What the Experts Are Saying About Moving Beyond HIV Stigma

In our roundtable discussion, experts urge a better understanding of the epidemic among African-Americans.

BY Andrew Harmon

April 30 2012 3:03 PM ET

4. Good data drives policy.

In the 2011 report “The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding,” the Institute of Medicine laid out a game plan for better serving the health needs of LGBT people. Central to that plan is a data-driven approach — one that can show in concrete terms where American health care can better address gay and transgender health issues.

Problem is, the data on LGBT Americans isn’t yet there, and as a result, there's insufficient understanding of how sexual orientation and gender identity interact with race and ethnicity in regard to HIV/AIDS and other health crises. Under Secretary Sebelius, HHS has sought to remedy this and will begin including sexual orientation questions in the 2013 version of its 100,000-respondent National Health Interview Survey (when the survey may also add gender identity questions is currently unclear). The data collected could greatly enhance understanding of how race and sexuality influence health care access and quality.

Hutson Inniss, executive director, National Coalition for LGBT Health: The importance of understanding what’s happening in our communities is huge. And when Secretary Sebelius designated sexual orientation as an additional population, it was a significant step forward. This is the major work that many of us advocates and academics do. It’s a move toward real change, in part because of the passage of the Affordable Care Act.

5. Marriage equality is a good thing, and so is the drive to achieve it. But this effort shouldn’t keep us from addressing the needs of those living with HIV and struggling for basic survival.

On that point, Moodie-Mills notes in her January 2012 report “Jumping Beyond the Broom: Why Black Gay and Transgender Americans Need More Than Marriage Equality” that over the past decade, national LGBT groups have produced more research studies on how the political push for marriage rights benefits black gay couples than they have on any other issue affecting the community, including domestic violence prevention and employment discrimination. (Why this is the case is becoming more and more obvious as the movement works to fend off an overarching antigay strategy “to drive a wedge between gays and blacks — two key Democratic constituencies,” as leaders of the National Organization for Marriage put it in a recently released internal memo.) Advocates worry that HIV/AIDS work is falling by the wayside as a result.

Baker: Look at the trajectory of when we seriously started talking about marriage. We started seriously talking about marriage after 1996, once the treatments were out, and once we could envision a different future for ourselves. But in many communities, black gay men are in the same place where white gay men were 25 years ago.

I believe in marriage, because we shouldn’t have discrimination, and it does benefit people’s lives, it does help them to be healthier. But we have to look at the fact that people are struggling on many different levels. People are dying today. So it’s not an either/or, it’s just simply a matter of priority of the moment.

Lettman-Hicks: I really hold our LGBT organizations responsible for elevating the voice. We must see HIV/AIDS as a priority. And we need more organizations to take a stand and say that while we’re not going to eliminate other priorities, we cannot allow anyone a pass on not making HIV/AIDS a priority issue amongst the larger equality agenda.

Moodie-Mills: The elephant in the room is that the top national LGBT organizations don’t necessarily focus on quality-of-life issues. They’re working on political expediency toward equality, and we’re thankful for the work, but they’re not focused on these other issues. We can’t ignore the fact that there’s classicism and racism within the broader LGBT movement, so once the powers-that-be and the folks who hold the purse strings can resolve their own crisis with HIV/AIDS, they’re not always concerned with the people who are left behind —just as we see in broader society of marginalized people left behind. They’re not doing enough, they’re not addressing the needs of black LGBT people in general, let alone those who have HIV/AIDS.

But if we look at the demographic shift of America, we know that by 2042 to 2050, the minority faces are going to be the majority makeup of America. If we are not addressing the issues that impact people of color who are LGBT in the movement, then there’s not going to be a movement.

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