Founder and CEO, AmASSI Health, Wellness and Cultural Centers

According to the Centers for Disease Control and Prevention (CDC), the incidence of HIV is uniquely out of control among African Americans. CDC data indicate that black communities experienced as a percentage of all new HIV/AIDS cases from 25 percent in 1981 to 50 percent in 2001. Among black males, the percentage among all new cases declined from 71% in 1983 to 44% in 1996–but the rate of new infections held steady over those years. This was contrary to some predictions made in the early 1990s that cases among black males would drop to about 25 percent of new diagnoses. These predictions were probably based on notions that black males at risk for HIV/AIDS would–as the white gay community has done–“manage” their epidemic, therefore contributing to the protection of black females and other black males. That did not occur. Thirty years into the HIV/AIDS epidemic, the HIV virus has morphed in the United States into a particularly black problem – we make up over half of new cases and around 1 in 50 sexually active black adults are estimated to be infected compared to less than 1 in 300 whites and Mexican Americans. As a community we must understand the reasons for this, and find solutions fast.
To efficiently resolve any problem it is important to discover its root causes. And solutions to a unique circumstance require examination of its unique parts.
The slavery experience in America and its contemporary manifestations are unique to African Americans. Historically, blacks in America have endured a very deliberate, brutal, and culturally disruptive brand of racism. Current symptoms of slavery and racism include an acculturated and unresolved fear among Blacks of White (or institutional) backlash and judgment. Recognizing the lingering and present-day symptoms of the slave experience is typically a challenge for Blacks. Many prefer just to avoid the topic. But finally addressing it may explain challenges still faced in the community, including the apparent inability to prevent HIV/AIDS.
It is now a new day. America may finally have its first president of African descent. In light of this potential progress, maybe we can begin to actively explore and repair the damage done to Black people and culture, and its impact on modern-day life.
Stigmaphobia, a barrier to black HIV success
Since slavery, up until very recently, being black and having a perspective that challenged institutionalized racism could be lethal. It could compromise one’s employability, quality of life and reputation. Under these conditions, blacks became self-conscious about taking action and about speaking their mind, even to each other, because of a socially induced lack of trust (i.e. Willie Lynch). A fear-driven silencing of black voices resulted in something this writer calls “stigmaphobia”-a fear of being stigmatized (again) by mainstream America or whites.
When watching T.V. news or hearing of terrible events or crime suspects, many blacks repeat to themselves the mantra “God, please don’t let them be black.” This is a common example of stigmaphobia.
Being stigmatized often resulted in Blacks suffering increased societal abuses–disenfranchisement, incarceration, and unemployment. And so for centuries, fear or terror among blacks resulted in the repression of reasoning or critical examination of difficult problems (or critical thinking). This was and is true particularly among males who were arbitrarily targeted by the most deadly versions of racial violence, e.g., Emmet Till.
Living in a patriarchal (male-dominated) country that privileged being a man, most black males rarely had opportunity to be a man (meaning: an adult male human being with the full capacity to participate in the advancement, success, protection and respect of his people, family, self and community). The post-slavery influence of this on Black males persists as high incarceration rates, health disparities, and unemployment (50 percent of black males in Richmond, California, and New York City are unemployed), and now, high HIV rates.
Black history in America has taken a huge toll on black manhood, community and self-concept. black humiliation, a cause and by-product of stigmaphobia, has been a primary immobilizer of Black action and protection against communicable dangers. It has also been a contributing factor to sexism and anti-homosexual attitudes in black communities.
The recent DL, or down low hype has convinced many that black women are the most impacted by HIV. The fact is, black males, by a wide (2:1) margin, are still the disproportionate majority of black HIV/AIDS cases in the United States. The on-going risk to black women results from that black males have yet to be effectively served by many existing prevention programs. Typically, they do not address or engage issues relevant to cultural affirmation, critical thinking, and internalized oppression, sexual abuse, or manhood insecurities.

Critical thinking and cultural affirmation: an antidote to stigmaphobia
In the late 1980s, it became clear to many of us in the health field that African Americans, particularly males, were being significantly affected by HIV. Reports about this sent an already stigmaphobic black community into an unspoken tizzy. HIV among Blacks would or could expose to “everybody” that the black community had homosexuals too. Not that this was news to many in the black community or to whites. But the idea that white people had most of the homosexuals had become an artificial way for some blacks to have racial pride. Investment in this concept helped to create stigma around being homosexual in the black community.
As a people, blacks continue to make great strides, and the more we collectively learn about ourselves the brighter our future is. While life is supposed to be a learning process, for many black people it needs also to be an unlearning process. We must unlearn myths and attitudes that prevent us from protecting ourselves and one another. Addressing uncertainty about black manhood and masculinity, female self-protection and internalized racism (self-hate) is Ground Zero for effective intervention against HIV/AIDS in the black community. Actively fostering mentally and emotionally healthy black people, and parents especially, will increase responsible behavior, increase interest in self-protection and decrease HIV risk to women and men.
Toward resolving the black HIV epidemic, the AmASSI Health, Wellness and Cultural Centers, based in Inglewood, developed a prevention method called Critical Thinking and Cultural Affirmation (CTCA). CTCA gave black males-whether at HIV risk or infected– the opportunity to engage all of the issues presented in this article. A six-month pilot study using the CTCA prevention strategy led to successful HIV risk-reducing behavior change and self-concept improvement among 80 percent of high-risk black male participants. The MAALES (Males of African American Legacy Empowering Self) project, a research intervention based on CTCA, is currently recruiting black men in Los Angeles at HIV risk, who have had both male and female partners.
CTCA and the MAALES Project embody innovative and culturally informed methods intended to reduce the black HIV problem. Greater involvement of black men in this and other culturally grounded efforts to address the challenge HIV presents African Americans is one of many steps necessary to dismantle the crippling effects of stigmaphobia. Moreover, participants report benefiting from the information provided and from the rare opportunity to share in a discreet and non-judgmental setting those factors that may keep them from optimal health.
– Cleo Manago is founder and CEO of the AmASSI Health, Wellness and Cultural Centers and can be contacted at cleomanago@aol.com. AmASSI can be reached at 310-419-1969 or 1800 STOP-HIV. For more information on the MAALES Project or to participate, call (310) 825-5474 or visit http://www.cdrewu.edu/MAALES/.

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