We received so many passionate responses to the last health post on the study, Back of the Line: The State of AIDS Among Black Gay Men in America 2012, that I felt it important to provide more information and insert other perspectives into the conversation.
There is a topic in public health called “Social Determinates of Health”, it is a topic that the World Health Organization (WHO) has been talking about since 2005 when they established the Commission on Social Determinants of Health in an effort to provide advice on how the conditions in which people are born, grow, work and age, including health systems, may help to determine their health.
The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention picked up the topic and in 2010 created a white paper called ‘Establishing a Holistic Framework to Reduce Inequities in HIV, Viral Hepatitis, STDs, and Tuberculosis in the United States’.
The WHO commission on Social Determinants of Health, 2005-2008 generated a report that concluded: “This ends the debate decisively. Health care is an important determinant of health. Lifestyles are important determinants of health. But… it is factors in the social environment that determine access to health services and influence lifestyle choices in the first place.”
There are reasons that help to explain our “lifestyle choices” and why the infection rate is so high for gay men, and for gay black men in particular, that go to the very core of our society and, in my opinion, they have more to do with topics like social isolation and loneliness, self-esteem, discrimination, religion, distribution of wealth, access to health care, and the horrid history that public health has and the reputation they have earned in the name of research, prevention and disease intervention activates.
I also want to say a little something about Adam4Adam, and hook-up sites in general. One of the consistent arguments that I have heard over the past 12 years is centered around blaming sites for everything from the rise of HIV to decline of gay society.
What is Adam4Adam without our members? A blank space with some adult ads.
What fills and makes Adam4Adam what it is, is us, gay men. We gay men are Adam4Adam, it is what we make it though the content we provide and the products we purchase.
Hook-up sites exists because there is demand, the ads are what they are because they sell products, it is simple: supply and demand rule, especially as a free site, that does not charge a membership fee.
We as Adam4Adam have no control over what men do in bed and, even after decades of spending billions of dollars on research, programs and some of the most intelligent minds in the country, organizations such as the Centers for Disease Control, also have no control over what men do in the bed room. I also wonder how much influence public health has on lifestyle choices. Can anyone be motivated to consistently wear a condom through a campaign or program?
If it is true that: “it is factors in the social environment that determine access to health services and influence lifestyle choices in the first place.” Then we, as society, that must take responsibility and it is we, as individuals that make up our society, that must work towards creating the change in the social environment that can improve the social determinants that influence health and therefore improve the health of all gay men.
Yours in good health,