Embrace, Celebrate, and Support LGBT People / Confront Homophobia

AFC's Mark Ishaug Envisions
The 2009 Gay Men's Health Agenda

Homophobia continues to be the primary social barrier between gay men and healthy well-being.

by Mark Ishaug
President and CEO
AIDS Foundation of Chicago

With new data demonstrating that gay men and other men who have sex with men (MSM) remain disproportionately affected by HIV and under-served by HIV prevention programs in the U.S. and around the world, a targeted and vigorous response is urgently needed to bolster the health and civil and human rights afforded to gay men in the U.S. and abroad.

The next president of the United States must hear the same message we heard loud and clear at the 17th International AIDS Conference in Mexico City in August 2008: with the majority of domestic HIV/AIDS cases among gay and bisexual men, it is unacceptable for us as gay men to be rendered invisible in efforts against the epidemic.

Leadership must address entrenched, structural homophobia head on and close significant gaps in our knowledge and programs so that better service models are designed and deployed to meet gay men’s health and safety needs.

In order to fully address the health needs of gay men, health and service planners must recognize the underlying conditions that drive HIV/STD disparity in the first place. Homophobia continues to be the primary social barrier between gay men and healthy well-being.

The U.S. must develop and deliver a national anti-homophobia campaign to promote greater awareness and support of LGBT people as a key strategy to engender healthier communities.

This campaign should affirm the lives of LGBT people, locate LGBT people in the context of valued members of our families and communities, recognize the benefits of inclusion and recognition, and strive to mitigate persistent anti-gay stigma and discrimination.

A portion of the campaign should target African-American and Latino communities specifically based on the input of LGBT African-American and Latino organizations and leaders. Furthermore, the campaign should explicitly describe the consequences of NOT confronting homophobia to public health and society at large and seek direct and measurable outcomes that may include dissemination of information, conducting local events, securing a number of proclamations, and/or other signs of local adoption of core social marketing messages.

The gay men’s health agenda in 2009 must also include vigorous support for increasing research and innovation to address escalating rates of HIV among gay men.

Of the almost 50 CDC-sanctioned effective HIV prevention behavioral interventions, only four have been developed for gay men – one of these for gay men of color. This is a sad reality that must be remedied immediately. Federal and state agencies must invest in the development of targeted interventions for gay men– especially gay men of color and those at increased risk of HIV infection due to alcohol or drug use.

We must also explore strategies to help men maintain behavior change and create more tools to help them discuss difficult topics like serostatus and safer sex with potential partners. Beyond research to develop better CDC-sanctioned HIV prevention interventions, the federal government should continue to invest in new prevention technologies, such as rectal microbicides, vaccines and pre-exposure prophylaxis, and support the innovation of “home-grown” and community-based interventions to reach those men most at risk of HIV transmission. I

In 2009, it’s also time for Congress to allow federal funds to support the development and dissemination of health promotion materials and services affirming LGBT sexuality and diversity.

The federal government should confront the health disparities impacting LGBT people by tasking the U.S. Department of Health and Human Services (HHS), and its subsidiaries including the Substance Abuse and Mental Health Services Administration (SAMHSA) and the CDC, among other agencies, with the development of new service models aimed at eliminating HIV/STD health disparities among gay men and other MSM. The Minority AIDS Initiative should be fully funded and tasked with the prioritization and design of programs to better serve gay men of color who are at risk for HIV acquisition and transmission. Program reach can be expanded by further investment in LGBT-specific health clinics and the development of culturally competent services and staff in other community health settings.

The next administration, and all public health decision-makers, should commit to making non-occupational post-exposure prophylaxis (PEP) widely and—affordable, accessible, and well promoted—to those communities most in need.

Gay men who may have been recently exposed to HIV should be able to access this life saving intervention regardless of their location or ability to pay. PEP should be marketed and available during the times when it is most likely to reach those in need – nights and weekends. All of these efforts should be rigorously evaluated with findings on implementation and expansion disseminated broadly.

The AIDS Foundation of Chicago also supports the creation of a national Office of LGBT Health charged with developing and implementing a holistic, community-driven health agenda for gay men as well as lesbian, bisexual and transgendered individuals.

Such an entity could help shepherd national healthcare reform and ensure that new health financing and delivery model meet the needs of LGBT people. The office could also be instrumentally in helping create and implement a National AIDS Strategy, which is desperately needed to recalibrate our HIV-related activities to a results-oriented approach.

It’s time for our nation to embrace, celebrate, and support LGBT people as valued and contributing members of our society. Without such an approach, health disparities will certainly persist among gay people and all others whose wellbeing is neglected in public policy and programs.


[LifeLube has been asking folks around the country to weigh in with their ideas regarding a 2009 Gay Men's Health Agenda. Click here to read the input. Please feel free to comment here - or you could send in a full post of your own here. We will be happy to publish it!]