The Future Is Now!

INTRODUCTION 

 

The path to ending the South's HIV epidemic should elevate, nurture, and provide Black leadership and organizations resources.  While this paper focuses on HIV, we must remember that HIV is a symptom of what is ailing the health of black people. We must look at the root causes, structural factors, social determinants of health, and trauma to End the HIV Epidemic. Shifting the Southern HIV epidemic approach will facilitate true freedom and liberation for black people - collectively and individually.  The crises of our present time should not and need not be our future; therefore, we seek to create a new narrative and legacy. This new narrative is reflective of our values of self-determination, equality, equity, empathy, freedom, liberation,  innovation, collective action, and community.

 

Despite the strength and resiliency -- the ability to overcome life's challenges – of black people, the level of social and health disparities that have plagued this community is no longer acceptable. Black people represent 13% of the U.S. population. Still, we also represent 50% of all persons living with HIV, 46% of incarcerated individuals, and the criminal justice (injustice) system, 40% of the homeless population, and now there is higher exposure, infection, and death from Covid-19 among black people. These gloomy statistics result from overwhelming systemic and structural inequities arising out of historical racism and discrimination and are further exacerbated by the unacknowledged and unresolved trauma resulting from historical and current events.  

 

The provision of funding, while helpful, is not the only answer. For example, government agencies charged with ending the HIV epidemic have received billions of dollars, and organizations charged with providing vitally needed services have received millions of dollars.  However, this forty (40) year effort has failed to reduce the level of HIV in the Black community significantly.  Black people are exhausted.  Black people are sick.  Black people are dying. 

 

The systemic racism toward Black people has undermined our ability to advance and prosper in a nation with an abundance of capital and expertise, which cannot continue.  The existing narrative must change.  The approach, strategies, and efforts must evolve to effectively address HIV, poverty, poor health, mass incarceration, and justice for the murders of Black men, women, and children by the police (public servants who are supposed to serve and protect).  It is time to move from talking to action, from incremental change to full change, and from complacency to standing firm in the face of white backlash.

There is a tremendous responsibility not only to say something but also to respond to injustices that continue to be perpetrated on black people and our communities.  This document, the "Future Is Now! A Political Agenda for Advancing, Building, and Sustaining Black HIV Leadership in the South" will provide Black leaders with a framework for educating the community and decision-makers working in the South.  Additionally, Black South Rising hopes this political agenda will lead to the engagement of Black people and other stakeholders in movement building, mobilization, and advocacy to end the HIV epidemic and other intersectional challenges facing Black communities in the South.

 

APPROACH: THE FUTURE IS NOW!

 

“The strongest people in the world are not those most protected: They are the ones who must struggle against adversity and obstacles and surmount them to survive.”

Author and Date Unknown

 

“We have risen. We know what we must do to secure our rights as human beings and citizens of this Country, and we will resist every attempt from those who seek to deny us.”

Black South Rising, 2020

 

Black South Rising, in honor of our ancestors and present leaders of the Black Southern HIV movement, whose shoulders we stand on, has created a political agenda or plan that addresses the moment -- today -- and not tomorrow or some distant future. This political agenda addresses the current political, social, and public health crises -- racism, voter suppression, HIV, and Covid-19 -- destabilizing and devastating Black communities in the South. Despite these grave challenges, we remain determined and hopeful. We rely on our resilient spirit and generosity that have enabled us to survive centuries of slavery, systemic oppression, and stigmatization to become a mighty people of varied social, cultural, political, and economic expressions. 

 

The current anti-black rhetoric and policy choices that threaten Black people in the U.S. are not new. Despite the centuries of racial precedent that have denied Black people their human and civil rights, we have been instrumental in building this Country, fighting its wars, and paying taxes. Leading the way to secure our civil rights was the Black South. The Black South still comprises the largest group of Black people -- African Americans -- in the United States. It was predominately in the South that our Black freedom fighters waged non-violent battles to end Jim Crow, obtain our civil rights, and led the advances for political, economic, and cultural power -- advances which have made the South a mecca for young Blacks and Blacks returning to the South seeking life within culturally and socially relevant environment. 

 

Yet, this country continues to treat us as "three-fifths” of a person, as referenced from a compromise reached among state delegates during the 1787 United States Constitutional Convention. In 2020, Black people in America do not have the same right to life in terms of controlling and protecting our bodies, the same right to viable opportunities for economic advancement, or the same right to create safe spaces to fully experience “life, liberty, and the pursuit of happiness." This political agenda acknowledges this country's deep-seated racism, anti-blackness, and the legacy of over 250 years of dehumanizing slavery, followed by more than 150 years of domestic terrorism and systemic discrimination. The continuation of government-sanctioned violence on our bodies, our communities, and the environment in which we live today leaves us with disproportionate levels of trauma, illness, and death. 

 

This political agenda addresses this legacy and its attuning consequences. Instead of seeking to work within existing systems and structures that protect white privilege and power, we will build upon the following three demands to develop, promote and safeguard emerging systems and organizations led by Black people.

 

1. First, multi-year investment in funding and non-monetary resources from foundations and corporations must be made in support of Black leaders, and organizations must address the aforementioned societal ills and wrongs..

2. Second, these resources must be used to:

   • Confer with Black southern elected officials, representatives and key staff members from the Congressional Black Caucus, and Congressional HIV and AIDS Caucus, and leaders from other Black coalition efforts to create a staffed commission (or think tank) organized for interdisciplinary research and to develop innovative systems and programs that are culturally specific to the Black experience in America. Black government officials will be invited as guest presenters to provide data and status reports on upcoming initiatives. 

   • Confer with funders to provide financial support to Black leaders who work in the South so they can fully participate in the creation and management of this commission or pursue other opportunities that will influence the work of the commission, e.g., fellowships to study specific areas or sabbaticals to learn or enhance knowledge and skills to put into practice. 

3. Third, systems and organizations exhibiting racism and bias -- intended or unintended -- must change or be defunded. 

 

Our grit, determination, and faith have enabled Black people to overcome tremendous odds against our ongoing survival. These demands and the following change initiatives are critical to creating lasting, sustainable change and growth for our lives and future generations of Black people and to ultimately end the HIV epidemic in the South. Our ongoing resiliency as a people is a powerful antidote to oppression. We shall not be moved.

 

AGENDA: CHANGE INITIATIVES

 

Using an intersectional analysis, we must challenge anti-blackness, systemic racism, and poor social determinants of health, making us vulnerable to HIV and other deadly health viruses such as Covid-19. The Black community requires a comprehensive response -- change initiatives steeped in racial and social justice -- developed and led by black people that address the underlying conditions that facilitate HIV transmission. 

 

HIV, combined with racism, stigma, economic inequity, fear, and mistrust of medical health systems, has had an outsized destabilizing and devastating impact on Black communities in the South, which has caused a decline in hope, trust in public health, and mutual respect. The change initiatives listed below strive to disrupt and correct the political, social, and environmental factors that lead to confinement, illness, disability, and premature death of black people.

 

While it is clear that the United States is far from addressing the lasting impacts of historic and continuing injustices, we must insist that the following changes occur without further delay.

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We insist on Black leadership and representation. We must prevent non-Black institutions, organizations, or individuals from blocking Black people from acting in their own best interests. As people of African descent, we are naturally spiritual and creative. As a result, we are intuitive, and from our many lessons on how non-Black people use power, we are keenly aware when the weather is changing. Just as an individual with a knee injury knows when it will rain, so do black people know when someone is acting out of their racism and bias. We will no longer accept other people's definitions of racism or prejudice. We will no longer debate or argue with non-Blacks about the state of affairs in the Black community. 

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The importance of this imperative cannot be overstated. Overall, we are generally not involved in the design and implementation of services for our communities. For the most part, the delivery services by non-Black people would be acceptable; however, many are -- aware or unaware -- of organizational and individual racial biases and anti-Black attitudes and behaviors. There is zero to little accountability to black people by these organizations or individuals. Our repeated insistence on meaningful involvement has no sway or credence with the majority of these organizations. 

 

Our approach will require the adaptation of organizational leadership and structural models that suit and meet the Black community's needs. Such an approach will require funders to think outside their comfort zone of what they think will work -- outputs and outcomes -- which does not bear any actual relationship to the actual malice and negligence suffered by Black people in this Country.  If funders want to see real change and progress, they must courageously fund black-led organizations to do the work that no one else can do by supporting: 

 

• Innovation. Innovation, which requires the opportunity to reflect and dream deeply, is a necessity. Many of the existing services are stale, outdated, and have few cultural reference points for Black people who may use them. Furthermore, how organizations carry out their mission and services must be rethought. Our survival goes beyond the standard working hours of 9 to 5. Supporting innovation would enable Black people to build organizations, services, and interventions that embody our cultural expressions in a manner that would naturally attract our people. Resources are needed to figure out how to make these dreams of innovation a reality. 

 

• Safe spaces. Safe spaces where Black people can be free are desperately needed. To many, our existence is a "no," which we have internalized. We must combat this internal "no" by providing spaces that allow people to express themselves for who they are.

 

We insist on human rights and social justice. The clarion call of "Black Lives Matter" requires us to protect every individual who identifies as Black in this nation regardless of race, gender identity, sexual orientation, age, immigration status, or class. We live not in one single world but a multi-diverse world, so we need multiple approaches and spaces. In other words, liberation comes in many forms. This rethinking of how we move through this world will require us to reimagine and reorganize our society. It begins with the call to stop shaming our people. While we must also strive for personal responsibility and accountability, we cannot do so in a manner that shames people. We cannot legislate attitudes and behaviors, but we can educate.“Black Lives Matter” requires us to go beyond who we say is black for black people are not homogeneous - we, of the African diaspora, experience the same anti-blackness, racial bias, gender inequities, homophobia, and transphobia. People must have options to grow, to succeed, or to fail on their own. 

 

We insist on the divestment and dismantling of destructive systems and institutions. HIV is also a moral issue and represents our moral failure as a nation that is rich in resources and expertise to stop the damage and carnage caused by social and public health crises. Ending the HIV epidemic by tackling multiple levels of stigma, criminalization, and dismantling systems are possible, but only if Black leaders have the external and internal resources to do this work and find the best platform for their work. Racial equity means that organizational leadership in the region must reflect communities most impacted. We insist upon a commitment to create and sustain new Black-led organizations and adequately support existing Black-led organizations. Once again, as referenced one of the three previously stated demands, we insist that systems and organizations exhibiting racism and bias -- intended or unintended --  must change or be defunded.

 

We insist on funders changing how they resource community projects, programs, and interventions. We must challenge the unwillingness of funders to change how they do business. Donors must accept that funding should be community-driven, particularly in the South, which should be treated differently from other regions across the nation due to its peculiar circumstances. Donors should be aware that existing organizational structures have neutralized Black leaders' power and impact their ability to advance policies and programs. These changes will address the lack of options for services within the community. We must look beyond the large organizations in the field to the Black leaders who stand shoulder to shoulder to fight for our people and our communities. Funders must understand that we have the capacity, skillset, and expertise to address and resolve our community's issues. But we do not have the funding. These resources are needed to support our movement building through messaging, mobilization, and remembrance. Thus, fighting for funding flexibility will enable Black organizations to serve the whole person and not be restricted in delivering services. 

 

Finally, funders must use their influence to promote Black leadership -- at the senior and executive management level, at the board of directors' level, and within the county and state health departments. Furthermore, we must ensure that Blacks living with HIV are afforded the opportunities to fully participate as subject matter experts, whether in organizations or at decision-making tables. We ask organizations that work in the South to re-examine their boards and staff and take steps to change if it is not reflective of Black leadership. Organizations cannot understand our needs and have our best interests at heart if we are not included at every decision-making level. 

 

We insist on implementing workable solutions to address root causes, e.g., social determinants of health, that elevate HIV vulnerability and risk.

 

• A right to a livable wage or universal basic income. We must insist on adequate compensation for work performed. After rent/mortgage, utilities, transportation to and from work, food, phone bill, one is working to survive barely. We must ask ourselves, how is one able to live comfortably or find any comfort at all? It is cruel and unusual punishment to ask people to work for low wages. People sometimes give up not because they lost hope, but because they realize they never had an actual fair opportunity to succeed. They look at the system as being rigged.

 

• A right to affordable, quality, and safe housing. We insist on removing state-sponsored segregation laws, regulations, practices, and traditions, which impedes affordable and safe housing. A ponderance of evidence exists that proves that housing stability, quality, safety, and affordability all affect health outcomes. The HIV community has long advocated for housing as treatment. This is no more evident in looking at housing and Covid-19. People inadequately housed or without accommodation are especially vulnerable to poor health and infectious diseases, including COVID-19. We must insist that people in shared living spaces with multi-generations of family members or individuals, and people who are confined in institutions such as long-term nursing homes, substance use recovery houses, prisons are equally protected from infectious diseases and premature death.

 

• A right to affordable, quality healthcare. Until legislation for universal health care or a one-payer system -- Medicaid for all --  is passed and enacted in this Country, we insist that Southern states that have not pass legislation allowing for Medicaid Expansion do so immediately. At present, the Affordable Care Act provides provision which enables governments to enact Medicaid Expansion to ensure that working-class and poor people can access the healthcare system.

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• A right to control our bodies from nonconsensual research, medical experimentation, and maltreatment. Starting with the harm perpetrated on Black people, the medical community must understand that the environment they created has to be addressed to get Black people to trust and re-engage with them.   Therefore, the medical establishment must acknowledge the harm and trauma caused by medical mistreatment and maltreatment. 

 

• A right not to be criminalized for behavior based on health conditions or economic survival. We insist that criminal justice reform -- changes in policing, mass incarceration, and systematic racism - also include HIV criminalization. There exists no scientific evidence that laws criminalizing non-disclosure, perceived or potential exposure, or transmission have any public health benefit. These laws may discourage HIV testing, treatment, and disclosure of HIV positive status.  We also advocate against the criminalization of sex work and substance use. In terms of sex work, We must educate our community about sex work and the difference between sex work vs. sex trafficking to prevent the criminalization of consensual sex work.  Consensual sex work can be defined as one's chosen profession or one's means of economic survival. In terms of substance use, we must educate the community that the further criminalization of drug use does not address the underlying issue of trauma born of mistreatment or neglect. Substance use can be viewed as an adaptive coping mechanism. For example, Black people suffer from higher rates of societal and personal trauma in the general population. Research and lived experiences indicate that trauma as substance use often goes hand-in-hand. Therefore, we support efforts to decriminalize substance use, starting with Congress' efforts to legalize marijuana.

 

• A right to be free from an unjust criminal justice system. We insist that there be reform of both the adult and juvenile criminal justice systems. These reforms should focus on phasing out the use of private prisons; creating sentence parity for individuals convicted of non-violent drug offenses to eliminate the sentencing disparities between racial and ethnic population groups; providing guidance on addressing abuses within our criminal justice facilities and probation and parole systems; and discontinuing forfeiture laws. We further insist on policing changes that hold police officers accountable for the loss of life due to the use of excessive and deadly force on unarmed Black men, women, and children.

 

• A right to comprehensive sex education. Comprehensive sex education based on human rights is required to support Black people across the life span. This information is vitally important when making decisions about one's sexual and reproductive health. When this information is unavailable, people end up being vulnerable to sexual coercion, sexually transmitted diseases including HIV, and unintended pregnancy.

 

• A right to cultural expression and creativity. As stated by the United Nations' Article 27 of the Declaration of Human Rights, "all individuals have the right to enjoy and make use of cultural heritage and cultural expressions."  As stated earlier, Black people are more likely to engage with service providers when they can see some semblance of themselves in cultural affirmations. Furthermore, our cultural heritage and expressions in storytelling – oral and written, the creative arts, and other cultural indicators serve to validate and sustain our identity and preserve our dignity.

 

We insist on accountability. We want change, but we, too, have a responsibility and accountability for making this change happen in light of a social contract that has gone beyond fraying at the edges and is shredding right before our eyes. Therefore, organizations must be willing to rise above mere charitable activity, engage in aggressive advocacy for society's outcasts, insist on a more equitable distribution of wealth and power, and provide checks and balances against overbearing corporations and governments. Nonprofit leaders must possess "vision, courage, accountability, ethics and competence," plus a willingness to put aside particular institutional missions to join coalitions working for the broader public interest. In other words, we also must confront the inherent tension between service and advocacy and move service providers from focusing solely on behavioral change to include advocacy. They must advocate for racial justice, social justice, and human rights. We know what needs to be done. It’s just in the hustle and bustle to survive that we forget. However, we have a history of black advocacy throughout this epidemic that enables us to stand on tradition and move forward.

 

Yet, Black leadership also has a responsibility and must be concerned with our privilege, causing us to inadvertently or deliberately act as gatekeepers around resources and issues of importance to the black community. We have solutions that can shift how people work and how we hold each other accountable. We can also build our systems beyond the existing structural systems which reinforce white racism, bias, and privilege. 

 

BACKGROUND

 

Black South Rising is a collective of advocates, community and organizational leaders, and black people living with HIV. Black South Rising aims to work in the South to raise Black HIV movement leaders' visibility. As Black HIV advocates doing movement work in the United States South, we recognize the urgency and necessity of reframing the narrative around addressing the epidemic.  The history of slavery, Jim Crow, and racial violence and the present-day horrors have shaped our current political moment in ways that exacerbate HIV that overwhelmingly impacts our lives. However, our history is not only one of horror. Our ancestors' courage inspires us as we stand on their shoulders in this fight. We are demanding a renewed commitment rooted in a Black cultural lens addressing HIV in the South.

 

We recognize the urgency and necessity of reframing the narrative around addressing the epidemic in our region. We are clear that Black people should lead the conversation about HIV in the South. Any discussion around HIV in the South that does not center the voices of Black people is a failed enterprise from the start. We will call out and seek redress from organizations that do not adhere to this demand of action.

 

Purpose. The purpose of this project was to a) gather information from Black HIV advocates and individuals doing HIV work in the South, b) better serve black people who may be at risk for, vulnerable to, or living with HIV, and c) better support movement-building efforts that can inform our HIV advocacy agenda.  Specifically, we wanted to understand what exists and what is working in terms of leadership,  advocacy, service issues, which may reduce existing HIV-related health disparities. This document represents the results of Black South Rising’s community engagement effort, as described below in the methodology section. 

 

Methodology. Black South Rising (BSR) sought the meaningful involvement of Black people residing in the South impacted by HIV. To this end, Black South Rising conducted and collected responses from an online survey of 100 and conducted in-depth interviews with eight HIV movement and organizational leaders. The data from these two activities was used to draft this political agenda. The draft document was then reviewed by a focus group of 8 individuals and the Black South Rising Workgroup members. The feedback from both groups was incorporated into this document.

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BLACK SOUTH RISING WORKGROUP MEMBERS

 

In alphabetical order: Maximillian Boykin, Linda Dixon, Dennis Hardy, Vanessa Johnson, Johnny Ray Kornegay III,   Leisha McKinley-Beach, Venita Ray, and Charles Stephens. 

 

THANK YOU

 

We thank the Black leaders and constituency who joined us on this journey to advance, build and sustain Black HIV leadership. Your feedback in the form of survey response, interviews, comments, and support for the initial Black South Rising statement was constructive and will enable us to move forward together.