There are many major themes that are examined, including poverty, stigma, homophobia and transphobia, lack of access to services for the poor, and HIV criminalization. The film also highlights the disparity of the HIV epidemic within certain inner-city communities, including the poor, people of color, substance abusers, women, young men who have sex with men (MSM), and people of trans-experience. The film adequately captures this reality that is often ignored within the mainstream media and traditional healthcare and prevention strategies.
The statistics of HIV prevalence in inner-cities across America are shocking and unnecessary. According to the findings of a March 2010 study released in the New England Journal of Medicine, HIV prevalence rates in these impoverished areas surpasses those found in Sub-Saharan Africa. For Washington, D.C., the setting for the film, HIV rates among adults now exceed 1 in 30 -- higher than reported rates in Ethiopia, Nigeria or Rwanda. Further, in these same urban areas across the nation, 30 percent of MSM are contracting HIV, compared with the overall population rates of 7.8 percent in Kenya and 16.9 percent in South Africa. This is utterly unacceptable for a nation as wealthy and progressive as America. The AIDS epidemic is far from over and given these bleak statistics, the epidemic seems to be gaining dangerous momentum.
One story highlighted within the film is that of Jose Ramirez, Youth Program Coordinator at La Clínica del Pueblo, a health clinic in D.C. that focuses on reaching Latino populations. Ramirez primarily works with Latino LGBT youth at risk of contracting HIV. For this population, there are many forces working against them including poverty, immigration concerns, substance use, lack of resources and support, and lack of employment. Because of this, many LGBT youth turn to prostitution to get by. As Ramirez points out in the trailer for the film (along with the passionate and remorseful commentary of legendary HIV activist Larry Kramer), if a young man is offered $150 more for "bareback" sex with another man (anal sex without a condom), he is most likely going to take the money. To that end, Ramirez has been advocating the use of the female condom for receptive partners as another option for protecting themselves.
The film's tagline is "In every city, there's another city," which eloquently captures the heart of the AIDS epidemic. There is the one city with HIV programs and services that provide necessary treatment to those who have access. There is the one city with prevention programs and services which help curb the spread to a select few. Then there is the other city with residents who cannot afford their life-saving medications. The other city with residents who rely on selling their bodies for survival. The other city that is virtually ignored and tossed in the gutter.
It is when we look at HIV/AIDS from this perspective that it becomes clear that this epidemic is very much a social justice issue. HIV would not spread as rampantly if there were more effective, creative, and culturally competent prevention services in place. Those living with HIV would not see their disease progress to AIDS (with some of those progressions resulting in death) in such large numbers if there were consistent and universal access to necessary care and treatment services.
Why are these most vulnerable populations essentially being left to die? As the film proclaims, this does not need to occur. With all of the advances in HIV medications and prevention programs, the epidemic should be more under control than it is. Something else is going on. Something scary and invisible. The Other City brings to light these tragic occurrences in our inner-city communities. The film also shows the resilience and hope of these communities. With continued awareness and exposure like with this film, we will soon regain control over the HIV/AIDS epidemic.