Long before health equity was a research topic that drug companies discussed and long before mainstream HIV conferences or publications recognized the talents and solutions that Black same-gender-loving men could contribute to the HIV field, John L. Peterson, PhD, dedicated his career to it. He died earlier this year.
“A couple of weeks ago, a titan in the HIV research and prevention field left this earth,” HIV clinician, activist, writer and public health expert David Malebranche, MD, MPH, wrote on Twitter on June 8, following the publication of a Counter Narrative Project’s tribute to Peterson. “Anyone who does work with HIV and Black gay men should know his name and work.”
Indeed, it was 1988 when Peterson, a professor and later professor emeritus in the Department of Psychology at Georgia State University, published an article in the American Psychological Association journal American Psychologist sounding the alarm that “ethnic minority men, particularly Blacks and Hispanics, make up a significant proportion of all AIDS cases in the United States”—but investment in HIV prevention research in those communities was not following suit. The article laid out a framework researchers could use when working with Black communities to quantify the disparities between Black same-gender-loving men and white gay men and to identify solutions.
If it sounds outrageous that this work could have begun so early with so little heed paid to it, it should, Ace Robinson, MPH, a longtime public health leader, told POZ.
“We can be very clear that the work we’re doing now [addressing the needs of Black gay men] could have been done 30 years ago,” said Robinson, who started his career as a vaccine researcher and has since worked in HIV clinical trials and HIV prevention and care efforts through institutions including the University of California, Los Angeles and NMAC. He is also a steering committee member for the Prevention Access Campaign’s U=U campaign. Robinson currently serves as cochair of the Federal AIDS Policy Partnership, a coalition of more than 120 local, regional and national groups instituted as part of the federal government’s “Ending the HIV Epidemic” plan.
“We’ve known about HIV for 40 years. Someone just under 35 years ago gave us solutions,” Robinson said. “If we had reimagined the HIV response in the early days and had people like Dr. Peterson on the stage of the first AIDS conference, think of how many people would be alive today.”
Since that 1988 journal article, Peterson authored more than 45 studies that aimed to characterize and correct those inequities. His research ranged from the first random household probability sample of HIV risk behaviors among Black and white men in San Francisco to a study of Black and white gay and bisexual men recruited from bathhouses, sex shops and other community sites. The study showed that poverty and sex work were associated with the 50% increased risk of condomless sex for Black men compared with white men. And that was just in 1992.
In 1996, Peterson was the lead author of a risk-reduction intervention for Black same-gender-loving men. He published a study on HIV testing among Black men the following year and served as coeditor of The Handbook of HIV Prevention in 2000. In more recent years, he published research about the barriers women living with HIV experiencewhen they look for social support, the ways in which homophobia did and did not explain the lack of access to care for Black same-gender-loving men compared with white gay men. Another study explained the different levels of HIV vulnerability among young Black gay and bisexual men.
Peterson counted among his coauthors Emory University’s Carlos del Rio, MD, and epidemiologist Patrick Sullivan, PhD; David Holtgrave, MD, dean of the school of public health at the University of Albany; Ron Stall, MD, cofounder of the Center for LGBT Health Research at the University of Pittsburgh; and Seth Kalichman, PhD, editor of the journal AIDS and Behavior.
Del Rio can remember phone calls with Peterson during which the pair discussed research topics, as well as those times when Peterson called him following a publication of del Rio’s data to “suggest things to consider for the next time.” And there was the time when Black clinic clients reported biased experiences with staff at del Rio’s clinic. Del Rio asked Peterson for help understanding the problem.
“He was a thoughtful advocate, thinker and challenger,” del Rio told POZ. “He tried to answer the tough questions. He didn’t stay in the superficial.”
Perhaps most importantly, though, Peterson guided and helped shape the careers of some of the HIV field’s most important Black researchers and clinicians. He mentored Gregorio Millett, MPH, a former epidemiologist at the Centers for Disease Control and Prevention and architect of the Obama-era HIV/AIDS Strategy who is now director of public policy at amfAR, the Foundation for AIDS Research. Together, the pair collaborated on Millett’s groundbreaking research on the inequitable impact of HIV on Black gay and bisexual men and inequitable access to HIV treatment, despite the fact that Black men got tested for HIV and used condoms more often than their white peers.
Peterson also mentored Malebranche and served as a coauthor on a study of how Black same-gender-loving men perceive medical culture and homophobia. Malebranche later went on to give a powerful plenary at AIDS 2018 on the ways in which the health care system fails Black gay men.
“Both David Malebranche and I considered John a father figure for whom we both owe our successful careers in science,” Millett told POZ.
This sentiment is echoed by the next generation of HIV researchers and activists as well. Robinson remembered meeting Peterson through Millett at an HIV conference years ago. At the time, Robinson was the director of the AIDS Prevention Unit at UCLA, working under Judith Currier, MD. Right away, Peterson asked him, “What are you going to do for us?”
By us, of course, said Robinson, Peterson meant the Black same-gender-loving communities Robinson was researching.
“That’s a very strong question to ask someone,” Robinson said. “I’m like 30 years old, I’m getting my footing and someone’s like, ‘With this role comes a level of responsibility. What are you going to do to support the most impacted communities with your work?’”
That changed Robinson’s thinking. He authored a conference paper in 2012 on pre-exposure prophylaxis (PrEP) for Black same-gender-loving men based on the foundational work Peterson had done. And he never forgot Peterson’s ethos that you don’t have to work harder if you do the right thing in the first place. Peterson was a believer in building new systems by and around the communities most impacted by HIV, not revising systems not built for them.
Daniel Driffin, MPH, a DrPH candidate and cofounder of THRIVE Support Services in Atlanta, concurred that Peterson did not mince words. But he was also the “speak softly and carry a big stick” type.
Still, he didn’t meet or know Peterson’s impact until Malebranche, Driffin’s own mentor, introduced the two at dinner one night. When Malebranche explained the work Peterson had done, Driffin told POZ he realized, “Oh my god, you’re the phoenix!”
“Especially when we think about many of the conversations that we still have today about ‘this community is a hard-to-reach community’—he proved that wrong 30 years ago,” Driffin said. “You hear about the amazing work he does, but he was the most humble guy, not in the limelight, just cranking out amazing research—and the nicest guy you’ll ever meet. He always had a smile and was willing to help out.”
Indeed, as Millett comes to terms with the hole Peterson’s death leaves in the HIV research community and in his own life, he said he knows that Peterson acted with integrity, guided by his own belief in doing community-based and community-supporting research.
“He made our community visible—so much so that research to address HIV among Black men who have sex with men has become common and mainstream over the past decade,” Millett said. “Although I lost a mentor, a colleague, a friend and a member of my family, John left so much behind with his research and inspired two generations of Black scientists. Because of John, Black (gay) lives matter. Because of John, my life and my work matters.”
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