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Black and African American men cannot be lumped into a one-size-fits-all category. They are the fathers, brothers, uncles and sons in Black communities. They are doctors and lawyers, barbers and bus drivers; they are Christians and Muslims and speak many languages. However, not every person who looks Black or African American will identify with these labels. In the US, Black men represent a diverse group, including, but not limited to, Afro-Cuban, Caribbean, Brazilian and African national men.

La consejería y prueba (C&P) del VIH es un componente importante en la gama de servicios de prevención y tratamiento del VIH. Ya que la visita para la C&P incluye una evaluación individual integral de riesgo, ésta ofrece la mejor oportunidad para remitir al cliente a otros servicios más intensivos. Por otra parte, la C&P es una de las entradas a los servicios de prevención y a otros servicios. La consejería breve y enfocada en el cliente que la C&P proporciona puede incrementar el uso de condones y evitar la propagación de las enfermedades de transmisión sexual (ETS). Conocer la condición de VIH, ya sea VIH- o VIH+, es clave para evitar la transmisión del VIH y para obtener consejería y atención médica. Se calcula que la cuarta parte de las personas VIH+ en los EE.UU. no saben que están infectadas. Una encuesta entre hombres jóvenes que tienen sexo con hombres (HSH) encontró que el 14% de los jóvenes negros HSH eran VIH+. El 93% de éstos desconocían estar infectados y el 71% afirmaron que era poco probable que fueran VIH+. Hace poco los Centros para el Control y Prevención de Enfermedades (CDC, siglas en inglés) anunciaron una iniciativa para expandir la C&P en EE.UU. Su plan estratégico del año 2005 pretende reducir en un 50% el número de personas que ignoran su condición de VIH. Si se cumple esta meta para el año 2010, se calcula que se prevendrán unas 130,000 nuevas infecciones de VIH, ahorrándose así más de $18 mil millones.

Substance use among youth and young adults continues to pose a variety of public health challenges. Young people who use opiates (heroin) and methamphetamine are more likely to have high risk sexual and injection practices, as well as more likely to be HIV+. Drug use among youth may be associated with a variety of problems including family trauma, academic difficulties, mental and physical health problems, sexual abuse, incarceration, poor peer relationships and violence. Youth in Northern California who are at risk for drug use, HIV and related health problems need to be better understood and targeted for prevention programs.

Rates of smoking among lesbian, gay, and bisexual adolescents and adults appear to be higher than rates for the general population (Gruskin, et al., 2001; Ryan, et al., 2001; Stall, et al., 1999). Smoking is also likely problematic among transgender people, many of whom face poverty, homelessness, stressful living and work environments, and depression in their daily lives. Despite the fact that smoking negatively impacts or complicates health issues of particular importance to LGBT persons (e.g., hormone therapy for transgender people, HIV/AIDS), tobacco companies target these communities. Yet, there is little research on smoking cessation by and for LGBT persons. Community activists in San Francisco started working more than a decade ago to address these problems. In the early 1990’s, Lyon-Martin Women’s Health Services initiated “The Last Drag,” the first stop-smoking group for LGBT and HIV positive smokers. The California Lavender Smokefree Project (CLSP), funded by the state in the mid-90’s, counteracted tobacco industry targeting of LGBT communities. In 1996, the Coalition of Lavender Americans on Smoking and Health (CLASH), with the help of Progressive Research and Training for Action (PRTA), (a community-based organization specializing in LGBT technical assistance), held Alive with Pleasure! the first federally funded conference on tobacco use among California’s LGBT population. In 1998, at the urging of CLASH members, the Center for AIDS Prevention Studies (CAPS) launched its first tobacco study with gay/bisexual men.

[S]ubstance use plays a major role in the transmission of HIV disease-indeed, a much larger role than has been generally recognized. Clearly, our nation's drug control policies must recognize this inextricable linkage between drugs and HIV disease and be designed to address the two aggressively and simultaneously. -National Commission on AIDS, The Twin Epidemics of Substance Use and HIV, 1991[1] Because neither a vaccine nor a cure for HIV infection appears likely in the near future, planning is needed for the long term to limit the spread of HIV among drug injectors, their sexual partners, and their potential offspring. -National Research Council, AIDS: The Second Decade, 1990[2]