Emory Experts Take on the HIV Paradox

HIV paradox
Emory professor Wendy Armstrong (right) and Atlanta activist Daniel Driffin, shown here outside the Ponce Center in Midtown Atlanta, serve as co-chairs of the Fulton County Task Force on HIV/AIDS.

It was July of 2015, the year he turned 29, when Daniel Driffin decided it was time to come out.

Driffin had openly declared that he was gay as a high schooler in Rochester, New York. After he went off to study biology at Morris College in small Sumter, South Carolina, he dedicated himself to HIV awareness, prevention, and care for gay black men.

Still, when he contracted human immunodeficiency virus in 2008, Driffin didn’t feel comfortable telling anyone about his disease. He knew well the stigma HIV and AIDS carries, especially among Southern blacks, many of whom have been steeped in the religious conviction that being gay is a sin and that the disease is a scarlet letter.

“Living in South Carolina at that time, I didn’t have the positive gay community to pull strength from,” he says. “Until you feel safe, you’re hindered in the process of coming out to be your true self.”

Driffin eventually found that strength and security after he moved to Atlanta to work with a community organization providing rapid testing to young, gay black men in 2010. And last summer, after five years of living and working in Fulton County, Driffin and two friends opened up about their own HIV status.

Driffin now cochairs the Fulton County Task Force on HIV/AIDS alongside Wendy Armstrong, professor of infectious diseases at Emory’s School of Medicine.

“Atlanta is one of the largest cities in the South,” says Driffin. “People who can’t be themselves in their own little towns flock to Atlanta. Here, you’re one of many instead of one of a few. You’re able to be yourself.”

Yet, Driffin says that even in a large, relatively gay-friendly Southern city like Atlanta, a deeply rooted shame prevents many black gay men from admitting they have HIV.

He wasn’t surprised this past May when researchers at Rollins School of Public Health published a study in the journal JMIR Public Health and Surveillance finding that while about 15 percent of gay and bisexual men in the U.S. have HIV, the rates of infected men who have sex with men (MSM) in some Southern cities are twice as high as the national average.

Although the South is generally known as a hot zone for HIV/AIDS, the Emory study, led by Eli Rosenberg, assistant professor of epidemiology at Rollins, was the first to break down HIV rates for MSM by state, county, and metropolitan area.

“The US Census does not capture MSM or gay men, so we couldn’t calculate the rates,” says Rosenberg. “The CDC had produced a national number [of infected MSM], but there was no subnational number. Everything below that was darkness. When we wanted to look at states and counties, we were at a loss.”

Rosenberg’s team’s solution was to collect data from the Centers for Disease Control and Prevention (CDC) on nationwide HIV infection and divide those numbers by MSM population estimates from another recently published Emory study.

The results were staggering.

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