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On World AIDS Day, We Must Recommit Ourselves to Eradicating Stigma

People living with HIV

There is much work that remains to fight stigma, especially in communities of color.

"AIDS is God's punishment!" proclaims the choir in the Tony Award-winning Broadway musical A Strange Loop,in a scene where the protagonist -- a young queer Black man -- argues with his parents in a heartbreaking dialogue in which they conflate HIV with being gay. This show paints a poignant picture of the current state of HIV: that there is a lot of work that remains to be done to eradicate HIV and stigma, particularly in communities of color.

This brilliant show illustrates that HIV today is mainly affecting queer communities of color, and because of stigma and discrimination, we are not talking about it enough, and we need this topic to be highlighted everywhere in mainstream media and entertainment.

Currently, HIV is most devastatingly impacting queer black and Latinx communities, straight cisgender black women, transgender women of color, and sex workers. Yet the resources, attention, and funding are not equally distributed and helping close this health and equity gap.

As we learned over the past three years of the pandemic, we are all only as safe as those members of the community who are most at risk. Luckily, in the queer community, we look after each other; we unite and fight together in the face of discrimination. In the 1980s, we supported each other and demanded the government to address the AIDS crisis. We did it again recently to demand equal rights and marriage equality, and respond to monkeypox and, most recently, the Colorado shooting. We must unite now to end HIV stigma and ensure equal access to health care for all.

However, we must come to terms first that HIV and AIDS are health equity issues where race and gender are part of the core.

Black individuals with HIV experience face multiple, intersectional struggles: racism from queer and white spaces on the one hand and homophobia and stigma from Black spaces on the other. The confluence of these factors has led to alarming statistics.

In 2020, Black people represented 12 percent of the U.S. population but accounted for 42 percent of new HIV diagnoses (12,827), according to the Centers for Disease Control and Prevention. Black men accounted for three-quarters of new HIV infections among all Black people in the United States. Black transgender women accounted for 62 percent of HIV infections among transgender women with HIV living in seven major U.S. cities. And Black women have 15 times the AIDS rate that white women do. Similarly, Hispanic people represented 19 percent of the U.S. population but accounted for 27 percent of new HIV diagnoses in 2020.

Centuries of racism have led to unequal access to health care. A core pillar of health care is stable housing and income; you only are able to fully take care of your health after your basic needs are met. In this country, BIPOC communities are at a severe disadvantage due to systemic racism that has led to unequal economic opportunities and large wealth gaps.

Health care access and insurance for Black communities and people living with HIV is also continually under attack. There has been a slew of lawsuits seeking to tear down the Affordable Care Act, part of which requires insurance companies to provide coverage to folks with preexisting conditions (such as HIV). In a more recent court decision, Braidwood v. Becerra, a judge struck down the requirement that pre-exposure prophylaxis be covered by insurance providers. Additionally, even when individuals can access health care, the National Academy of Medicine found "racial and ethnic minorities receive lower-quality health care than white people" even when considering all other factors.

Stigma in Black communities has also led to the disproportionate impact of HIV. In 2017, Nikko Briteramos was refused service at a Los Angeles barbershop based on his HIV-positive status. Lambda Legal and the Black AIDS Institute partnered together and launched a national education campaign called "Cut the Stigma." As the Black AIDS Institute observed, "Black people living with HIV are often confronted with discrimination connected to stigma and misinformation in public places of importance within our community."

So what can we do to support our BIPOC siblings living with HIV? Fundamentally, we must let the community lead the charge and provide the resources needed to make the change happen. We must listen to and center the voices of queer BIPOC communities. We need to advocate to government agencies and private organizations to respond to these needs. At the very least, we must provide more funding towards black and BIPOC HIV issues and donate to organizations trusted and rooted in the community, such as the Black AIDS Institute. Education, access to preventative measures such as condoms and PrEP, and linkages to health care have been identified as the core needs for the community.

Now we must come together again as a community to continue to fight racism, discrimination, and HIV stigma. The stakes remain as high as they are everywhere.

Jose Abrigo is the HIV project director at Lambda Legal, the oldest and largest national legal organization committed to achieving full recognition of the civil rights of all LGBTQ+ people and people with HIV.

Views expressed in The Advocate's opinion articles are those of the writers and do not necessarily represent the views of The Advocate or our parent company, equalpride.

To commemorate World AIDS Day, you can join Lambda Legal and award-winning Broadway musical A Strange Loop for a special evening show and talkback panel with cast members and Cecilia Gentili with a special discount price. You can find more information here.

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