[DOWNLOAD ORIGINAL ARTICLE IN WORD FORMAT]
[DOWNLOAD EDITED ARTICLE IN WORD FORMAT]

Black Brothers Esteem

AIDS is now the leading cause of death among African-Americans between the ages of 25 and 44,according to a study published this week by the Henry J. Kaiser Family Foundation.

Black Brothers Esteem (BBE), a San Francisco-based prevention program for bisexual and gay African-American men, hopes to change these statistics through community and self-esteem building.

Under the auspices of the San Francisco AIDS Foundation, BBE has offered support groups, interventions, community forums and workshops for HIV-positive and HIV-negative African-American men who have sex with men since 1997. The program focuses on the Tenderloin, Castro and South of Market corridor, an area with with high rates of HIV infection for African-American men.

Gay and bisexual African-American men face racism in the gay community and homophobia in the African-American community says Jamal Bey, BBE program coordinator. Coupled with poverty and isolation, those factors have a strong negative effect on the way people think about themselves. These men aren't allowed to be who they are, they feel oppressed and so continue to live on the down-low, to lead lifestyles that put them at risk, said Bey.

The down-low is slang for men who have unprotected sex with men, but keep their identity closeted. Such men often leada double life and have unprotected sex with their wives or female partners, which leads to greater rates of HIV infection. The phenomenon is a common problem among African-American gay and bisexual men uncomfortable with their sexual orientation, and one that Black Brothers Esteem is working to address through weekly workshops like Phoenix Rising.

The weekly drop-in group offers food, stability and a safe place for men to
talk and share their lives. In the past, people who are African-American and gay have not had places to which they can turn, said Bey. BBE workshops foster a welcoming environment, and that's the goal. The more people feel good about themselves, the more they will look at themselves in a different light, and act responsibly.

In the Tenderloin, Bey says, sex is a commodity. Not only do people exchange sex for drugs, but also they often use sex for human contact, , however fleeting. The BBE gives clients a sense of community, Bey says. It teaches the men to be leaders in their own lives by giving them skills and choices and enabling them to make better decisions for themselves, he said.

With 15 years experience in public health, Bey has been with BBE since it
started.. Although some of the original Phoenix Rising members have died, a dozen men or so still come regularly to the Market Street office. And today, over 400 men a year come to the support groups, interventions, workshops organized by Bey and his logistics coordinator Gregory Howard.

As AIDS rates of infection increase among African Americans atan
alarming rate, BBE and other prevention programs must tackle major
challenges. The Kaiser Family Foundation's recent study reports that in
2000, more African-Americans are estimated to be living with AIDS than any other racial or ethnic group in America. Though African-Americans represent about 12 percent of the population, they now account for 54 percent of new HIV infections and 47 percent of new AIDS cases.

One of our biggest challenges, said the BBE's Gregory Howard is to make people realize that they have to protect themselves, that despite the fact that HIVwill remain a serious health issue, it's not inevitable for them if they take care of themselves.

But, says Bey, prevention is not merely an issue for people with low self-esteem. As AIDS increases in low-income communities, the people at the gravest risk of AIDS are also the least equipped to handle and prevent the epidemic.

African-Americans face poverty and racism among a host of other issues that affect public health , says Bey, and prevention efforts have traditionally overlooked such factors.

"We need to look at the day-to-day issues that impact people's lives," he said. "If people are hungry, if they are homeless, then getting tested for HIV or using protection is not a priority. Finding shelter, finding food is. So before people can come to a support group, you need to meet their basic needs first"