Em-URGE-ing Voices

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HIV Stigma and Queerphobia in Pop Culture and Public Health 

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May 16, 2023

Disclaimer: Mentions of HIV Stigma, anti-LGBTQ+ stigma, and healthcare discrimination 

As I entered adulthood, I began having more access and space to talk about sex. Being raised in a household where sexual health was not discussed, and there were anti-LGBTQ+ attitudes, talking about sex and expressing curiosities about dating were new to me. One thing I noticed from conversations I had with my peers about sex (many of whom identified as cis-straight Black women), was that there was frequent speculation about other people’s sexual identities. I remember being asked a couple of times if I would engage romantically with a bisexual guy. At the time, I didn’t understand these types of questions because I, too, was queer. I couldn’t fathom why it would be my concern if I dated other queer or bisexual people, including men. Why was it my business? Where was this coming from? 

I always had curiosities surrounding dating and where people got their beliefs from. This speculative concern about a partner’s sexuality reemerged when I watched Tyler Perry’s film adaptation of Ntozake Shange’s book, For Colored Girls. My curiosity about where people got their beliefs from and why there was such an investment in men’s sexuality and sexual desire clicked soon after watching this movie. There’s this infamous scene where a Black woman named Joanna, played by Janet Jackson, confronts her partner, Carl, played by Omari Hardwick, about his past cheating with another man. It’s revealed that Joanna and Carl are both living with HIV, and the focus of the conversation turns to Joanna’s concern for Carl’s same-gender sexual experiences. Carl is supposed to represent the “Down Low” trope, which is typically used to refer to men who are in a straight-presenting relationship but have repressed same-gender relations either currently or in the past. In the scene, Joanna expresses disgust at Carl’s sexual relations with another man. When she says, “How did you marry a woman, and then turn around and let a man bend you over?” it reveals underlying anti-LGBT beliefs concerning how a man is supposed to act. The DL trope and biphobia in this scene as well as Tyler Perry’s other film, Temptation: Confessions of a Marriage Counselor, portrays the idea that Black women are victimized by DL and bisexual men’s deception. It is this premise that seeks to incite panic and fear and demonizes bisexuality further. This contributes to the blame placed on bisexual men for the HIV epidemic. Because of these harmful tropes surrounding people living with HIV, there are laws today that still criminalize people with HIV. 

The themes and tropes commonly presented in Tyler Perry’s body of work are also reflected in public health research. When Black LGBTQ+ and Black sexuality is brought into conversations for research and interventions, it largely focuses on mitigating HIV risk. This risk-centered messaging, associating risk with LGBTQ+ identity and experiences, contributes to a narrow view of Black sexuality. The risk-centered focus can also further perpetuate HIV stigma and anti-LGBTQ+ beliefs. A 2012 study, “African American Women’s perspectives on ‘down low/DL’ men: Implications for HIV prevention,” found that in the case of partner infidelity, many of the straight Black women participants were more concerned if their partner’s infidelity occurred with a same gender partner versus with another woman. Additionally, the participants perceived higher HIV risk if engaging with men who they saw as “down low” or bisexual.  

These underlying beliefs promoting gender norms about men not being gay or bisexual and not engaging in same-gender intimacy contributes to HIV stigma and biphobia. Anti-LGBTQ+ beliefs are linked to HIV stigma. These stigmatizing beliefs and attitudes can be traced back to heteropatriarchy, heterosexism, and white supremacy. Associating a person’s sexuality with risk, such as the tropes and imagery promoted in For Colored Girls and the rigid narratives within public health, is harmful, places blame more on LGBTQ+ sexuality, and erases the entire context of how the HIV epidemic has disproportionately impacted Black communities through systemic barriers. 

Speculation about Black sexuality and HIV stigma not only impacts dating experiences but also how Black LGBTQ+ people engage in health care and prevention. When I first went to my local sexual health clinic to get tested, I was looking forward to getting sexual health information and learning more about safer sex. It was an added plus to see Black women nurses and practitioners there, and it made me feel comfortable raising my questions and curiosities. I asked about the types of testing they offered, the contraceptives they recommended, and general information about how to understand my test results. However, the vibe shifted as soon as I disclosed that, at the time, I identified as bisexual. The conversation quickly became focused on promoting abstinence, implying that because I was bisexual, I was promiscuous and faced a lot of “risk.” I couldn’t understand why there was this shift even though on paper, I was doing my best to engage in safer sex practices such as “knowing my status.” 

Things started to click during one visit when I was getting tested regularly. I was placed in one of the appointment rooms waiting to be seen by a nurse. When the nurse came in to see me, I saw a blue pamphlet in her hand. She gave it to me and immediately left the room so I could read it. The pamphlet was for Pre-Exposure Prophylaxis (PrEP), a medication to prevent HIV. I remember skimming through the PrEP pamphlet, which in bold words read, “Who is at Risk for HIV?” Included were (1) bisexual people and (2) people who engage in “promiscuous” sexual behaviors. Left to wait in the room by myself without any further education from a provider I trusted, I felt a surge of emotions, including humiliation, confusion, and anger. Although I couldn’t pinpoint what I had experienced in the moment, I knew something was not right and that it was harmful. 

 As you can imagine, I was not the only one who had experienced sex-negative messaging from this sexual health clinic, the last place I thought would perpetuate these ideas. Other people had recounted experiences where their sexual behavior was scrutinized when using this clinic’s sexual health services. The attitudinal barriers held by the nurses at the clinic –which refers to the ways societal attitudes may prevent people and communities from accessing health care—HIV and the stigma and queerphobia that permeates media, pop culture, and public health settings reveal attitudinal barriers to treatment, care, as well as quality of life. The attitudes I’ve seen concerning Black queer sexuality and the demonization of people living with HIV can affect how someone views themselves and whether they seek testing and prevention care or not. It’s these harmful tropes, speculation, and beliefs that further marginalize Black communities and Black sexuality. 

Combatting HIV stigma and addressing anti-LGBTQ+ beliefs continues to be a major barrier to ending the HIV epidemic and is a deterrent to the liberation of Black sexuality. Public health research, media & pop culture can perpetuate harm, especially HIV stigma, homophobia & sex-negative attitudes. However, together as a community and greater society, we can stop HIV stigma and queerphobia. 

We need to address stigma on all fronts: through comprehensive LGBTQ+ inclusive sexual health education, confronting the harmful narratives pushed by media, pop culture, and within public health research, decriminalizing HIV, and by combatting attitudinal barriers carried by health care providers. Most importantly, prevention needs to ensure people, including those living with HIV, have quality and safe healthcare experiences with providers who are invested in their holistic well-being. It’s imperative that prevention aims to link people to adequate care across the HIV continuum and that PrEP is made accessible to all

“Untitled,” Acrylic Painting. 2022 

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