to his word.

Stephanie Mills’ “Home”: So Black and So Gay!

If you’re a Black gay of the Classic Era (meaning you’re over 30, or at least have Classic Black Gay Sensibilities, or CBGS), you’ll know that Stephanie Mills‘ “Home” is really the Black gay anthem. The song, written for the 1975 Broadway play The Wiz for which Mills was cast as Dorothy (and Diana Ross played in the 1978 film version and does a lackluster version of the song. In fact, it is Lena Horne’s “Believe” that becomes the showstopper in the film. But I digress.), is the “Somewhere Over the Rainbow” of this black version of the Wizard of OZ.

Why is this song, so Black and so gay, you might ask?

One reason that the Black gays of the classic era love this song, in my opinion, is that it speaks to the pain of feeling cast out of the larger Black community–we have no “home” in a sense. The song is about a stateless person–someone who has dreams of a physical place, but the lesson that they learn is that home has to be made in the family and community we create.

But Mills re-recorded the song for her 1989 album “Home” (with a Capella group Take 6 singing the background vocals). She has said that she recorded the song after the deaths of Kenneth Harper (The Wiz Producer, whose mother told the New York Times he died of cancer at age 48 in 1988)  and Charlie Small, The Wiz Composer who died in 1987 of a burst appendix.  I think that many Black gay men from the Classic Era were in the throes of so much death due to HIV (and sometimes violence) that this song became a song about the losses they were feeling too. I started going to gay clubs when I was 18 or so, and this song was a staple drag performance for about a decade. I think the part that really cinches it for the Black gays, me included, is at the end of the 1989 recording, when she sings “I can hear my friends tellin’ me, Stephanie, please, sing my song.”

Because it so much speaks to the Black gay experience, Stephanie Mills’ Home is So Black and so gay! The video below is a live verson from the Apollo in the 1980s. To see yet another un-embeddable music video from the theives at Universal Music Group, click here.