Creating spaces of care

Two innovative programs more than 2,200 miles apart are successfully reweaving the frayed social networks of older gay, bisexual, and same-gender-loving men living with HIV. Both prove that home-grown social support networks could become the backbone for people living with HIV to build a happier and healthier future as they grow older. Their remarkable success and resilience in the face of a world upended by the COVID-19 pandemic stand as a testament to the need for—and the power of—social connection to extend our lives and make them feel worthwhile.

In Los Angeles, saving men’s lives with outdoor and virtual connections

APLA Health and Wellness’s program for 50-and-older gay, bisexual, and same-gender-loving men of all ethnicities—dubbed HIVE (HIV-Elders)—was designed to address social isolation. Isolation is strongly associated with poorer health and shorter lives in the general population; multiple needs assessments across the U.S. have found it is highly prevalent among older people living with HIV.

HIVE’s program coordinator, Emmanuel Sanchez-Ramos, sees his role as an amalgamation of facilitator, confidant, cheerleader, and event planner to the dozens of men who attend HIVE’s events. Sanchez-Ramos says that each event is geared to help members see that they are not alone.

“They know they can show up, and there are no expectations,” he says of the members, “but [they will always] feel cared for and respected.”

A look at HIVE’s January 2021 event calendar shows the diversity of offerings, ranging from online support groups and one-on-one chats to beach walks, virtual happy hours, and bingo games. It also suggests that older adults with HIV can successfully gain the technical skills needed to maintain social connection despite the stay-at-home orders that haven’t meaningfully lifted since COVID first slammed Los Angeles in the spring of 2020.

Frank Largaespada, an active HIVE member for more than a year, names Tuesday Night Bingo as a literal lifesaver during his COVID-induced isolation. For the 52-year-old Nicaraguan transplant, isolation is especially deadly, having served as fuel for the debilitating depression and years of methamphetamine abuse that accompanied his HIV diagnosis in 2012. A self-described loner who rarely left the comfort of his home and his dog, he was introduced to HIVE by a friend in 2019.

“We go on outings and have events,” he remembered his friend telling him. “You’ll get to meet people and have fun.”

Delicious food, laughter, bowling, and bingo have not only helped cure Largaespada’s loneliness, they’ve also helped him avoid misusing substances and keep his HIV undetectable.

A large percentage of HIVE participants are Latino, though the program serves men of all ethnic backgrounds. The staff and membership have proved an exceptionally safe and welcoming home away from home for Largaespada. As is often the case for immigrant communities, HIV is not spoken of openly in his family. His mother has asked him only obliquely about his HIV.

“Son, are you sick?” Largaespada said she asked him once, to which he simply replied, “Yes, Mother.”

He credits the brotherhood he’s found at HIVE with giving him a voice and saving his life, despite the crushing stigma that keeps so many silent. In fact, he’s almost jubilant about sharing his story in POSITIVELY AWARE, joking, “I’m going to be famous!”

Celebrating life while facing stigma and trauma in Atlanta

According to Malcolm Reid, a co-founder of THRIVE SS’s Silver Skills education and support curriculum, the seeds of the program emerged on a gay cruise in 2016. After some false starts, a friend proposed a simple Facebook Messenger group where, Reid said, “We say good morning to each other, talk shit, and have a good time.”

The group organized a photoshoot, determined to openly portray the beauty and vibrancy of life for Black gay, bi, and same-gender-loving men over 50 living with HIV. Having noted the absence of such men in HIV- and gay-related spaces in Atlanta, Reid knew visibility was critical. So many of his friends had shared an experience he calls “no longer being the cute face at the end of the bar.”

Silver Skills sessions take place over the course of a weekend. The program directly addresses HIV and aging, post-traumatic stress disorder (PTSD) and trauma, loss and spirituality, and ends on stigma. “We focus on the intersectionality of being Black, being older, being gay, living with HIV, and the stigma and everything else you have to deal with growing up,” Reid said.

Facilitators provide ample space for grieving, processing, and bonding over shared trauma—including the impact of living through the earliest days of the HIV epidemic as Black men. However, Reid also believes the best antidote to stigma is openness and celebration. The program always culminates with the event that started it all: a group photoshoot.

“I don’t do pity parties,” Reid tells group participants at the end of the program. “Life ain’t over. Let’s live!”