BTL Editorial
The numbers are staggering. The numbers are terrifying. The numbers represent a threat to the health and safety of gay, bisexual and other men who have sex with men. And the silence around this threat is just as terrifying.
New predictions from the Office of National AIDS Policy show that the current cohort of 20 year old gay, bisexual and other men who have sex with men have an overall prevalence of 10 percent – today. And the news is much more dire for 20 year old black gay, bisexual and other men who have sex with men, the prevalence in that group is 20 percent – today. At current infection and transmission trends, when this group reaches age 50, half of them will be infected, and 70 percent of black MSM will be infected.
The federal government has known about this threat since 2009. The Michigan Department of Community Health has known about the threat since 2009. How did those appointed to protect the health of the public respond to these prevalence numbers?
Silence.
There have been no massive press events to highlight these numbers. The state has even admitted it did not bother to share the numbers with AIDS Service Organizations or LGBT groups.
What is clear here is that current HIV prevention efforts are a failure, and current public health authorities in Michigan do not care about gay, bisexual or other men who have sex with men – unless and until they are infected with HIV.
The state has authorized $2.5 million in HIV prevention funds. Of those dollars, only 16 percent will be spent on engaging MSM who are HIV negative in prevention efforts. On the other hand, 60 percent of the funds will be spent on HIV prevention for positives who are MSM. A significant majority of that funding is directed at programming designed to help HIV-positive persons disclose their status and prevent transmitting the virus. Some of that money is used for testing initiatives to identify persons with HIV who do not know they are infected.
The CDC estimates that 20 percent of people infected with HIV in the U.S. do not know they are infected. A person who is infected and unaware is 3.5 times more likely to transmit their infection. That group is also responsible for more than half of all new HIV infections in the United States.
The silence from those empowered to protect the public's health is appalling and shameful. But they are not alone in abandoning our brothers and transgender sisters to the epidemic.
For too long, a bright line of division between LGBT equality and HIV prevention, care and treatment has acted as a barrier. As happened in the early days of the epidemic, it is our community who must pick up the neglected conversation of HIV among our own, and immediately create new, innovative programming to hold responsible, sex positive and fact-based education to the community and beyond. Public health has shown it has no compunction about ignoring MSM and allowing this epidemic to decimate a generation, but our leaders in the LGBT equality movement cannot accept this.
It is time to end the silence – from our community, from our leaders and from the government agencies tasked with protecting our health. These numbers mean an obliteration of a generation of gay, bisexual and other men who have sex with men as well as transgender women. Equality will mean nothing if half of our brothers and sisters are infected with HIV, struggling to pay thousands of dollars a year for access to life-saving medications – medications which while generally better than a decade ago, still carry significant side effects. Equality requires that our community not only be free and equal under the law, it also demands that infectious disease no longer disproportionately impact our community.
While HIV is not a gay disease, it is disproportionately impacting our community. The silence ends today.
