Billboards in South Los Angeles urging gay black men to take health precautions cause a stir in the community over subject matter.
Last year in South Los Angeles, billboards overlooking Crenshaw Boulevard showed two shirtless black men standing and embracing each other on a beach. "Our Love is Worth Protecting .... We Get Tested," read the sign.
The ads, 10 in total, were developed by Jeffrey King, executive director of the Los Angeles advocacy group In the Meantime Men. The message's purpose, King said, was to promote love and HIV testing among black men who have sex with men.
After the billboards went up, however, "the immediate reaction of the community was shock," said the Rev. Eric P. Lee, president of the Greater Los Angeles chapter of the Southern Christian Leadership Conference. "It showed how we have commonly dealt with homosexuality in the community, which is 'Don't ask, don't tell,' a silence that doesn't condemn or affirm."
Safe-sex advocates say the reaction to the billboards shows how difficult it can be to tailor sexual health messages to fit some black communities in which the subject of sex, specifically non-heterosexual sex, remains taboo.
"Nobody wants to talk about the fact that our kids are having sex and a large part of them are gay and are having sex with each other," King said.
That stigma, according to HIV prevention advocates and public health officials, keeps many black people from getting tested or receiving treatment.
Although West Hollywood has the highest HIV infection rate in L.A. County, health officials said, young black men with HIV tend to live in predominantly black communities, such as South L.A.
Nationally, black Americans are disproportionately infected. They account for 14% of the U.S. population but almost half of the more than 1 million HIV cases, according to 2013 data from the Centers for Disease Control and Prevention. Among men of all races who have sex with men, young black men account for the highest number of new HIV infections. .
"It's true nationally, it's true locally, it's true in most metropolitan areas in the nation," said Dr. Jonathan Fielding, director of public health in Los Angeles County. "It's been a very serious problem, and we've been aware of it for years."
Public health officials are concerned that stigma is leading to less testing and treatment among various black communities, even though medical advances have greatly improved longevity when HIV is diagnosed early.
The controversial billboards in South L.A. have since been replaced by ads that feature a single word, in boldface capital letters and crossed out: "HOMOPHOBIA."
The new campaign aims "to address one of the key factors in why we're seeing high rates of HIV, especially among gay black men," King said.
Although a lack of resources remains a prominent reason for the racial disparity in HIV infections among those who are lesbian, gay, bisexual, transgender or still questioning their sexuality, Fielding said the attitudes some people have toward men who have sex with men are also partly to blame. Black men who have sex with men "suffer from stigma, discrimination, from a reduced rate of acceptance for their same-sex orientation, and they also have historically had less access to healthcare," he said. And, he said, they tend not to use condoms.
Also, King said, many gay and bisexual black men in South L.A. are not getting tested for HIV because the very act might "out" them, while many straight black men are not getting tested because they don't want to be perceived as gay.
"One of the key reasons we're seeing HIV rates as high as they are is linked to homophobia in the community, which is taught from a high place, which is the church," King said.
Lee said he's more "progressive" than most clergymen in South Los Angeles."I don't believe promoting safe sex is promoting sex. It's promoting, if you decide to have sex, to do so with caution," he said.
Lee added, "I think it's the responsibility of leaders to ensure that the people they're speaking to are provided with information that keeps them healthy."
The Los Angeles-based AIDS Healthcare Foundation is paying for the In the Meantime Men ads, as well as other billboards that seek to promote the sexual health of men who have sex with men.
Across town, an attempt to tailor the safe-sex message to a more open community has raised different concerns. In heavily gay West Hollywood, billboards overlooking Santa Monica Boulevard feature provocative images of muscled, bare-chested male torsos. The men appear to be white and Latino, and near their bodies are the words, "Be Safe. Be Sexy. Be You," a slogan coined by the West Hollywood safe-sex advocacy group Impulse.
Like the South L.A. ads, the purpose of this campaign is to promote safe sex in a neighborhood where HIV infections are high, said Jose Ramos, founder and president of Impulse.
Those public displays have elicited criticism about not only who is being portrayed in the majority of safe sex messages but also how they're portrayed.
"This does not represent us," said Gregory Victorianne, a researcher at UCLA and a member of the Black Los Angeles HIV/AIDS Coalition (BLAAC). Victorianne, who identifies himself as a "black man who has sex with men," explained: "I need to see myself up there, but nothing in a compromising position. That's not good."
Christopher Hucks-Ortiz, an evaluation specialist at the nonprofit John Wesley Community Health Institute, also said that messages promoting the sexual health of gay and bisexual men should use models who represent a spectrum of races and ethnicities.
"Men who are taller, bigger, who don't fit this lean six-pack shape, may not go any further if they can't relate to these images," said Hucks-Ortiz, a member of BLAAC who identifies as gay.
Sexual health advocates agreed that curbing HIV infection rates requires more than billboards that promote safe sex. They said more resources are needed to aid education and the implementation of safe-sex practices.
In West Hollywood, Impulse distributes condoms at nightclubs and has chapters opening up nationwide where parties are held that promote safe sex, Ramos said.
"All the people in Impulse, including myself, we really do it from a place of love for the community," he said. "Are we doing it a hundred percent correctly? Probably not. But at least we're trying."