The CDC’s Tale of David and Goliath

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Newsmaker

By Rashad Burgess

Rashad Burgess is a program officer for the Centers for Disease Control and Prevention. During the 2005 HIV Prevention Leadership Summit in late July, Burgess, a black gay man who has been working in HIV since early in the epidemic, delivered the following keynote address.

The annual meeting brings together organizations, individuals and local officials funded by the CDC to do HIV prevention work. It is considered a central event for shaping the year’s priorities. Noting that he wanted to do “something different” from the usual numbers-crunching in his speech, Burgess spoke from a personal perspective about the summer’s startling new research on HIV infection rates among Black gay and bisexual men.

Good Afternoon!

Usually when we at CDC speak during plenary sessions we give you power point presentations, statistics, graphs and charts, and many words or phrases that most people work very hard to understand, including me. Well, this afternoon I was asked to do something different, out of the ordinary and, for some, maybe even strange coming from CDC. I am charged with making a Call for Action.

Now because of my own belief systems and the vision of those that asked me to speak, I am bringing all of me and my experience to this talk — from previously managing a HIV Prevention program on the south side of Chicago, to my time spent on a community planning group, to my work at the Chicago Department of Public Health, in developing the MOCHA Coalition, and my current role as Team Leader at CDC. But this talk is rooted not only in my professional life, it also comes from my personal life as a Black gay Christian man — someone who grew up in a time where I saw so many men like myself become ill and die, one by one in profound silence and shame.

So this may not be the norm, but hopefully it will be a call that will ring far beyond these walls and this building.

Over the past several years, CDC has released significant data describing the awful impact that HIV is having on Black ‘men who have sex with men.’ In case you missed it, let me remind you of some of the highlights of what this data have shown us.

First, in 2000, Dr. Linda Valleroy of the CDC released data from a six-city Young Men’s Study showing that approximately one in three — 33% — of young Black MSM ages 23-29 were HIV positive.

Secondly, in 2001, from the same study we found that the HIV incidence [the rate of new infections each year] among young Black MSM was 15%.

Well, here we are in 2005 and the story continues to be dire — and for too many of us even worse. In June of this year CDC released an analysis of data from five cities participating in the National HIV Behavioral Surveillance system and the results were saddening to say the least.

Of MSM of all races, 25% were HIV positive with 48% unaware of their status. When the data was stratified by race the HIV prevalence rate for Black MSM was 46%, and two-thirds were unaware of their HIV status. That means that nearly half of all of the Black MSM that were tested in this study were HIV positive and the far majority did not know it.

When I first heard this information, I remember initially thinking to myself: Well that was what we expected. I mean this is consistent with the results of the Young Men’s Study. Also, many of the CBOs who do work with Black MSM have seen relatively high rates in their counseling and testing programs. So this wasn’t necessarily new. We knew things were bad.

But once I got beyond my initial attempt to validate the newly released data by connecting it with what I already knew, it hit me that there was no emotion behind my analysis. I did not feel anything. I did not feel what I believe I should have felt — the feelings of anger, sadness, hysteria, or outrage!

So why? How could I hear that nearly half of us anywhere in this country are HIV positive and most don’t know it, and it not sadden or outrage me. This was frightening. Had I been bitten by the bug? You know, the bug of apathy and numbness? Had I lost the emotion that one experiences whenever a community, anywhere, is devastated by any disease at these proportions?

Had I gotten so used to people who look like and feel like me living with HIV that I no longer possessed the vision for us to live without HIV?

It seems as if it has become the norm for Black MSM — Black gay men, Black same-gender-loving men — to have disproportionately high rates of HIV infection, which are equal to and surpass some sub-Saharan African Countries.

This is not OK! This is not right! This is not normal! I must be moved! All of us must be moved. We must not accept that it is OK for anyone else of any group to become infected with HIV. When we hear that potentionally one-third to one half of a single community may be HIV positive, right here in our own back yard, churches, schools, clubs, cities…We must act and act now. Apathy is no longer OK. We must be outraged.

It is important for me to say that since June there has been some activity, and a group of amazing African American men are mobilizing to respond. We at CDC are in the planning stages of a number of responses including a consultation with key community members and stakeholders. But I am afraid that even if these efforts are amazingly successful the problem is so big and so dire that it will not be enough.

Well, I know that some of you may be asking, what can I do? Well I’m glad you asked. First we need you to be angry, outraged, mad and sad! Not accepting that it is OK that HIV infections among Black MSM are so high.

Second, be willing to take the risk and raise the issue even if it doesn’t directly benefit you. Ask the questions at the next community planning group meeting: What are we doing? What have we done? Are we doing enough to address this problem? Raise your voice. Make a commitment to do something.

Recently I was speaking with both my partner and grandmother about what is going on with Black gay men in HIV infections and how frustrated so many of us are. Even with some of the organizing that is taking place, I’ll take the risk and say many of us are tired, weary and frustrated that 25 years into this epidemic we are in this place. People who have given their lives to the cause of HIV have gotten tired, even the new folks are getting tired quick.

So when I shared this with her she said the strangest thing to me. “Remember David,” she said. At first I didn’t know who or what she was talking about. We don’t have any relatives named David, so I was really at a loss.

She continued, “Remember David and Goliath.” Now, I told you that I was going to bring all of me, and part of me is a deep church boy. So, my Grandmother knew that the reference of David and Goliath would have deep meaning for me.

I am not sure how many of you know the story but it is quite an interesting story. David, a young, Israelite and unassuming man, is at the forefront of the battle between the Israelites and Philistines. And the Philistines’ great warrior is this huge, overpowering giant named Goliath, and all that encounter him deeply fear him. After much discouragement from his brothers, because they didn’t believe David was a match for Goliath, David faced him head on. He took what he had, looked the tall giant in the eyes and reached in his bag, pulled out a pebble and threw it at him, and did so three times. On the third throw he hit him in the center of his head and it pierced his skull and Goliath fell to his death.

This story brought to my mind that each of us has a pebble that can be used against those forces that are working against our greater good. I began to wonder what it would mean if everyone sitting in this room took out one of their pebbles and threw it in the direction of HIV and the impact it is having on Black MSM.

For some, that pebble will be in the form of raising the issue at the next community planning group meeting. For others, the pebble will be going to speak with your executive director, program director or board of directors and asking to make some programmatic expansions or shifts. For others your pebble is releasing an RFP and targeting resources to address this issue. For some the pebble is making a commitment to target more Black MSM for HIV counseling and testing. For you, the pebble may be organizing some people who care to do much more than I can even speak to.

Just imagine that if David, one person, can defeat a Goliath with several throws of a pebble — which later leads David to his kingship — just imagine the impact if all of us picked up just one of our pebbles in our possession and directed it towards this issue.

I am going to leave you today with this. I believe that if we just make a commitment to do something, to act, to pick up just one of our pebbles and direct it towards this issue, the universe will conspire for our success.

Thank You.

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