As HIV Activists in the Age of Trump, We Need to Look Beyond the Gay Paradigm
In the online panic after Trump was elected president, many of my friends began reposting articles from the summer -- based on campaign literature from 16 years ago -- saying that Vice President-elect Pence had advocated that AIDS treatment money from the Ryan White HIV/AIDS program be redirected toward gay conversion therapy. Meanwhile, a very recent and well-documented story about a sudden and severe HIV outbreak in Indiana while Pence was governor received much less traction. The disparity in attention between the two stories troubles me and illustrates a longstanding problem with the response to the epidemic: What we don't see when we view HIV primarily through a gay (and often implicitly white) lens. It's vital that we confront this oversight as we begin to deal with AIDS in the age of Trump.
Conjecture on Conversion Therapy From 2000 Pence Campaign Literature
The conversion therapy story seems to stem from a July 2016 Buzzfeed article that quoted campaign literature from Pence's successful 2000 run for Congress:
Congress should support the reauthorization of the Ryan White Care Act only after completion of an audit to ensure that federal dollars were no longer being given to organizations that celebrate and encourage the types of behaviors that facilitate the spreading of the HIV virus. Resources should be directed toward those institutions which provide assistance to those seeking to change their sexual behavior.
Congress should oppose any effort to put gay and lesbian relationships on an equal legal status with heterosexual marriage.
Congress should oppose any effort to recognize homosexual's as a "discreet and insular minority" entitled to the protection of anti-discrimination laws similar to those extended to women and ethnic minorities.
As Mark Joseph Stern wrote for Slate after Pence was booed at Hamilton:
Pence, in other words, insisted that no federal funds should go to AIDS organizations that accept homosexuality. Instead, he argued: "Resources should be directed toward those institutions which provide assistance to those seeking to change their sexual behavior." Put simply, Pence wanted to redirect critical HIV funding from AIDS treatment programs to ex-gay conversion therapy -- i.e., torture.
While Pence's record on LGBTQ issues is horrible, as Mathew Rodriquez at Mic has made clear, and conversion therapy needs to be called out and stopped, there is no clear indication that Pence ever specifically called for the reallocation of HIV funding for this purpose. Last week, Pence denied the connection through his spokesperson Marc Lott, who told The New York Times it was "patently false" that Mr. Pence "supported or advocated" for conversion therapy.
Meanwhile, in the run up to the election, much less attention was paid to a story that directly commented on Pence and HIV prevention.
The Real-Time HIV Outbreak on Pence's Watch in Indiana
In 2011, as a congressman, Pence worked to reduce Planned Parenthood funding. By 2013, the effects were in full swing. Due to the cuts, small, often rural, clinics that provided the only sexually transmitted infection and HIV information and testing for miles were forced to shut. During this time, a surge in new HIV cases took place.
By 2015, 190 new cases of HIV appeared within communities of people who inject drugs in Austin, Indiana, a town of only 4000 people. Pence was then governor, exacerbating the public health emergency he had helped to create. As Erin Schumaker wrote for The Huffington Post, Pence "dragged his feet" before signing legislation allowing temporary needle exchanges, doing so only after people's life chances had already been reduced and with the proviso that counties must prove an outbreak of new cases of HIV or hepatitis C. A year later, the federal ban on needle exchanges was lifted, except for the prohibition on purchasing the syringes themselves.
Some of my friends suggested that the conversion therapy story was a plant by people within the Hillary camp seeking to play on gay fears and achieve a certain staying power in the media. The topic of conversion therapy was a trigger for many friends; some might say that the facts of the story were less important than bringing media attention to the torture happening across the nation, often to young people beginning to express their sexuality. So, I understood the draw.
At the same time, it seemed to me that journalists and people on social media were going to a lot of trouble to put forward an idea about the vice president-elect when concrete examples of his AIDS-related track record were available and verifiable. The more I thought about it, the more I saw how it mirrored the longer story of AIDS activism, in which an implicitly white and gay lens overlooks huge swaths of the HIV epidemic as well as the problems driving it.
You Likely Don't Know a Black Teenager Died of AIDS in 1969. Here's Why That Matters
We know that HIV was circulating in the U.S. as early as the late 1960s. The life and death of Robert Rayford, a black teenager who died of AIDS-related causes in 1969 -- as reported by The New York Times and confirmed in the 1988 Journal of American Medicine -- shows us this, a fact further supported by last month's news in Nature, a science journal, confirming that the HIV could be found within sexual networks in New York as early as 1970.
But it was not until rare illnesses appeared in young white men's bodies in the early 1980s that the medical and scientific communities started paying attention. A murderous presidential administration reacted with apathy and inaction, and plague befell the nation and soon the world.
But, even before the mysterious illness had a name, a test or an effective treatment, activism around it was led by the people getting sick who could see that the life and death situation they and their communities were in was being ignored because they were black, Latino, gay, women, trans, poor, living on the streets, doing drugs or a combination of all of the above.
Influencing AIDS activism from the start have been the civil rights movement, gay liberation, women's health advocacy and housing and poverty alleviation organizing. This resulted in a harm-reduction-based approach to care that literally met people where they were. In his essay "At the Club", Darius Bost tracks how nightlife became not only a place for mourning and resilience but also a site of peer-led community outreach where people underserved by the medical establishment could find and share information about the virus.
Amid all this, journalist and theorist Cindy Patton started noting in the early 1980s how, long before activists and academics reclaimed the word, a queer paradigm began to exist around HIV/AIDS. As she wrote in a February 1985 issue of the Gay Community News, regardless of who seroconverted or how, a person living with the virus was thought to be queer -- that is to say, not normal.
And just as the word "queer" came once again to be largely associated with the LGBTQ community, HIV/AIDS became identified as a gay disease. This put too much focus on gay behavior rather than the impacts of poverty, racism, education and health care systems on our well-being. This myopic focus has created villains and victims out of the gay community and drawn attention and resources away from other impacted -- but not necessarily gay -- communities, hurting their ability to respond to the epidemic. For example, because of the focus on gay men and their behaviors, early in the crisis women were thought not to get HIV (they just die from it, as the Gran Fury poster stated). This finally changed in 1993 when activists led by incarcerated black women demanded that the Centers for Disease Control and Prevention change the definition of AIDS to include women.
How White Supremacy Blocked Recognition of HIV's Impact
As someone involved with the AIDS response for almost 15 years in the U.S. and Canada, and as someone who has recently been researching the lives of people living with HIV before 1981, it seems to me that, with hindsight, we can see that white supremacy prevented people from seeing HIV's impact in the U.S. throughout the 1970s and after because premature death within already minoritized communities was accepted. And then homophobia -- coming from the president, no less -- prevented the U.S. government from stopping it.
This inability to see the impact of HIV amid minoritized communities beyond the gay community exists to this day. Interviewed by The New York Times, an unnamed women now living with HIV in Indiana after the swell of new cases said, "I thought it was just a homosexual disease." The narrow ways in which HIV gets discussed in the U.S. puts people's health at risk; this coupled with health care systems under attack spells disaster in the years to come. To change this, we need to continue to address the homophobia that exacerbates the ongoing crisis, while also seeing HIV within the bigger picture.
Words Matter -- and So Does the Helms Amendment
Part of the reason journalists have been able to make the conversion therapy link is the vagueness of Pence's language -- an Orwellian result of the Helms' amendment to the 1987 AIDS appropriation bill, which prohibited the use of federal tax dollars for AIDS education materials that "promote or encourage, directly or indirectly, homosexual activities."
In the AIDS funding landscape that Pence's conservative forefathers created, communication around AIDS prevention is opaque. As someone who has worked at AIDS service organizations, the phrase "change their sexual behavior" is familiar to me as the language used in grant reports, funding requests and even workshops.
Condoms were once a "change in sexual behavior" and pre-exposure prophylaxis (PrEP) certainly is a "change in sexual behavior." Even offering to enroll people in drug rehabilitation as a funded HIV-prevention activity can often be, in part, an attempt to change the sexual behavior sometimes associated with the economics and marginalization of drug use.
For many, such as Rea Carey, the executive director of the National L.G.B.T.Q. Task Force, Pence's lack of clarity in his 2000 campaign literature was an intentional dog whistle of homophobia. However, Isaac Sharp, a social ethicist and Ph.D. candidate whose research focuses on American evangelicalism, told me that he believes Pence's wording was not a specific call for conversion therapy. Rather, Sharp thinks Pence was signaling a broader message: that he will fight to protect what is called religious freedom.
This would fall in line within the long tradition of the Christian right using AIDS to galvanize its base in the face of changing cultural norms (as Anthony Petro charts in his book After the Wrath of God). Along this line of thinking, HIV funding (along with money for reproductive health) is a casualty of the larger fight to maintain the influence of the Christian right in the face of what Pence and others see as an erosion of their power and the U.S.'s claim for moral superiority. If anything is being dog whistled, it is white supremacy and a perversion of Christian values.
The question for us in the movement is, then, with a Trump/Pence administration, what should be done now when it comes HIV/AIDS?
When considering this challenge, it's worth noting that Trump's second act in his 100-day action plan to make America great again is a hiring freeze on federal employees except in the military, public safety and public health. As activist and scholar Ian Bradley Perrin noted when we discussed this story, it is no accident that Trump has weaponized public health as part of the militarized police state. Adding to the worry, Trump is nominating conservative Representative Tom Price as his choice for health secretary.
Frustration as an Activist Tool
Frustration can be a useful tool, especially when it comes to activism. It helps me tap into my passion and helps me articulate problems I see in the world. As I look at my friends doing the work, it is clear that the days ahead will be difficult. Many were looking to move on to second or third acts. People are tired, communities are fractured and many issues big and small need addressing to reduce the harm of HIV and end the crisis.
Exacerbating all of this is the fact that unacknowledged early deaths, homophobic gay exceptionalism and white supremacy are baked into the foundation of AIDS activism in the U.S. While some -- namely those in the grassroots, black communities and communities of color dealing with HIV -- acknowledge the role that race, class, gender and other lenses play within the epidemic, most often the mainstream does not. The story of AIDS is overly narrow within many circles, as it was this summer in the attention paid to decades-old campaign literature instead of the more recent, specific impact of Pence's policies in Indiana.
In the stories we tell about HIV/AIDS in America, we have forsaken communities of color, the rural, the poor, women (cis and trans) and people who inject drugs. In the dim light of a Trump administration, this mistake will compound our problems. In the days ahead, we would be wise to reconnect with the intersectional past of the HIV response and address the specificity of the crisis, while also chopping away at the systemic issues at the root of the epidemic.
Canadian born Theodore Kerr is a Brooklyn-based writer and organizer whose work focuses on HIV/AIDS. He was the programs manager at Visual AIDS; he received his M.A. at Union Theological Seminary where he studied Christian Ethics and HIV/AIDS. Currently Kerr teaches at The New School.