Ralph Garcia’s friends didn’t know he had AIDS until he died. He didn’t want to tell them he was gay.
“There’s many stories like that, where men don’t seek care because they don’t feel they can be honest,” said Gina Thompson, administrator of the HIV program at Bushwick’s Wyckoff Heights Medical Center. “Many people are dying right now because of that stigma.”
Despite gains in both treatment and perception, lingering fears against being labeled gay or HIV-positive are hindering any further decreases in the high diagnosis rates of this majority Latino area. Gay youth who are shunned by their families are particularly at risk. Medical providers, social workers and Bushwick residents are combating homophobia to lower HIV transmission in the neighborhood.
“When you’re in an environment where you don’t feel comfortable being gay, you’re not going to access services,” said James R., author of Bushwick Daily’s recent Closeted in Bushwick essay. “You’re going to put it on the back burner.”
Such unease inhibits treatment in Bushwick and Williamsburg, an area that has suffered diagnosis rates in the top ten highest in the city in 8 of the past 11 years, according to the city Department of Health and Mental Hygiene. In 2011, about 73 residents out of 100,000 in the two neighborhoods were diagnosed with HIV, the fourth highest ratio in the city and nearly two times that of Brooklyn.
Thompson of Wyckoff Hospital said in a phone interview that Bushwick’s poverty, education levels and substance abuse contribute to transmission of the virus.
[pullquote]Bushwick’s poverty, education levels and substance abuse contribute to transmission of the virus.[/pullquote]
“This area is just saturated with cofactors that are associated with risk,” said Thompson, who has led the Positive Health Management program at Wyckoff Heights since 1995.
Daniel Mercado, an AIDS patient at Wyckoff Heights, knows the circumstances of the neighborhood firsthand. Mercado, 43, grew up in a working-class Puerto Rican household in Williamsburg and he caught HIV from his first partner in 1990.
“I’ve been through a lot of regimens,” said Mercado. “And I’ve been through every possible cocktail.”
Latino-American men are two and a half times as likely as white men to become infected, according to the Centers for Disease Control. The entrenched definitions of manhood in many communities often feed these higher rates by pushing sexual minorities to the margins. Mercado said some in his old neighborhood were willfully confused about his condition.
[pullquote]Latino-American men are two and a half times as likely as white men to become infected…[/pullquote]
“I remember the Spanish people saying, ‘He has cancer,’” said Mercado. “They knew what it was but there was a stigma.”
Incidents like the 2011 beating of Williamsburg resident Barie Shortell make stigma a potent issue in an area that has seen a lot of changes. During intermission of a recent edition of the bawdy show hosted by Macy Rodman, Jake Noodles, the talent booker for the Monday night “Bath Salts” drag show and Rupaul watch at Don Pedro in East Williamsburg, said he’s watched neighbors adjust over the years.
“There were people in the neighborhood who hated it,” said Noodles about the presence of a gay scene. “But the more times they were here and they were around people, they said, ‘Oh, I get it.’”
HIV prevention will get better if more people get it. Public health experts cite the stigma of being gay as a reason for the spread of the virus alongside injection drug use, unprotected sex and other risk factors.
Jesus Ramirez-Valles of the University of Illinois-Chicago studies how to best reduce the prevalence of HIV among Latinos, and he has cited homophobia as a major influence.
“The stigma toward gender nonconformity and HIV/AIDS still defines the lives of Latino gay men,” he wrote in a 2007 essay in the American Journal of Preventive Medicine. “It represents, along with racism, one of the major obstacles to a healthy and fulfilling life.”
A new facility scheduled to open next summer at Wyckoff Hospital is an attempt to bring on that healthy and fulfilling life by offering patients a new treatment center targeted toward Bushwick’s LGBTQ population. The hospital will use a federal grant of $312,500 to hire three staffers and set up a wing where youth will not feel outed or ashamed.
“Unfortunately sometimes the frontline staff are actually the people who make you want to walk out,” said Luz Santiago, who will manage the LGBTQ center she’s dubbed “Ralph’s Place” after her friend who passed away in the mid-nineties. She added in the phone interview, “We don’t want to do that.”
Arrangements like the new center speak to prejudice Bushwick resident Barbie Gomez said she had noticed at some traditional medical facilities.
“The way they treat you as a straight man, they’re not going to give me the same love and attention,” she said.
The hospital is trying to welcome the ostracized group often served by programs benefiting runaway homeless youth. Paul Sealy, director of Williamsburg’s Independence Inn temporary residence program from the SCO Family of Services, said blacks and Latinos often face a “double-edged sword” of economic disadvantage and homophobia.
But the 180 young people who live in the extended living quarters, as well as those who use computers, cots and laundry units at another SCO Family facility nearby, are not conspicuous in their need.
“The face of a runaway homeless person doesn’t look the way you expect it to look,” said Sealy. “They’re not sitting on a cardboard box. Nine times out of ten they don’t look that way.”
Gomez, who receives sex change counseling at a New York Psychotherapy and Counseling Center in Bushwick, said these runaway youths sometimes find themselves selling their bodies to survive.
“What happens is that they don’t have a family backbone,” said Gomez. “And if they don’t have anyone behind them, they go out and do desperate things.”
Gomez then left to join her brother, who had accompanied her to the center. He had walked down the block and was hidden around a corner.