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A Question of Priorities

June 15, 2011

fogcityjohn

fogcityjohn

Since June is the month in which we celebrate Pride, I thought it might be appropriate for me to address a question to my fellow members of the LGBT community, and in particular to my gay brothers. I want to talk about an issue our community used to think was really important, but which seems to have fallen off the radar screen recently. That issue is HIV.

HIV/AIDS used to be an existential threat to our community, and we treated it as such. Nowadays, medical science has made HIV a chronic illness, at least for those of us lucky enough to have access to very expensive antiretroviral therapy. Nevertheless, HIV remains a tremendous health problem, and it's still rampant among gay men. Yet our community seems to have decided to direct its attention elsewhere, and I'm trying to figure out why.

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I came out in 1981, the year AIDS burst onto the scene. So it's been a factor throughout my entire life as a gay man. First, it was a dreaded plague to be avoided, and much later, it became a disease with which I live. Back in the 1980s, the gay community (we weren't yet the "LGBT community") coalesced around the fight against AIDS. Frankly, we had no choice. Gay men were dying all around us, and no one in power gave a shit. A threat of such magnitude tends to focus the mind, and AIDS thus unleashed a period of furious activism, epitomized by ACT-UP's direct action tactics. That activism got results, and it brought gay people and gay issues into the spotlight. In my view, it was a pivotal moment for the entire movement, because AIDS forced us out of the closet and into the streets.

In part because of that successful activism, antiretroviral therapies became available, and with the arrival of protease inhibitors in the mid-90s, AIDS ceased to be an inevitable death sentence. Since the mid-90s, ARVs have continued to improve, and we now have an arsenal of highly effective drugs that will keep the virus in check. But these drugs are only therapies, not cures, and people with HIV can still suffer all kinds of health complications. Some of those are caused by the virus, and others are caused by medication side-effects. In short, while this disease is treatable, it's anything but trivial.

In the beginning, HIV/AIDS was considered an exclusively gay disease. Fortunately, we've largely moved beyond such homophobic characterizations, but we gay men need to realize that HIV still has a disproportionate effect on us. According to a Centers for Disease Control study of men who have sex with men in 21 U.S. cities, 19 percent of MSM are HIV positive. Back in 2008, the CDC published an estimate of new HIV infections in the U.S. The CDC's analysis showed that of the new HIV infections occurring in 2006, some 53% were the result of male-to-male sexual contact. While HIV may no longer be an exclusively gay disease, by the look of things it's going to remain a predominantly gay one unless we, as a community, give it the attention it deserves.

So what are our advocates in the national LGBT organizations doing about HIV these days? Not enough, if you ask me. I think Kellee Terrell, editor here at TheBody.com, pretty much summed up what's going on when she recently wrote:

But many of the large, national LGBT organizations -- the ones that have the most visibility, influence and funding -- need to take some responsibility for why HIV has fallen off their own community's radar as well. While some of these groups will occasionally lend a hand to HIV/AIDS organizations when it's convenient, they essentially have turned their backs on the epidemic and have taken up more "relatable" platform issues, such as marriage equality, adoption and "Don't Ask, Don't Tell." And while I understand that the stigma of the early days has helped shape homophobia and misconceptions about gay people, now is the time for LGBT people to let go of that hang-up and re-own this epidemic as if it's 1985. HIV is still a gay disease.

Lest you think Kellee's got it wrong, take a look at the web sites of our national LGBT rights organizations, and you'll see that HIV is hard to find. Take the home page of the Human Rights Campaign for instance. There you'll find links to stories about marriage equality and transgender inclusion, but other than the obligatory recognition of the 30th anniversary of the epidemic, there's nothing about HIV. If you click on the "Issues" link at the top of the page, you won't find HIV listed. What you will find is a tab for "Health." That's the first place you'll find HIV mentioned:

The Human Rights Campaign's health information has historically focused on issues surrounding the HIV/AIDS pandemic; however HRC is broadening its scope to include a wider variety of issues such as lesbian health, healthcare discrimination and the Healthcare Equality Index (HEI), a project that provides a quality indicator for healthcare related to LGBT people.

So HRC has "historically" focused on HIV but is now branching out. Don't get me wrong, I'm all for attacking issues of lesbian health and health care discrimination, but I get the uncomfortable feeling that HRC sees HIV as yesterday's fight.

Looking at the National Gay and Lesbian Task Force's HIV/AIDS issues page all I find is an article talking about stuff that happened in 2009. Has NGLTF just not updated this page, or has it really found nothing worthy of note on HIV in the past two years?

In my home state of California, things seem to be even worse. Here's what you'll see if you go to Equality California's page on "Health":

The newest project of EQCAI, the LGBT Health and Human Services Network is a statewide coalition composed of LGBT and allied organizations that provide non-HIV health and human services to LGBT Californians and their families.

You read that correctly. EC has devoted its "Health" page to crowing about a new initiative that specifically excludes HIV from its purview. EC has offices in San Francisco, which was the epicenter of the AIDS epidemic, so it's hard to believe they can be this clueless. Incredibly, they follow up with this:

The Network focus is on state level policy issues that impact health and human services for LGBT people in California.

Our primary goals are to prioritize the health policy issues impacting the LGBT community, to connect existing organizations with statewide funding sources that have not necessarily been directed toward LGBT communities in the past, and to build the capacity of our LGBT health and human service organizations.

Sorry, but can you name an issue that impacts the health of the LGBT community more than HIV? What universe do these people live in?

It's not just California, either. Head on over to the Empire State Pride Agenda's web site and you won't find HIV anywhere among their list of issues. You won't find the topic in their site map. You have to use their search engine before you come up with anything related to HIV.

Mind you, I know these organizations do work on HIV, and I certainly appreciate that. Indeed, if it weren't for LGBT groups, there'd be no HIV advocates outside of some underfunded AIDS service organizations. My complaint is that they're just not giving it the priority it deserves.

Now, I can't say for sure why that is, but I'll share my theory with you. I think that most national LGBT organizations have opted for what I'll call an "assimilationist" strategy for achieving equality. That is, the strategy isn't trying to change the rules of heterosexual society so that we LGBTs can be accepted on our own terms. Instead, HRC and other advocacy organizations have decided the way to go is for LGBTs to convince straight people that we're just like they are. Hence the focus on issues like adoption and marriage equality -- issues that are, to use Kellee's term, more "relatable" because they're things that make us seem just like straight people.

If I'm right about that, you can see why HIV would be viewed as a problem. It's a sexually transmitted infection. It makes straight people think about the "sexual" in "homosexual," and I'm sure it conjures up disconcerting thoughts about things lots of straights find distasteful -- like anal sex. And if you're trying to persuade straight people that you're no different than they are, butt sex is probably the last thing you want to bring up. So poz guys like me are a PR problem for HRC president Joe Solomnese and the assimilationist crowd. We're an embarrassment, and we make for bad optics because we don't fit this new idealized image of the committed, monogamous, middle-class gay couple that just want to get married and have kids.

And since we're on this topic, I'll raise a related and uncomfortable subject. This discomfort with poz gay men isn't limited to the political arena. There are a lot of seronegative gay guys who feel they have nothing in common with those of us who are HIV positive and who don't feel that HIV is something that's relevant to their lives. I sometimes wonder whether a large segment of seronegative gay men just wish we pozzies would disappear. Then they could get on with their lives, free of the stigma that comes from being part of a population that's so closely associated with a deadly disease. Believe me, guys, I can understand the urge. Homophobia is plenty enough to deal with. Having to combat the perception that you're a disease carrier, even when you're not, is a burden I know no one wants. But if we poz guys can't count on our negative brothers, to whom are we supposed to turn?

So that's my take on things. Now I'd like to ask all of you LGBT readers what you think is going on. Why has HIV fallen so far down the list of our community's priorities? Why aren't our state and national organizations putting this issue in the forefront? I hope you'll agree that we can't afford to be complacent about this. Not with one-fifth of gay men already infected and more infections occurring every single day. Can't we at least acknowledge the magnitude of the problem and demand more from those who are supposed to be our advocates?

I'm leaving the floor open to you now. Hope to see you in the comments section.

Send fogcityjohn an e-mail.

Read more of Outlier: My Unusual Journey With HIV, fogcityjohn's blog, at TheBody.com.

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This article was provided by TheBody.com.
 
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Reader Comments:

Comment by: Anonymous Mon., Jul. 4, 2011 at 11:50 pm EDT
Earlier this evening, I was reading an article in the disappearing gay bar on a major website. The article described scores of gay men hooking up with strangers through smartphone apps. When the author asked about "health concerns", his interviewee deadpanned that he didn't need to worry because "everybody asks whether or not you're DDF". The article moved on effortlessly from there, as if this was an effective, or even rational game to play. I was flooded with a host if questions: what about the more than 1 in 5 gay men who are in fact "diseased"? Isn't anyone concerned about OUR health and socialization? Why doesn't anyone point out how idiotic, how stigmatizing and how myopic that sort if question is?!? The answer which volunteers itself is that we are invisible, not just to general society, but negative gay men who make every effort to exclude anyone who is honest about their status. I couldn't have said what you did any better John, thank you. This is a topic which sorely needs addressed. Their desire to mainstream themselves has long ago transcended into a marginalizing tendency, and the consequences have been tragic.
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Comment by: Nathan (London UK) Fri., Jul. 1, 2011 at 2:46 pm EDT
The other issue, an elephant in the room, which seriously embarrasses our community leaders and those striving for acceptance through mainstream respectability is the fact that we have a commercial scene that glorifies and facilitates casual sex.

As a community we also have a major substance abuse problem as well as the mental health impact of homophobia all of this leads to high risk behavior. It is very difficult to know how to address this without actually undermining our own sense of identity and adopting heterosexual norms which many do not and even more cannot live by. We can find our own way without self destructive behavior and without adopting a heterosexual template but its not easy.
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Comment by: @HandsomeMe727 (near Saint Petersburg, FL) Fri., Jul. 1, 2011 at 12:56 pm EDT
Through assimilation and mainstreaming (the great priority of American society -- all ethnicities have to assimilate into mainstream American culture, or be marginalized-- that was the late Sen Patrick Moyinhan's PhD Dissertion) we have steadly been losing our sense of community. When LGBT groups began to form, we tried to create a sense of community, of belonging to a marginalized and heavily fragmented group that was being victimized by the dominat heterosexual culture. That was the fight of the LGBTQ community. When hiv/aids came into our community, our community became fragmented again only to congeal into the few radical movements that would ensure our own survivability as a species and bring a new focus into our survivability and existence. The leaders of the hiv/aids movement, were also the leaders of the LGBTQ movement. With their demise and burn-out syndrome, so went our leadership that inevitably had linked the two together: gay=hiv resulting in a new stage of a new fragmentation.
We pozzies are a minority within the broader gay community, and we're fighting for a voice in both the gay as well as the predominant mainstream American culture. The HRC has been focussing of the rights of the broader LGBTQ community, after all they are the majority, and the HRC is doing the bidding of the majority. In the meantime, trying to fight both homophobia and aids-o-phobia which are present at all levels of our societies, is a fight that is being carriedon. What is sad is that even within our broader LGBTQ community, we --the pozzies, are viewed as an "endemic condition", thus taking the initiative out for a fight with our community as an ally. It's a community illness that will not be going away anytime soon or fast.
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Comment by: Eddie (Houston, Tx) Fri., Jul. 1, 2011 at 12:53 pm EDT
Maybe the pharma companies,government,and people in general should conduct massive activism to try and stop the epidemic from spreading, especially in the gay community, just as the same community fought, in part, to have these drugs available today. In other words, we should reverse the picture. A condom =$.50, Aids treatment=$20,000 a year for life. It makes me upset that the people who get infected these days,except children, have the power to control their own actions and prevent the disease from spreading. I am convinced that drugs are not the solution.It is prevention.
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Comment by: Kinney (Atlanta,GA) Fri., Jul. 1, 2011 at 9:24 am EDT
I agree completely about priorities being misplaced but I also would like to add where is the leadership in the LGBT community?
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Comment by: Eddie (Houston, Tx) Thu., Jun. 30, 2011 at 3:08 pm EDT
When is it going to end? Despite the medical breakthroughs we've had in the last 20 years or so, The infection rate among MSM is still more than half in the US alone and it continues to rise. It is extremely difficult to control human behavior, or even understand it sometimes that not even Magic Johnson wants to talk about,or even mention HIV anymore.
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Comment by: Nathan (London UK) Thu., Jun. 30, 2011 at 2:39 pm EDT
Its the same story here in the UK....its called 'mainstreaming' rather than 'assimilation' and it has also influenced our HIV sector as well. Its really very silly, those Gay men who imagine they are able to pull this off are very naive, we are still only 'tolerated' and maintaining that is a constant battle, it can change almost overnight. For those comfortably off middle class seronegative gay men who are so called 'community leaders', preserving their own positions, lifestyles and access to the corridors of power and funding/revenue streams are their main concerns in an increasingly 'conservative' political, social and economic climate....they are living in a comfortable 'bubble' not in the real world and it can burst at any time, they should remember this: to a homophobe of any stripe we are all just 'queers' no matter how you dress it up....not much has changed really, some people are simply more 'polite' or silent about their homophobia but its still there...
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Comment by: Kenny (San Francisco, CA) Wed., Jun. 15, 2011 at 12:52 pm EDT
Thank you for writing this, John. It is excellent writing and and captures much of what I've noticed in the community over the past few years. I understand the impulse toward the assimilationist strategy. It has been somewhat successful. However, it disregards the fact that LGBT people are queer by definition. It is our difference that makes us a historically oppressed community. We need not deny our difference while we work for true equality where our differences from our straight brothers and sisters are just as protected as our similarities.

Queer Nation and ACT-UP knew this, and their heroic efforts in a time of tremendous despair for our community literally changed the course of history for our community and for other communities affected by HIV/AIDS all around the world. Those guys will always be my heroes! Somehow, today radical activism seems to be disdained as ineffective despite its track record; and radical activists are dismissed as freaks with anger management issues. Sorry, but if you're a LGBT person without anger issues, there is something wrong with you!

Need I also mention that Gay Pride started not as a celebration, but a protest? Is it me, or does it seem like the community as a whole has ghettoized itself into a glass closet where equality is a perception of fabulousness rather than a legal reality? We have far more to protest this gay pride than we have to celebrate. So where's the community's anger? Where's the protest? Why are there not bodies in the streets? It seems the community has forgotten its history, and those who forget their past are usually destined to repeat it.
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Replies to this comment:
Comment by: fogcityjohn (San Francisco, CA) Wed., Jun. 15, 2011 at 6:57 pm EDT
@ Kenny: The men and women of ACT-UP are heroes to me as well. But we have to remember that they weren't superhuman. They were just a bunch of scared, desperate people trying to make those in power pay attention to a monumental health crisis. I say that not to denigrate them or their achievements, but rather to make the point that we are just as capable of that kind of activism today. Which naturally leads to the question you ask -- why AREN'T we protesting?

I agree completely about LGBTs and anger. I always tell my friends, "If you're gay in this country and you're NOT angry, that just means you're not paying enough attention." We could all use a big dose of righteous anger right now. It's time for our community to stand up and shout about HIV. And that goes double for the members of Gay, Inc., like HRC, NGLTF, and others. We need money for ADAPs, for effective prevention campaigns, and for cure research. It's past time we started demanding it.


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