Ending the HIV epidemic in the United States will take effort far beyond implementing policies about HIV. A president who wants to end the epidemic must consider health care policy, reproductive justice, mass incarceration, housing, immigration, and myriad other issues that drive the epidemic’s numbers in marginalized populations across the U.S. As the 2020 Democratic primary begins its early voting, TheBody asked prominent writers and activists to consider how each Democratic candidate, if elected, would fare in ending a health crisis that is now in its fourth decade.
Pete Buttigieg, formerly the mayor of South Bend, Indiana, is the first person to seek the presidency who was born after the world learned of HIV/AIDS. He was born six months after The New York Times first reported that “[d]octors in New York and California have diagnosed among homosexual men 41 cases of a rare and often rapidly fatal form of cancer.” Over the formative years of his childhood, from his home in the heartland, Buttigieg would have witnessed the impact of HIV/AIDS on America’s body politic. Growing up 90 miles north of Kokomo, Indiana, he would have seen Ryan White become a national symbol of the fear and bigotry that accompanies the virus.
Buttigieg doesn’t say much about how the specter of HIV/AIDS affected him as he came to terms with his own sexuality. For many gay men, HIV shaped our relationships and informed our experiences. It must have been harrowing for Buttigieg to come of age in Indiana, where state law still requires anyone receiving an HIV diagnosis to agree, in writing, to disclose their status to sex partners and then subjects them to criminal penalties if they don’t.
On the campaign trail, Buttigieg has only told one story of how HIV/AIDS has directly affected his life. It’s about the ban on gay men donating blood. He first mentioned it during the October CNN/Human Rights Campaign (HRC) Town Hall and later documented it in the opening to “The Beginning of the End of AIDS,” an essay he published on World AIDS Day. He writes, “I remember the moment when I realized that—unlike most initiatives I spearhead [as mayor]—I couldn’t lead by example, because my blood’s not welcome in this country.”
For Buttigieg, the only material reference to his personal relationship with the most terrifying, politically fraught plague of the modern world—one inextricably connected to the lives of gay men—is a frustrated sense of civic leadership.
And yet, despite this detachment, Buttigieg, among all the candidates, has produced one of the most comprehensive plans for ending the HIV/AIDS epidemic. His campaign platform, which promises to end the epidemic by 2030, is an unambiguous roadmap for meeting his ambitious target. Buttigieg addresses treatment, prevention, and access to care. He identifies and includes all affected communities, with a scope both domestic and international. He openly discusses topics often considered taboo, such as harm reduction tools for intravenous drug users and the need to provide sexual health services in schools. He speaks of HIV decriminalization and reducing stigma as key elements of the strategy.
This is indeed a plan that can end the epidemic.
But ending the epidemic requires more than a great plan based on the input of the nation’s best and brightest. The federal government already has that. What’s needed to defeat HIV/AIDS is not only data-driven, science-based policy but also the ability to win the politics of implementation. What’s needed is the depth of commitment and sense of urgency that fueled activists and experts during the worst days of death and dying.
In 1988, Vito Russo, a co-founder of ACT UP and GLAAD and a lifelong gay activist, gave a speech, “Why We Fight,” at a protest outside New York’s capitol in Albany. “Someday,” Vito said, “the AIDS crisis will be over. Remember that. And when that day comes—when that day has come and gone—there’ll be people alive on this earth, gay people and straight people, men and women, black and white, who will hear the story that once there was a terrible disease in this country and all over the world, and that a brave group of people stood up and fought, and in some cases gave their lives, so that other people might live and be free.”
On that day in Albany, closer to the beginning of the crisis than its end, Vito spoke of a future created by people fighting to conquer the disease. Unfortunately, Buttigieg isn’t a fighter. He has no record of addressing HIV/AIDS as an elected official, and only a single tweet from 2017 connects him to any discussion of the 2015 HIV outbreak in southern Indiana’s Scott County, then one of the most severe in the country. In 2016, a senior health official in South Bend warned that the city and its local county faced a similar risk, but there’s no indication Mayor Pete acted on those warnings. Perhaps the lack of fighting spirit and failure to lead on HIV/AIDS was simply connected to his approach in dealing with all issues regarding the city’s LGBTQ+ community.
According to the Municipal Equality Index, an annual scorecard from the HRC detailing the pro-equality activities of local governments across the country, South Bend during Mayor Pete’s second term scored zero points for providing services to the “HIV/AIDS population.” The city also scored zero points for providing services to its LGBTQ youth, elders, and homeless populations; zero points for offering transgender-inclusive health care benefits; zero points for providing services to the transgender community; zero points for offering an inclusive, welcoming place to work; and zero points for being more pro-equality than (even Mike Pence’s) Indiana as a whole.
LGBTQ+ people who care about the way Buttigieg handled these issues have organized themselves into the activist collective, Queers Against Pete. They’ve stated a number of concerns regarding the Buttigieg candidacy, including his opposition to “Medicare for All” and the fear that as president he will ignore other needs important to marginalized parts of the LGBTQ+ community.
Members of the group recently attended a Buttigieg fundraiser in San Francisco and interrupted his formal program in order to highlight their concerns. His response: “I respect your activism, but this is a gathering for supporters of our campaign, and I just got a question about my husband, and I’m really excited to answer it.”
Twenty-eight years earlier, Bob Rafsky, an activist with ACT UP who was dying of AIDS, found himself on the receiving end of a similar exchange with Governor Bill Clinton. After Rafsky interrupted Clinton to demand answers on the candidate’s platform to combat the disease, Clinton engaged him briefly and then famously barked at him, “I feel your pain.”
The openly gay man who now commands the stage as a candidate for president, whose sexual politics are most visibly epitomized by his marriage, has yet to show that he feels our pain.
In the closing paragraph of “The Beginning of the End of AIDS,” Buttigieg wrote: “After meeting with several AIDS activists this past June, I stood beneath the soaring AIDS Memorial in New York City, my husband by my side. Surrounded by LGBTQ+ activists pushing us to further incorporate the realities of their struggle into our policies, I thought about what we’ve lost and how far we’ve come. I thought about how close we are to getting this right—to ending HIV/AIDS and shaping an America defined not by exclusion, but by belonging. That will be a core commitment of my presidency in keeping with the tradition of those who have fought this epidemic with their tears, sweat, and blood.”
“Their struggle ... their blood.”
Vito was speaking to all of us, including Pete, on the day in Albany when he said, “AIDS is really a test of us as a people. When future generations ask what we did in this crisis, we’re going to have to tell them that we were out here today. And we have to leave the legacy to those generations of people who will come after us ... and then, after we kick the shit out of this disease, we’re all going to be alive to kick the shit out of this system, so that this never happens again.”
Fourteen months after Pete Buttigieg was born, Larry Kramer, a co-founder of ACT UP and GMHC, memorialized the first 1,112 who died of AIDS with a warning to those living under the specter of the mysterious disease. He wrote, “Our continued existence as gay men upon the face of this earth is at stake. Unless we fight for our lives, we shall die.”
In 1990, Vito Russo died of AIDS-related complications; so did Ryan White and 31,194 other Americans.
In 2018, there were 37,832 people in the U.S. who received an HIV diagnosis—a number greater than all the American service members wounded and killed during the years of war in Afghanistan. That same year, 17,032 Americans received a stage 3 AIDS diagnosis.
However smart Pete’s policies and however much he trusts their necessity, he’ll never fight for them. He doesn’t see himself in the AIDS crisis—not as a gay man and not as a Hoosier. Until his struggle is as personal and as urgent as we need it to be, Pete Buttigieg isn’t the candidate who can end the HIV epidemic.