"AIDS is the number one cause of death for African Americans
between the ages of 25 and 44. That is startling.... Today you're
going to hear many reasons why AIDS is on the rise again. And
here's a shocker. It's one of the big reasons why so many women
are getting AIDS: Their husbands and boyfriends are having secret
sex with other men... OK? OK? This lifestyle even has a name.
It's called living on the down low. Have you heard about it?…" [1]
The date was April 16, 2004. The words were those of Oprah Winfrey
leading off that Friday’s version of her long running syndicated
daily TV show. But instead of information on the promised “many
ways you can get AIDS,” what Oprah’s audience got was an hour
of disinformation, stereotyping and hucksterism. They got just
one way to avoid the deadly infection, from one source: secretive
and predatory bisexual black men, “Living on the Down Low.”
During that hour, Oprah and her guest, J.L. King, the author
of what became, thanks to exposure on Oprah’ TV show and web site,
a best selling book, did incalculable and lasting damage to the
battle for HIV-AIDS prevention, treatment, and understanding of
the epidemic in the African American community.
Huckster J.L. King portrayed himself as a typical example of
a “down low brutha,” supposedly reformed just enough to want to
sell his book and services as a speaker, passing on tidbits of
useful information such as where he and other “down low bruthas”
go to meet each other:
Mr. KING: He could be available and he could
be part of the society, this invisible fraternity. I'm going to
go into a church. I can go anywhere in the country and find out
where churches--where most of the guys are or where I can make
that connection and that's where I'm going to go. You're not going
to find me in no gay club because I have nothing to do with the
gay culture.
Mr. KING: That's them. That's their thing.
WINFREY: OK. So you would go to a church.
Mr. KING: I would go to a church. There's be one--I--I can
go to the church, a gym or a grocery store.
WINFREY: Or a grocery store.
Mr. KING: Anywhere. Anywhere, 'cause we're
everywhere. [2]
Among the sage bits of advice King had for black women on the
lookout for signs of “down-lowness” in their sweethearts and spouses,
was to “watch their eyes,” pay attention to their gay friends,
to follow them around.
WINFREY: But let's just say what should you be looking for
to figure out if your husband or boyfriend is living on the
down low? You, who said that you have been surprised yourself...
Mr. KING: Yeah.
WINFREY: ...by guys who were on the down low, so how is
a woman who is, number one, in love, going though the motions
of, you know--how--you know, the daily routine, 'cause how would
your wife have--have known?
Mr. KING: Women have a--a--an intuition, a sixth sense,
that something is not right in their home. And they will follow
their intuition and really start...
WINFREY: Well, she literally followed you...
Mr. KING: Yeah.
WINFREY: ...to the--yeah.
Mr. KING: Yeah, she got nosy.
WINFREY: Yeah.
Mr. KING: If women really want to find out, if they really
want to know what their man is all about get nosy.
WINFREY: Yeah.
Although Oprah Winfrey is not a public health professional, what
she says and what she allows to be said on her show concerning
the AIDS epidemic definitely matters. According to the Black
Aids Foundation, one of whose representatives did appear in
the final minutes of the April 16, 2004 Oprah show, the number
of print and broadcast news stories about the domestic AIDS epidemic
declined by 57% between 1997 and 2002, during which time the occurrence
of new HIV-AIDS cases among whites declined. Since then, the
incidence of new HIV-AIDS cases has spiked in the African American
community, but without an attendant increase in coverage. The
Kaiser
Family Foundation confirms that it is the popular media which
provide the public with most of what they know about the epidemic.
It’s not Oprah’s fault that news we can use about the HIV-AIDS
epidemic in black America is so scarce. But it is precisely the
lack of information about this burgeoning public health crisis
which imposes moral and ethical responsibilities on communicators
and broadcasters, especially those with large audiences directly
affected by the epidemic to get it right. The Oprah show and
fearmongering AIDS hustler J.L. King instead got it very, very
wrong. The real lowdown on the down low is that it just ain’t
true. Most of the existing HIV-AIDS cases are not gay men, and
hedonistic bisexual black men on the DL are NOT the major vector
of virus transmission to black women.
Is it True? Does it Matter?
Oprah’s declaration that secretive and predatory bisexual black
men, of whom author J.L. King offered himself as a typical example,
were in some large part responsible for the AIDS epidemic – “one
of the big reasons why so many women are getting AIDS” – was then
and remains today factually untrue. BC will not
speculate on how the fraudulent nature of this claim eluded the
Oprah show’s producers some 17 months ago. But for a good while
now, anyone with Internet access has been able to bring up the
search engine www.Google.com and type in the terms “HIV-AIDS
+ downlow” (without the quotes). The topmost result is a page
from the Center for Disease Control titled “FAQ – Men
on the Down Low.
It says, in part:
What are the sexual risk factors associated
with being on the down low?
Much of the media attention about men on the down low and HIV/AIDS
has focused on the concept of a transmission bridge between
bisexual men and heterosexual women. Some women have become
infected through sexual contact with bisexual men.1 However, many
questions have not yet been answered, including:
- Do men on the down low engage in fewer or more sexual risk
behaviors than men who are not on the down low?”
- Do people other than bisexually active men who do not disclose
their behavior to sex partners identify with the down low?
What are the implications for HIV prevention?
The phenomenon of men on the down low has gained much attention
in recent years; however, there are no data to confirm or
refute publicized accounts of HIV risk behavior associated with
these men. What is clear is that women, men, and children
of minority races and ethnicities are disproportionately affected
by HIV and AIDS and that all persons need to protect themselves
and others from getting or transmitting HIV.
There it is in black and white. When you ask the Centers for Disease
Control about this “down low” stuff the first things they tell you
are that they don’t know whether or not “DL bruthas” account for
more HIV transmission to women than men who inject drugs. They
don’t know whether DL bruthas are more likely to be HIV infected
than other men, including exclusively heterosexual men. There is
no data to back up Oprah’s assertion that DL behavior is “one of
the big reasons why so many women are getting AIDS.”
We at BC are not the first to note that the Oprah
Winfrey show and Down-Low author J.L. King are in deep
disagreement with the Center for Disease Control, and with the known
facts of the AIDS epidemic. Of the eight medical doctors, public
health professionals, HIV-AIDS treatment and testing providers and
advocates on the case level and the policy level whom BC
interviewed for this article, not one could be found to co-sign
the notion that “down low bruthas” are chiefly responsible for the
epidemic of HIV-AIDS among black women.
We humbly suggest that Oprah owes her audience a sincere and profound
apology for popularizing this damaging myth, and a follow-up show
that features real doctors, real HIV researchers, real public health
professionals who minister to the epidemic on a daily basis, along
with real advocates of testing, treatment, healing and prevention. A
great place to start might be someone from the Black AIDS Foundation,
who only got a handful of words in edgewise in the final moments
of the infamous “down low” show.
BC Consults a Doctor/Researcher
To see how easy it might be to follow our own advice, BC
looked around for a real medical doctor to ask about the “down
low,” one involved in public health issues as they relate to the
black community. Dr.
David Malebranche, an MPH and assistant professor of medicine
at Atlanta’s Emory University, has been speaking, writing and
conducting research on public health issues and HIV-AIDS for some
time.
“It’s a racist slander,” Dr. Malebranche told BC
when we asked him what he thought of the proliferation of media
stories about the DL. At the 2004 International AIDS Conference
he had this to say about the Oprah show and the DL hype machine:
“Demonizing Black male sexuality has been a staple of
American culture since slavery, where our role was to work and
breed, and the Mandingo stereotype of a hyper-sexual Black man
with an insatiable appetite for white women was created. That
history haunted my thoughts as I watched Oprah Winfrey’s
recent show about ‘down low’ Black men, or guys
who live a ‘heterosexual lifestyle’ (whatever that
means) but have sex with other men on the side.
“The show misquoted HIV statistics,
offered sensationalistic generalizations, and portrayed down
low men as hedonistic predators who carelessly have unprotected
sex with men and women. It did all of this in an effort to convince
Oprah’s faithful audience that the current HIV epidemic among
Black women is mainly due to the down-low, or ‘DL,’ brothers….
“All of this
is just as much of a fantasy as the Mandingo stereotype. The
majority of public health research doesn’t support the theory
that DL men are a “bridge” for HIV to the general Black community.
There are no substantive studies on down-low Black men. That’s
in large part because researchers can’t find actual DL men – few
of them would be willing to participate in a study discussing
the sexual behavior they are supposedly so invested in concealing.”
Still, the hype goes on. J. L. King and others who counsel scapegoating,
suspicion, misdirection and the bulk purchase of their books continue
to be celebrated in the media and prosper on the lecture circuit.
BC asked Dr. Malebranche why TV and the media
publicize lurid and bogus allegations while stories based the
findings of real researchers and treatment professionals are so
rare. His answer was illuminating.
“Because those findings don’t demonize black men,” answered the
good doctor.
We add to that trenchant observation this selection from Emory
University’s Emory
Report, summarizing a recent study published by Dr. Malebranche
and co-author Greg Millet of the Centers for Disease Control:
“When you look at the whole
issue of what down-low means, it really translates into the
issue of disclosure – who you’re telling and who you’re not
telling – and may be dependent upon the nature of the relationship
and gender of the individual with whom you’re having sex,” Malebranche
said. “If some black MSM (men who have sex with men) are secretively
bisexual, studies have demonstrated that they’re more likely
to have more female partners than disclosing black MSM, and
thus are more likely to have unprotected sex with these female
partners. However, these same men report lower rates of unprotected
sex with their male sexual partners than disclosing MSM.”
These facts lead the study team to ask, “If bisexual
black men represent a small proportion of black men in the United
States, and nondisclosing black men are less likely to be HIV
positive than gay-identified men or engage in high-risk behavior,
then is this population primarily responsible for the HIV epidemic
among heterosexual black women?”
According to recent statistics,
approximately 40 percent of the cumulative AIDS cases among
black women through 2003 are attributable to intravenous drug
use, with another 40 percent attributable to risky sexual behavior.
However, it’s not known what proportion of these cases are infected
through having sex with heterosexual, bisexual or homosexual
men.
”The flawed logic often perpetuated by the media is that only
homosexual men have HIV, bisexual men only contract HIV through
homosexual behavior, and the only way black women contract HIV
is through sexual contact with these bisexual men,” Malebranche
said. “Homosexuals are not the only ones with HIV, and just
because someone keeps their same-sex behavior secretive doesn’t
necessarily mean that they are irresponsible with condom use.”
The authors
argue that the issue of high-risk sexual behavior among heterosexuals
has been absent from the discussion involving men on the down-low
and the high prevalence of HIV among black women. For instance,
they found that rates of condom use by black heterosexuals are
low, even among couples, where one partner is HIV positive and
the other is HIV negative.
“Secretive sexual behavior has been around since the dawn of
time,” said Dr. Malebranche to BC. “Why is it
that now we need a new name for this behavior, aside from our
need to blame and demonize black men, and distract our attention
from what’s really going on? … Aside from…injected drug use, most
of it [AIDS] comes from one place – unprotected sex. And most
of the sex that most of us are having and continue to have with
partners of the same or either sex continues to be unprotected.
It’s foolish, and in the context of an epidemic it’s dangerous
to imagine that so-called ‘down low brothers’ have a corner on
the market for risky behavior or unprotected sex. They don’t.
We all have a hand in this.”
BC thinks Dr. Malebranche is onto something
here. The myth of the downlow fails to accurately explain where
the virus comes from or equip us to protect ourselves and each
other. It is both a racist and a homophobic slander. Oprah’s
producers must have known that however false and misleading it
might be, their “down low” show would attract viewers and be remembered
by them, just like that low-down hustler J.L. King knew it would
sell books. The market has an endless appetite for shocking tales
of unique black depravity. We need look no further than last
week’s reports broadcast around the world of sniper fire halting
the helicopter evacuation of hospital patients in New Orleans,
which the FAA now confirms never
happened.
BC suspects we may be seeing a new kind of defamatory
offensive against African America, in which some of the worst
pathologies of white America are projected by its corporate media
upon us. One such canard currently in wide circulation holds
that the African American community in general, and especially
the black church, are, unlike their white counterparts, bastions
of virulent homophobia.
Certainly there is no doubt that black homophobia exists, and
that many backward pastors drink and dispense from this poisoned
well. It’s also true that gay male musical directors in black
churches are prevalent often enough to be a kind of cliché. Nobody
at BC has spent much time in white Baptist churches,
but we doubt they see much of that, or that gay band leaders and
drum majors are a cliché in white colleges either.
BC Consults an HIV-AIDS Treatment Professional
As Executive Director of the South Carolina’s
HIV-AIDS Council, Dr. Bambi Gaddist has been on the front lines
of HIV-AIDS treatment and advocacy a long time. She has a PhD
in Public health. In our conversation with her about the “down
low,” homophobia, the black church and the AIDS epidemic
Dr. G addist recounted that for years there have been several
standard questions she has asked every person who comes through
her agency’s doors for service, and which she has also asked
many hundreds of people for whom she has done workshops and presentations.
Among those questions are:
Uniformly, Dr. Gaddist reports, those questioned
say they were under 20, used no protection and doubt anyone could
have said anything to pre vent the encounter.
“African Americans concerned about the HIV-AIDS epidemic are
not well served when we allow lurid conversations about the ‘down
low’ to take up all the oxygen in the room… There are vast disconnects
between what we as peers and parents tell each other, between
what many of our churches are telling young people, and what we
are actually doing, and yet another disconnect between that and
what we must do to get a handle on this epidemic,” says Dr. Gaddist. “HIV-AIDS
is not a ‘gay disease’, and ‘down low bruthas’ are not lurking
everywhere, but the virus could be anywhere… It’s the spirit of
shame, fear, and judgment that continues to perpetuate the spread
of the virus throughout our community and families.”
Dr. Gaddist added that the South is now ground zero for the black
HIV-AIDS epidemic, its 36% of the US population accounting for
40% of the nation’s AIDS prevalence (existing cases) and 46% of
AIDS incidence (new cases) in 2003. If HIV-AIDS was a gay
male disease, she points out, why is it on the decline in the
western and northeastern US, but on the rise in the south, including
the rural South? The answer is that HIV-AIDS is increasingly
a black disease, and the southern states is where half of us still
are.
Dr. Gaddist believes that, notable exceptions aside, there is
plenty of hope and love for all God’s children, regardless of
sexual orientation, within the African American church. Its
leaders, she says, have a vital role to play in bringing a halt
to the epidemic. “Bishops, pastors, and those entrusted with
the authority to guide their flocks are now, more than ever, being
called to unconditional love for ‘the least of these’. The
South Carolina HIV-AIDS Council exists to help them answer that
call.”
Where America Refuses to Look For HIV: The Prison
Industry
An obvious, overlooked and under-researched vector of HIV-AIDS
into black women and black communities is the planet’s largest
prison industry, right here in the United States. The US leads
the world in the numbers and the percentage of its citizens behind
bars. Black America, representing just one-eighth of the nation’s
population, contributes about half of the prison industry’s
human raw material. Despite mountains of anecdotal evidence, little
research to date has been done on the incidence and prevalence
of HIV-AIDS in America’s prisons and jails, and the relationship
between the epidemic on either side of the walls.
“The
Time is Now: The State of AIDS in Black America”, is
a compelling, authoritative and easy to read document issued by
the Black AIDS Foundation in February 2005 which we highly recommend
to any and everyone. It addresses the prison-HIV connection first
by pointing out that the grossly disproportionate rate of black
incarceration exists alongside the soaring rate of HIV-AIDS infection:
“It is reasonable to assume Black inmates account for
a similarly disproportionate share of the HIV infections. But
further, more than three times as many African American inmates
died of AIDS-related causes in 2002 than did whites. Politically
and culturally the African American community desperately needs
to demand more of the public health systems governing state
and federal prisons.
“Rarely do we see as gaping of a disconnect between public
policy and the reality it is intended to govern as that between
the rules organizing our nation’s prisons and the rapid
spread of HIV and Hepatitis C within them. The party line among
prison officials is that HIV infection rates are high in their
facilities because they are high in the populations from which
prisoners are disproportionately drawn – young Black and
Latino men and women. But what if it’s the other way around?
What if HIV’s disproportionate impact on urban Black and
Latino communities can be traced at least in part to the high
incarceration rates in those same neighborhoods – and
the unsafe sex, drug use and tattooing that takes place inside
prisons?
“[E]ven if we simply accept the fact that
a large number of those entering prison do so with an HIV infection,
the potential epidemic inside – and eventually outside –
is awesome, for few environments would better facilitate the virus’s
spread.
“Prison officials are famously reluctant to allow researchers
to study the frequency of risk behavior in their facilities,
and they do few epidemiological studies of their own…
But given the testimony of current and ex-offenders about the
realities of inmate behavior, and given the high prevalence
of both HIV and hep C, we can only assume the worst.”
“[T]he tools proven to be most effective
at stopping HIV’s spread, condoms, clean needles, fresh
tattoo ink, are banned in most correctional facilities. Few systems
provide adequate HIV education and still fewer offer substantive
services to aid those living with HIV when transitioning back
into their home communities upon release. Given the astronomically
high incarceration rates, we cannot afford to ignore the prison
epidemic. “
But that’s exactly what we do when we concentrate on myths
and distractions like the hunt for those ubiquitous and invisible
“DL bruthas.” Just as much of black America’s
leadership is content to ignore the fact of our nation’s
disastrous public policy of mass incarceration of black youth,
we have so far turned a blind eye to the growing the threat to
public health posed by the epidemic in America’s prisons,
where again, we are the majority. Prison industry officials, for
their part, are doubtless fat and happy to be so ignored. Many
states and large counties, have privatized inmate health services
too, creating an additional large disincentive to prevention,
testing or aggressively treating HIV and hep C positive prisoners.
BC believes that South Carolina is one of only
two states that tests inmates on entry for HIV, offering them
counseling and in some cases sending them to separate facilities.
The Good News
TV shows like Oprah’s try to end on a positive note ---
a ray of light, a success story, a glimmer of hope. BC
didn’t have to look far for this either
Last month in Illinois, where African Americans make up 15% of
the state’s population, are 51% of the diagnosed AIDS cases,
and 65% of the prison census, activists successfully enacted groundbreaking
legislation that enables Chicago State University to conduct the
nation’s first comprehensive
study of the connection between the HIV-AIDS epidemics in
prison and in the state’s African American communities.
We talked to Chicago’s Lloyd Kelly of the Let’s Talk,
Let’s Test Foundation, one of the principal advocates behind
this initiative.
“'Let’s Talk, Let’s Test’
stands for let’s talk about HIV, and let’s go get
tested,” Kelly told us. “We have talked about this
for a while, and now we are going to test it, too. People have
pointed for years to a possible link between prisons and the HIV
epidemic. The CSU study will give us some hard, useful data and
go some of the distance to prove or disprove between the HIV crisis
out here, and the one behind the walls.”
The Illinois legislation does not provide for mandatory testing
of prisoners. “That would be a bad idea,” said Kelly.
“Inmates have rights too…. Who are we to tell people
they have to be tested, given the consequences of coming up positive?”
Brother Kelly’s point, and we think he is right, is that
potential employers, landlords and other parties have been known
to acquire people’s medical records through various means
and discriminate against people who are HIV-positive. Ex-offenders
have enough to deal with already without compulsory HIV testing.
Just as placing exclusive blame on bisexual black men for the
HIV epidemic is unproductive, scapegoating prisoners is wrong
too.
Among the provisions of Illinois House Bill 2578, according to
an August
19 Chicago Tribune article:
- HIV-positive inmates who are released must receive transitional
case management and referrals to support services through the
Department of Corrections and other agencies.
- HIV-positive welfare recipients may request changes in their
work, education or training program if they meet Americans With
Disabilities Act standards for disability.
- High-traffic state offices, such as driver's license facilities
and public aid offices, located in high-risk communities must
provide space to community groups to offer rapid HIV testing.
Community groups, Kelly told BC, will be able
to walk up to people in line getting drivers licenses or applying
for unemployment benefits, and administer an HIV test with results
in 20 minutes. Additionally, there is to be a permanent panel
including two ex-offender reps who will review implementation
of the act. A provision for the distribution of condoms was struck
from the law late in the process to ensure its passage. Called
the HIV-AIDS Response Act, it awaits funding in the next session
of the Illinois legislature.
There is no doubt that the Oprah show which featured low down
J.L. King and helped legitimize his ghetto-centric and homophobic
boogeyman theories about the spread of HIV set back the cause
of addressing the epidemic which is ravaging black America. The
DL boogeyman does not begin to explain the facts of the HIV epidemic,
in which substantial proportions of infections occur daily from
injected drug use, from sexual contact with an injected drug user
or someone else who has been with such a user. It doesn’t
take into account the prison factor, and it allows us to forget
that many heterosexual men as well as women have multiple undisclosed
partners and are unprotected with many, most, or all of them.
Besides allowing us to ignore or evade responsibility for our
individual and collective sexual behavior, discussion and media
hype over the DL hype diverts attention from commonsensical public
policy measures like those recommended by the Black AIDS Institute’s
“The Time is Now,” which call calls for engaging HIV
“not only as an individual health concern, but also as a
political and social struggle.”
Those recommendations, on pages 7 and 8 of the report are
- 2. Fight to lower the cost of HIV-AIDS and all other drugs affordable
without bankrupting existing or future public health insurance
plans.
- 3. Fight for the Future of Medicaid: The Bush Administration
intends to end Medicaid as we know it.
- 4. Support for Needle Exchange Programs: End the federal and
state bans against these programs which have been proven to save
lives.
- 5. Reject Scapegoating in the Black Community: Instead of looking
for someone to blame, we need to change individual and collective
behavior and public policies to prevent new infection and prolong
the healthy lives of those already infected.
- 6. Restore Comprehensive Sex Education: “Abstinence-only”
education is ineffectual at best, and federally funded “abstinence-only”
often contain outright disinformation.
- 7. Institute Sensible HIV Prevention Measures in Prisons: Offer
free voluntary HIV testing to current and former inmates, real
assistance with transition, clean needles and condom distribution,
etc.
The “DL brutha” is a boogeyman, and boogeymen are
for children. When we become adults, we cast aside childish things.
It’s time to send the DL boogeyman back to wherever he came
from. Oprah helped unleash that boogeyman. Will she help bury
him?
Bruce Dixon can be contacted at
[email protected]
[1] Transcript
of the Oprah Winfrey show, “A Secret Sex World: Living on the
‘Down Low’”, Executive Producer Ellen Rakieten, April 16, 2004,
page 2. Downloaded transcripts from the Oprah Winfrey show are
only $6.
[2] Ibid, P,
11
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