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The uninsured relied on emergency rooms and “the stigma was so strong they were almost dead before they would take help,” recalls Hopkins.

Accessing HIV/AIDS services for some gay men of color has historically been made challenging by social, economic, and cultural barriers to care. It has, for example, been repeatedly documented in the literature that many minority gay men did not at the onset of the epidemic (and do not today) identify as “gay” men. These men are frequently identified as “men who have sex with men” or abbreviated MSM by epidemiologists, researchers, and prevention and outreach workers. Fear of being seen going into a site that serves predominantly gay men, has created barriers for some in accessing services.  Compounding this issue, gay men of color – and communities of color in general – have historically suffered disparities in access to health care and, as a result, poorer health outcomes. Thus, they have been less likely to receive preventive health care or to have an ongoing relationship with a clinical services provider. There are many cultural barriers, too, the most obvious one being perhaps lack of language services available at some locations for Latino gay men.

Just as approaches designed to address the unique needs of White gay men often needed modification to work for women, injection drug users, or heterosexual men, the same was true for minority gay men. And HRSA has worked to build programs and initiatives that reflected the needs of gay men of color.

 

Pie charts depicting Estimated MSM/MSM-IDU Diagnoses by Race/Ethnicity for 1990 and 2009 using data from accompanying table.
View as a table
MSM/MSM-IDU AIDS Diagnoses by Race/Ethnicity
Year White Black Hispanic Asian American Indian Other
1990 17,920 = 67.69% 5,199 = 19.64% 3,029 = 11.44% 209 = 0.79% 53 = 0.20% 63 = 0.24%
2009 7,118 = 37.91% 6,741 = 35.89% 4,136 = 22.02% 277 = 1.47% 101 = 0.54% 408 = 2.17%
*MSM= men who have sex with men (term used in data source)
**IDU= injection drug users
Source: CDC, HIV/AIDS Surveillance Year-end Report, 1990
Source: CDC, HIV/AIDS Surveillance Year-end Report, 2009

 

HRSA made significant efforts in the early years of the Ryan White HIV/AIDS Program to acquire the cultural competency to serve gay men of color. As time passed, organizations took steps to diversify their staffs – including HRSA’s HIV/AIDS Bureau, when it was made responsible for implementing the Ryan White HIV/AIDS Program in 1996. Grants were awarded to expand capacity within minority-serving communities, and providers of HIV/AIDS care built relationships with minority community based organizations in order to reduce the very high number of minority gay men who were not in care.

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