National Black HIV/AIDS Awareness Day Q&A with Tony Bradford

Tony Bradford is manager of Black Brothers Esteem, a prevention and support program empowering men who live in and around the Tenderloin and Sixth Street Corridor in San Francisco. San Francisco AIDS Foundation started the program 14 years ago because African-American gay, bisexual, and same gender-loving men are at a disproportionately high risk for HIV infection. For more information about Black Brothers Esteem, go to: http://www.SFAF.org/bbe

Q – What role does the African-American culture have in creating stigma around HIV?
A – Around the United States and in other parts of the Bay Area, HIV and AIDS are not discussed as openly as they should be. In San Francisco, we’re fortunate to have community support groups like Black Brothers Esteem (BBE) that promote education and empower individuals to take control of their health. Our experience tells us that increasing dialogue with black churches is also critical to educating the community about HIV prevention because of the influential role that churches play in the lives of so many people.

Q – How is HIV-prevention work different among African-Americans than other groups?
A – Not everyone has cable TV or access to the Internet, and this is particularly true for the people who we’re trying to reach. We have to bring our prevention messages, training and information to the people where they live. Peer education, self-esteem classes and support meetings are among our most useful tools. Promoting conversation about HIV and other health issues is key to increasing awareness.

Q – African-Americans continue to be the ethnic group most affected by HIV. Blacks make up 12 percent of the U.S. population but account for 45 percent of new HIV infections, 40 percent of cumulative AIDS cases and 46 percent of the estimated number of people living with HIV. Why?
A – Not enough people are getting tested. HIV testing is not on their radar because they have so many other problems to tackle and testing isn’t readily available to this population. That’s why I’m so excited about San Francisco AIDS Foundation beginning testing at our Sixth Street facility. It will enable partners of BBE members to find out their HIV status. By making testing a comfortable and convenient process in their own neighborhood, it reduces the stigma around it.

Q – In San Francisco and nationwide, AIDS survival rates for blacks are much lower than those of whites and Latinos and fewer HIV-positive blacks are on antiretroviral therapy. What is the correlation?
A – Blacks face enormous challenges – poverty, inadequate or no health insurance, marginal housing and racial discrimination. Many have no personal doctors and rely on public hospitals when they get sick. Once they are diagnosed with HIV or AIDS, distrust of the medical establishment can make them afraid to take medications. Mental health and substance abuse issues can further jeopardize sticking to a medication regimen.

Q – What accounts for scientifically documented differences in how African-Americans experience and respond to HIV treatment? What can be done to erase those differences?
A – Our society needs to provide greater access to HIV testing and medical care. African-Americans are often diagnosed with HIV later in the course of the disease because they tend to get tested only after having symptoms. By being diagnosed later, they have weaker immune systems and have a more difficult time fighting other infections. Also, blacks have higher rates of diabetes and heart disease that jeopardize their overall health. With greater access to health care and routine screening, the outcomes for HIV-positive African-Americans will dramatically improve.

Q – More than 3 percent of the black residents of Washington D.C. are HIV-positive. Are there effective programs in San Francisco that could be replicated there?
A – Increasing the availability of needle exchange programs that prevent HIV and Hepatitis C infections among intravenous drug users is a proven intervention. Another is sending role models out into the community to encourage routine HIV testing.

Q – How do we pass the torch of HIV/AIDS awareness and prevention to the next generation?
A – Essential to reducing the number of new HIV infections is reaching young people. We need to go out and recruit young adults as peer educators. Another way to bridge the generation gap between older survivors and young people is to send speakers and performance artists into the schools to talk about HIV/AIDS prevention.

To observe National Black HIV/AIDS Awareness Day, Black Brothers Esteem will join the San Francisco Department of Public Health AIDS Office and other community-based organizations on Friday February 5, 2010 for a 5 p.m. press conference on the steps of San Francisco City Hall followed by a candlelight march to Castro Street and a community discussion at the Harvey Milk Academy.