Not A Gay Disease: HIV, Homophobia, and the Americas

When a friend of mine heard one of her medical school professors refer to HIV/AIDS as a 'gay disease,' she had to speak-up. "We need to be clear when talking to patients that it isn't being gay that puts people in a higher risk category, it's anal sex."

Noticing the stunned looks of her classmates, she assumed that they simply hadn't understood her point and attempted to clarify, "Look, while I was living in Honduras I had a friend who insisted that he wasn't at risk, because he sometimes had sex with women and therefore wasn't gay. His doctor had told him that only gay men needed to worry about HIV. We need to make it clear to patients that any unprotected sex puts them at risk, and it is unprotected anal sex with multiple partners - not identifying as gay - that increases your chances of catching the virus."

My friend has been shunned by many of her classmates since making her point. Apparently, honest talk about sex isn't ladylike - even in a hospital.

Yet disease isn't deterred by cultural taboos, and we are needlessly endangering people through this combination of homophobia and excessive prudishness. By stigmatizing homosexuality, and by making being openly gay dangerous, we encourage people to lead double lives and to lie about their sexual experiences - putting themselves and all their partners at risk. An unwillingness to openly talk about sex only compounds the problem.

As the New York Times reports, the myth of AIDS as a 'gay disease' is common throughout the Americas, and interferes with efforts to protect people:

Martín Márquez Chagoya, a gay man who has had H.I.V. for 14 years and counsels other men, visits a park in downtown Puebla [Mexico] where men go to have sex with other men, but he says his efforts to promote condom use there often fall on deaf ears. The No. 1 response he hears from men there is that they are not gay and are therefore not at risk. They say they are merely having sex with gays.

It is time we all acknowledged that fear and misinformation do not constitute a prevention plan.

In order to limit the spread of disease, we need to fight homophobia and discrimination. Here in the United States, we are currently working to pass legislation that would ensure that no one could be fired on the grounds of sexual orientation; but even if the Employment Non-Discrimination Act (ENDA) passes the Senate, it faces the risk of a presidential veto and fails to extend protection to transgender citizens. Denying legal protections to the LGBT community sends a frightening message to young gays - that they should stay in the closet. We cannot ask people to be honest about their identities while threatening the livelihood of anyone who is openly gay. If our societies paint homosexuality as something punishable, how are we to encourage young people to be honest about their sexual identities - even with their doctors and partners?

We also need to combat the myth that people's sexuality can always be fitted into neat little categories. As Professor Hector Carrillo of San Francisco State University recently explained to the New York Times, "Sexual identity is a very complex thing... We like to think that once someone figures out their sexual attraction, they will fit into the categories we’ve created. But life isn’t like that." A greater acceptance of how very fluid sexual identity can be for many of us would help combat myths about who is at risk.

We also need to stop kidding ourselves about the progress we've made. Sure, the world is a more accepting place than it was 50 years ago, but homophobia still kills. According to the Mexican gay rights group Letra S., "[b]etween 1995 and 2006, about 1,200 Mexicans were killed because of their sexual orientation." And violence against gay and transsexual citizens is not a country-specific problem, but is common throughout the rest of the Americas as well. Yes, even here in the States, where people come with the expectation of protection (rest in peace, Angie Zapata). Our governments need to ensure that hate-crimes are recognized as such, and prosecuted. Parents need to make sure that their children know that dehumanizing someone because of their sexual identity is evil. We cannot continue to create an environment of hate, and those who promote intolerance need to keep in mind that the ripple effect of acts of violence has the ability to impact us all in a multitude of ways.

We cannot fight disease with lies, threats, or platitudes. If we want to keep all of our citizens safe, we need to respect and protect them. And that means being honest - even about sex.