Gay donors are still giving generously to causes they believe in. While we have seen millions of dollars well spent on issues such as marriage equality and repealing “don’t ask, don’t tell,” somehow AIDS has fallen off, or at least moved well down, the list of priorities.
From the beginning of the epidemic, progress has always come when the community has banded together. We disseminated information about HIV through gay newspapers such as the Washington Blade. We created community health organizations; here in D.C., the Whitman-Walker Clinic was a crucial early center for treatment, testing and prevention of the disease (and remains important today). And we raised our voices, forming groups such as Act Up that proclaimed the truth — that silence about AIDS would mean our deaths.
Many of today’s successes, including antiretroviral drugs, flow from that generation of activists. We are now working on many other important causes, but it was the fight against HIV, and governmental complacency and indifference to it, that ignited our activism. Because we won our battles, life-saving medications became available to more people — at prices most could afford (provided they had insurance) or via vital government initiatives such as the AIDS Drug Assistance Program (ADAP). We forced the government to pay attention to us, and we forged alliances that seemed unbreakable.
Somewhere along the way, though, HIV and AIDS seem to have fallen by the wayside among our community’s most prominent funders. The disease is far from a nonissue even for those who are financially well-off and have easy access to antiretroviral medications. But while these drugs are not trouble-free, HIV is no longer the death sentence it once seemed — for them, at least. A healthy HIV-positive man is simply a much more visible figure (and not evidently in need of a host of services) than poorer HIV-positive and at-risk Americans who lack ready access to treatment. And a disproportionate number of those people are black and gay or bisexual.
Black MSM live at the intersection of multiple inequalities: racism, homophobia, economic disparities, high incarceration rates and limited access to quality health care. In the District, 6.3 percent of black men are HIV-positive, a rate that exceeds that in many sub-Saharan nations.
Not only are black men far less likely to have health insurance, they often lack access to the institutions that provide HIV treatment. Many LGBT-specific institutions are based in predominantly white neighborhoods and are entrenched in a gay culture to which some black men may not readily relate. In more conservative communities outside major cities, particularly in the South, homophobia is a major problem at organizations that provide care.
And the programs that support lower-income Americans with HIV are in peril. According to an analysis by the Kaiser Family Foundation, in fiscal year 2012, federal funding to combat HIV and AIDS was more than $21 billion. But some of those resources could be at risk. Congress is divided and dysfunctional, and headed for a showdown on the budget that could result in dramatic cuts to virtually every important source of funding to treat and combat HIV, including the Ryan White Care Act and ADAP, without which thousands will lose access to HIV drugs and care. And all health and human services programs will be vulnerable as well.
“Living with AIDS is like living through a war which is happening only for those people who happen to be in the trenches,” Russo, the HIV-positive activist, once said. Because of the extraordinary efforts of so many, that war is not as deadly as it once was. Many have moved out of the trenches. But we cannot overlook HIV as a priority for our community while it is still a crisis for so many of us. As at the start of the epidemic, we are at our strongest when we are united in this fight.
dtietz@acria.org
Daniel Tietz is executive director of the AIDS Community Research Initiative of America.
Read more from Outlook:
Should doctors keep patients’ HIV status a secret?
A smarter way to fight AIDS in Africa
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