By Iván Espinoza-Madrigal
Legal Director, The Center for HIV Law and Policy
Over the last decade, LGBT people have experienced greater societal acceptance and legal recognition. The military's former "Don't Ask, Don't Tell" policy has been dismantled, and we are on the cusp of marriage equality for same-sex couples. Regardless of your personal views towards marriage or the military, more queer people than ever before are able to take part in the same institutions, and make the same choices as heterosexuals. Every year, at least in the U.S., sexual orientation becomes increasingly irrelevant to our ability to make life choices such as where we live, what we do, whom we love, or whether we parent.
In tandem with this progress, many LGBT groups have jettisoned HIV equality from their agenda. Whatever their reasons for this - funder fatigue, the desire to decouple HIV from gay life, or the so-called "changing face of the epidemic" - abandoning HIV as a policy priority conflicts with the equality struggle that placed HIV on the LGBT advocacy docket in the first place.
Although HIV always has had a major impact on people of color and women, there is no question that the federal government's slow response to the epidemic in its early years was due to its association with gay men. For many homophobic people, HIV was (and remains) the manifestation of what it means to be queer: HIV is the "wages of sin." Not only was HIV deadly, but it was perceived as something you usually had to be gay to get. HIV stigma, then and now, is inextricably intertwined with the stigma of being queer, long after the initial terms used to describe the disease, "gay plague" and GRID (Gay-Related Immune Deficiency), were dropped.
Military and marriage equality reflect a dramatic drop in stigma for LGBT people who want to get married, have children, and serve their country. The visibility of gay people in mainstream American life has had a profound impact on stigma. But switch the topic to men who have anal sex with multiple partners, or transgender youth engaging in sex work to survive, and the warm embrace loosens. Across the country, irrational fear and hatred of gay men who visit online sex sites rather than marriage license bureaus maintain a culture of stigma and the related cascade towards more sexually transmitted infections, including HIV.
The history of the HIV epidemic demonstrates that AIDS phobia was grafted and evolved from homophobia. Even today, HIV is used as an excuse for excluding people from professions such as health care and the military - not surprisingly, most of the people shut out are queer. Immigration courts are finding that the many state laws making sex and sex work while HIV positive a felony, and even requiring sex offender registration, are a handy way to get around the recent lifting of the federal government's ban on HIV-affected immigrants, and forcibly deport gay and transgender people. With the combination of underfunded healthcare, homophobia, and HIV phobia, and the disproportionate impact on people of color, the single most effective action an agency can take to help save lives is to tackle HIV stigma and equity in healthcare access.
Laws and policies designed to exclude people based on their identity or health condition - particularly when the latter also triggers connections to race, sex, sexual orientation, gender identity, class, and immigration status - are intolerable forms of discrimination, marginalization, and institutionalization of second-class citizen status. As we hit milestones in the movement for LGBT equality in military bases and marriage license bureaus across the country perhaps we should adopt a new mantra for the next generation of our struggle: Leave No Queer Behind! If we embrace this principle, we will have no choice but to re-embrace the struggle to end HIV-related stigma and discrimination. We can add substance to this commitment by joining forces against HIV criminalization at the federal and state level, and by calling for an end to exclusion from any dream, opportunity, service, job, or parenting decision based on HIV status. If we are successful, we will increasingly make HIV status irrelevant to our ability to make our own life choices.
This blog post was featured in the Huffington Post.