Growing Epidemic in Gay and Bisexual Men in the United States Heightens the Call for a National AIDS Strategy Bridging Race and Sexuality

[photos are from the the first international march against homophobia that took place in Mexico City yesterday, in advance of the International AIDS conference. Thousands of folks from all over the world participated. Homophobia, and policies that spring from it, are a significant driver of the HIV epidemic in the United States. Read an excellent blog post about this event here.]

In the wake of disturbing news about higher HIV rates in the United States, people living with HIV and allies are calling for a national AIDS strategy that confronts the homophobia, violence and bias at the heart of the U.S. epidemic.

The Centers for Disease Control and Prevention (CDC) says that the new figures released on Saturday, August 2 reflect a "stable" epidemic, albeit one with a higher level of annual infections than previously estimated. However, the data reveal an ongoing and persistent increase in rates of infection among gay men and other men who have sex with men (MSM), many of whom are Black and/or Latino.

"The new estimates confirm that a vast majority of new infections in the U.S. occur in gay and bisexual men, and that Blacks are significantly more heavily impacted than other racial/ethnic categories. However, the data fail to clearly link the two, perpetuating a longstanding, damaging polarization," explained Walt Senterfitt, CHAMP board co-chair and an epidemiologist living with HIV who served as a Visiting Scientist at CDC's Division of HIV/AIDS Prevention. "We need CDC to clearly show the HIV incidence numbers in gay men and other MSM of color."

"A substantial number of Black people infected every year are gay or bisexual, and a substantial proportion of gay and bisexual men infected are Black. In fact, the heaviest impact is at the nexus of the two – being both black and a man who has sex with men. Yet this population is significantly marginalized, even stigmatized within both larger populations of which it is an integral part. A national AIDS strategy must tackle this fundamental challenge," he added.

Advocates state that CDC's response to the new estimates, despite acknowledgement of the U.S. epidemic as majority gay/bisexual, does not challenge the pervasive homophobia that the federal government refuses to confront.

They point to research on gay men who experience bullying and violence in adolescence and later have higher rates of drug use, intimate partner violence, and HIV/AIDS. According to the National Anti-Violence Project, there was a 24% increase last year in the number of victims reporting anti-LBGT violence.

"The rising incidence in our communities is a direct result of years of policies and programs that demonize and ignore the sexual health needs of gay men, especially African-American and Latino gay men who bear the brunt of the epidemic in the United States. Gay men of all colors face significant health disparities that directly compound chances of becoming HIV-positive," said Jim Pickett, Director of Advocacy at the AIDS Foundation of Chicago.

"We must prioritize a holistic, asset-based gay men's health agenda that goes well beyond a 'navel to knee' focus. We must also address their physical, mental, emotional and spiritual health needs that, when neglected, foster conditions in which HIV thrives."

Activists note that the national AIDS program of the Mexican government's public health department sponsored public campaigns against homophobia in subways and buses, television spots, school programs and by working with telenovela and movie producers.

"If this socially conservative country, with far fewer resources than its wealthy neighbor to the north, can ambitiously confront homophobia with government sponsorship and funding, why can't the United States?" asked Coco Jervis, CHAMP's Director of Policy.

"CDC talks of the need to develop more and better prevention messages, including more prevention interventions for Black gay men and gay men of all races. But such strategies will never be sufficiently effective or taken up by those most at risk until – and unless – homophobia is directly confronted," added Kenyon Farrow, National Public Education Director for Queers for Economic Justice.

"Instead, politicians of both parties and the Department of Health and Human Services have caved into pressure from right-wing politicians, squelching not only sexuality research but anti-homophobia and pro-sexual diversity messages in HIV prevention and general health promotion alike. Will our next administration buck this trend, or will it be more of the 'business as usual' that's decimating my community?"