Dr. Anthony Fauci said Tuesday the visibility LGBTQ people brought to themselves during the height of the HIV/AIDS epidemic helped change the tide for public perception.
Dr. Anthony Fauci at press briefing
Fauci made the remarks during the daily White House Coronavirus Task Force briefing when responding to COVID-19’s disproportionate impact on black Americans, saying the disease has “shed a light” on health disparities in the United States much like HIV/AIDS did with LGBTQ people.
“During that time, there was extraordinary stigma, particularly against the gay community,” Fauci said. “And it was only when the world realized how the gay community responded to this outbreak with incredible courage and dignity and strength and activism — I think that really changed some of the stigma against the gay community, very much so.”
Biomedical advances against HIV since the dawn of the epidemic have been nothing short of astonishing. An almost always fatal disease is now, for those with the privilege of access to treatment, a manageable chronic illness, treated with a single daily pill. A person who acquires HIV today has every reason to expect to live a normal life span.
Yet with such astonishing success in treatment, why is HIV stigma worse today than ever before? Why do so many long-term survivors, including many who were exceptionally open about their HIV-positive status for years, find they must now keep it a secret, sometimes going deeply into closets they thought they had left for good years ago?
Many people—especially those who do not have HIV—find these questions startling. That’s because they remember the days when one had to wear a spacesuit to visit a person with AIDS in a hospital or was afraid to eat in a restaurant with gay waiters or refused to touch a person they thought might have the virus.
Both relationship-specific and structural factors influence whether coupled gay men living in New York City choose to use pre- and post-exposure prophylaxis (PrEP/PEP) for HIV prevention. Some men – particularly those in monogamous relationships – felt that discussing PrEP and PEP in the context of a relationship could threaten the relationship by raising issues of trust, while others felt that it had the potential to enhance sexual health and satisfaction.
Stigma from the gay community and healthcare providers around promiscuity also presented barriers to PrEP uptake. This qualitative research was conducted by Stephen Bosco, Dr Tyrel Starks and colleagues at City University New York and published in the Journal of Homosexuality.
Gay and bisexual men accounted for 66% of all new HIV diagnoses in the US in 2017. It is estimated that 35-68% of these infections happen within the context of a long-term relationship. This indicates that coupled gay men have the potential to benefit significantly from biomedical prevention strategies, such as PrEP (taken on an ongoing basis) and PEP (taken shortly after a suspected infection). However, only 7% of the potential 1.1 million gay and bisexual men who could benefit from PrEP were prescribed it in 2016. Black and minority men in the US remain most at-risk for HIV infection, while also having the lowest rates of PrEP uptake.
Stigma did not create AIDS. Yet it prepared the way and speeded its ravaging course through America and the world. First stigma delayed understanding of the disease: it’s a gay cancer, it’s a punishment from God, they brought it on themselves, so who cares? Then stigma delayed government action, research, and assistance for the sick and dying. Stigma made people afraid to get tested for HIV and treated. Stigma made people ashamed, isolating and alienating them from friends and family. Stigma cost people jobs, professional standing, housing, a seat on an airplane or in a dentist’s chair. Stigma made many afraid to live, and want to die. But then it began to make some brave people very angry and AIDS activism was born. The activists quickly realized that to end AIDS we must end stigma.
AIDS activism did more to fight the stigma on being gay or having AIDS than any other social force. In this way, AIDS activism, like the civil rights movement, became a great moral movement of our time, defending the innocent, restoring dignity to the violated, giving hope to the desperate, and reviving faith in the disillusioned. AIDS activism gave LGBT people courage, dignity, and power they had never held before. It inspired many to stand up and proudly proclaim who they are and who they love. Twenty-six of the world’s most advanced countries now recognize gay marriage and today a gay man openly married to another man is a prominent candidate for President of the United States.
Let’s talk about drugs—specifically, drugs that keep HIV-positive gay men like me “undetectable,” and the drugs used in PrEP (pre-exposure prophylaxis) that, when taken daily, can prevent HIV-negative gay men (and others) from becoming infected.
That’s essentially the theme for this year’s Gay Men’s HIV/AIDS Awareness Day—today, September 27—“The Conversation About HIV Is Changing: Talk Undetectable. Talk PrEP.”
But if we only talk about drugs to prevent and treat HIV, and don’t talk about the trauma behind gay men’s high-risk sexual and drug-use choices, we’ll see that same trauma continue to play out in our disproportionately high rates of crystal meth abuse, alcoholism, and other potentially harmful sexually transmitted infections besides HIV.
There is no question that today’s HIV drugs have dramatically changed the conversation about HIV. From the terrible illness and death that almost inevitably followed a positive HIV test 30 years ago, those of us living with the virus today can expect to live a virtually normal lifespan—so long as we adhere to treatment.
The campaign captures 24 hours in the lives of people affected by HIV stigma, which impacts everyone regardless of age, race, or status. The social media-driven campaign, now in its tenth year, is an opportunity for people to share a moment of their day and tell their story, while breaking down the barriers that stigma creates and raising awareness about HIV, as stated in a press release.
“Stigma can isolate and scare people,” said Positively Aware art director Rick Guasco, who created the campaign. “It can also prevent people from accessing care and treatment. A Day with HIV brings people together; it shows that we’re all affected by stigma, and that people living with HIV are just like everyone else.”
We encourage you to take a picture and post it to your social media with the hashtag #ADayWithHIV and include a caption that gives the time, location, and what inspired you to take the photo.
Images can also be uploaded to ADayWithHIV.com, where they will be considered for publication in a special section of the November/December issue of Positively Aware.
OAKLAND, Calif. — MPact Global Action for Gay Men’s Health and Rights has announced the launch of its fourth global survey on the health and human rights of gay men, bisexual men and other men who have sex with men.
The 2019 Global Men’s Health and Rights Survey (GMHR 2019) focuses on factors that impact the health of gay and bisexual men around the world including discrimination, access to services, and the criminalization of homosexuality. The survey also addresses issues of mental health, freedom of gender identity and expression, and social connection and wellbeing which have all shown to be indicators of broader sexual health.
“We are very excited to launch the GMHR 2019 and to continue to collect information that allows us to advocate for the needs of community members,” said Sonya Arreola, Senior Research Advisor at MPact. “It is critical that we are amplifying the voices of those most marginalized in the global response to sexual health and human rights. We anticipate that this survey will provide insight into the lived realities of key populations locally and globally, including gay and bisexual men, transgender people, people living with HIV, sex workers, and people who use drugs.”
Last launched in 2014, the previous iterations of the GMHR survey yielded more than 10,000 responses from around the world, revealing vital information about the state of homophobia, human rights and access to health services worldwide. As in the past, this year’s survey is designed to support knowledge generation, policy development, program implementation, and advocacy linked to the issues that matter most to community members at the local and global level.