You might say Paul Johnson, whose real name editors have withheld because he wished to remain anonymous, was lucky.

Now 49 years old, he came of age during the 1980s when a peculiar new virus began surfacing.

“There was people who was dying, but back then I didn’t know it was AIDS,” Johnson said. “Their family hid it. They told folks it was something else.”

Gripped with that certain feeling of invincibility that is the downfall of so many teens, Johnson began what became a lifestyle of secret hook-ups with various other men.

“Yeah, back then I didn’t think I could get it (the virus),” he said. “Really, I didn’t know nobody that had it.”

Last year, though, Johnson was presented with some bad news.

“I found out I had [HIV] in June of last year,” he said. “I had got sick in March of 2011 and had been going to the emergency room, but they never could figure out what was wrong with me.”

In the black community, Johnson is what is referred to as a “down-low brother,” a bisexual man who deceptively carries on heterosexual relationships while secretly sleeping with men.

Billy Kilpatrick, executive director of West Alabama AIDS Outreach, works with Johnson and said his case is all too similar to many that he sees daily.

“Down-low is a huge problem; you just don’t see this in the white community,” Kilpatrick said. “I’m not black and I’m not gay, but I do know it’s a hell of a lot harder to come out as a gay black man, especially in the circles that I’ve seen.”

The down-low phenomenon has become such a problem in the U.S. that the Center for Disease Control recently created a separate category for these men called Men Who Have Sex with Men (MSM).

According to data from the Alabama Department of Public Health, black males between ages 25 and 34 in the MSM category now make up the largest number of HIV/AIDS cases in the state.

“If I ask a black male, ‘Are you gay or homosexual?’ they might say no, but if I ask they them if they have sex with men, they might say yes, which means they are so focused on rejecting the negative images associated with the labels, they forget to focus on the risky behavior,” said Pamela Foster, deputy director of the UA Institute for Rural Health Research and principal director of a 4-year CDC-funded project to decrease AIDS stigma in the black community.

Kilpatrick said though the disease has shifted from a gay man’s disease to one that affects largely people of color, most of his clients have one thing in common – poverty.

“About 85 percent of our clients are African-American, 99 percent are at or below poverty level,” Kilpatrick said. “We’ve seen it become a disease of poverty, and the south has the most poor, rural areas in the country.”

As of March 2013, 536 HIV/AIDS cases were reported in Tuscaloosa by the ADPH. Trailing closely behind the leading category, the impoverished, are young people ages 13-24, who make up 2,710 cases in Alabama.

“If you look at the peaks [of HIV/AIDS cases] they’re definitely in their young 20s,” Foster said. “College campuses are definitely a target for prevention because college students are young adults who often engage in risky behaviors such as unprotected sex, which increases their risk for all STDs including HIV, and they also are at increased risk for engaging in using drugs such as alcohol, prescription drugs which increases their risk of intravenous use or unprotected sexual activity.”

Although Johnson can’t undo his past, he now wants to focus on preventing more cases like his own.

“I think people should be more educated about it. I think nowadays people are just not using condoms like they should,” Johnson said. “That’s why I think it’s spreading a lot. I know it’s a lot of people who have it, and know they have it, but they’re not practicing safe sex. I found out my partner knew he had it but didn’t tell me.”

He said he’s made a lot of progress over the past year, attending weekly sessions with a group at the WAAO clinic. His doctors tell him it’s okay for him to have sex as long as he uses a condom, but Johnson said he’s given that up.

“I just don’t want anybody to go through what I done had to go through,” he said. “Before I got on my medicine, I remember I went from 140 pounds to 119 in a week. I was walking on a cane, [and] I would pass out. When I first found out I had [it], I thought I was going to die the next day. But I learned from WAAO that I’m gonna die one day, but I ain’t going to die of AIDS.”

Editor’s note: Billy Kirkpatrick, the executive director of West Alabama AIDS Outreach, sent a clarification to The Crimson White on April 24 to clarify some of his quotes featured in the above article “AIDs remains an issue for Alabama’s poor, young.” The quotes that ran were shortened because of the contraints of space in the newspaper and word count limits. Because of the severity of the issue of AIDs in Alabama, Kirkpatrick thought it necessary to ensure that his quotes were presented in their full context, which they are in his letter, which can be read here.