Acceptance Journeys Project History
In October 2009, the Centers for Disease Control and Prevention (CDC), in collaboration with the Wisconsin AIDS / HIV Program, the City of Milwaukee Health Department, and Wisconsin’s HIV Prevention and Testing Programs, came to Milwaukee for an “EPI-Aid.” This investigation was prompted by state data indicating that Milwaukee was experiencing a large increase in HIV infection in young African American gay and bisexual men. The EPI-Aid found that the increases were real and not merely the consequence of improved case finding or surveillance. Preliminary CDC analysis also showed the following:
Gay & Bisexual Men
Gay and bisexual men continue to be severely affected by HIV. Historically, in Wisconsin and Milwaukee, the population most affected by HIV infection has been gay and bisexual men. In 2009, 63% of reported HIV cases in Milwaukee were among them (4% of these men also engaged in injection drug use). CDC estimates gay and bisexual men to comprise between 4 and 8 percent of the male population, thus case reports represent a disproportionate impact of the epidemic in this group.
African American Gay & Bisexual Men
Black gay and bisexual men are one of the most disproportionately affected subgroups in the U.S. Among gay and bisexual men reported with HIV infection in 2009, 49% were African American, 35% were white, and 13% were Hispanic. Rates of infection among African American gay and bisexual men in Milwaukee are estimated to be between 20% and 40% of that population.
Young African American Gay & Bisexual Men
Nationally, most new infections among black gay and bisexual men occur among young men. Adjusted reported cases of HIV in black gay and bisexual men age 13-29 years tripled between the years 2000 and 2008 in Wisconsin, with almost all cases occurring in Milwaukee.
The CDC also conducted a qualitative analysis of interviews with young HIV-positive gay and bisexual men in Milwaukee. Following are the results of the in-depth interviews conducted in late 2009:
- Anti-gay discrimination plays a significant role in the transmission of HIV in the gay community, especially among gay and bisexual men of color.
- The CDC identified four transmission pathways that affect the transmission of HIV among gay and bisexual men, especially African American gay and bisexual men: housing instability, HIV stigma, code of silence about same-sex behaviors, and internalized homophobia.
Initially in response to this situation, Diverse & Resilient has partnered with the University of Wisconsin and the Medical College of Wisconsin to study the beliefs and attitudes of Milwaukeeans to determine their readiness to address the issue of the social exclusion of LGBT youth. The assessment we used suggests that sampling of the community be done by defining relevant segments of the community.
Preliminary results of these efforts show that segments of the community in Milwaukee are either vaguely aware of anti-gay discrimination in the community or are resistant to addressing it. Based on this information, we understood that collecting and disseminating personal stories and images from parents, pastors, friends, colleagues, and public figures about anti-gay discrimination and social acceptance were critical to increasing community awareness. These efforts drew the attention of the MAC AIDS Fund, who supported the early development of Acceptance Journeys through a generous grant.
Project Development & Implementation
These stories have come together to form the nucleus of Acceptance Journeys. The initial round of photo-story combinations includes 32 story cards, usually found packaged in folders that require the people interacting with the cards to work a bit to get to them – thus beginning a journey of their own. The photos on their own communicate a degree of closeness and acceptance that many have found moving. Some people who initially viewed these pictures said, “Lives are getting changed through love.”
Story cards have been distributed through United Way of Greater Milwaukee to funded agencies and by request to whole staffs of community-based organizations and faith-based groups. Some of the stories have also been recorded by the people who told them for broadcast as ads on local radio stations.
Photos have also been developed into billboard and bus ads. The billboards, found elsewhere on this website, initially appeared in Milwaukee General Mitchell Field and the Intermodal Station. A short time later, an additional 50 billboards and bus ads appeared across the city. These ads show a picture of the close relationship between LGBT people and the heterosexual person in their lives. They are paired with the tag line: Whose life could you change with love?
Because our initial research among LGBT people revealed significant discouragement and some hopelessness about finding acceptance in their lives, the Acceptance Journeys project has also been paired with Imagine More, a sister program that encourages LGBT people to increase their expectations for fair treatment and full support from the heterosexual people in their lives. Through this the program hopes to have heterosexual people and the LGBT people in their lives striving for the same high standards.
While Acceptance Journeys was prompted by the unacceptable rates of HIV transmission among gay and bisexual men, our increased understanding of the role of anti-gay discrimination as a determinant of health risks and health outcomes for LGBT people has encouraged us to expand its application to other areas of health disparities. Mental health, suicide rates, substance use, and incidents of community violence may all improve with a more inclusive, accepting community in which LGBTQ people can thrive, living healthy, satisfying lives.