AIDS Is Still a Huge Problem


The following is an excerpt from the new paperback edition of Hold Tight Gently by Martin Duberman (The New Press, 2014):

Since the midnineties, public concern in the United States about the AIDS pandemic has continued to decline, even as the disease continues to spread. The number of Americans who consider AIDS the most urgent health problem facing the nation dropped from 44 percent in 1995 to 6 percent in 2009. One reason, surely, is that AIDS has become less and less a white disease and more and more a disease associated with people of color. Globally, fewer than half the people afflicted with AIDS are receiving treatment, and in light of recent budget cuts reducing AIDS expenditures, that number is likely to decline further. Even in the most “developed” countries, suppression of HIV through antiretroviral medication remains incompletely effective.

In its most recent (May 2012) report, with data through 2009, the Centers for Disease Control (CDC) shows a vast disparity of new infections among racial-ethnic groups in the United States. Though African Americans make up only 12 percent of the population, black men who sleep with men account for 45 percent of new AIDS diagnoses. This is despite the fact that young gay black men have fewer partners, less unprotected sex, and lower rates of recreational drug use than other gay men. Some Latino men who sleep with men—who made up 20 percent of new AIDS diagnoses in 2009—like some African American men do not primarily self-identify as gay (not least because many consider “gay” a white term). Those who sleep with women as well as men help to account—especially in hot-spot cities such as Washington, D.C.—for the recent realization that new HIV and AIDs cases among African American women are now comparable to rates for women in sub-Saharan Africa. Infection rates continue to rise among white gay men as well, but the mortality rates aren’t comparable: the proportion of deaths among whites (and especially among those with high levels of education—and the income and access that follow) has declined, but HIV and AIDS among men and women of color in the United States of all sexual preferences continues to skyrocket, especially among lower-income populations. African American women are now dying at fifteen times the rate white women do. Self-identified gay men of all colors, however, are still fifty times more likely to contract AIDS than any other demographic group.

One would expect to find mainstream LGBT organizations and spokespeople still vociferously active in pressuring pharmaceutical companies and researchers to come up with better treatments and preventative strategies, and governmental agencies—the CDC, the National Institutes of Health—offering greater services to those already ill. But that isn’t the case. The sense of urgency among gay people themselves is seemingly gone; a portion of the new generation dislikes using condoms for safer sex and tells itself that with the advent of protease inhibitors, AIDS is now a “manageable” disease. It is, for those who can afford and who can tolerate the medications, though no one knows how long they’ll remain effective and what secondary damage they’re doing along the way; for some people the drugs don’t work at all, for others only briefly.

The older generations of white gay men who have physically survived the epidemic have buried their dead—and to a regrettable degree, their heads in the sand. As the longtime AIDS journalist John-Manuel Andriote has put it, the “traditional donors—middle-class and affluent white gay men—have ‘moved on’ since they can now get their HIV-related medical care from their private physicians. . . . The old ACT UP slogan of ‘Silence = Death’ still holds, if by ‘silence’ we mean withholding of support.” Since the midnineties the mainstream gay agenda has demoted AIDS from its top priority and replaced it with what those of us on the left call the assimilationist items of legal matrimony and the “patriotic” right to serve openly in the armed forces. 

In Africa, AIDS is primarily a heterosexual phenomenon, but in the United States it remains a profoundly gay one, with poor, young, nonwhite men disproportionately impacted—though children, intravenous drug users, and heterosexual women are hardly immune. But self-identified gay men in the United States do still make up 48 percent of the 1 million people currently living with AIDS. We haven’t even reached the point where the annual increase in gay male patients being treated exceeds the number of gay men being newly infected. 

Copyright © 2014 by Martin Duberman. This excerpt originally appeared in Hold Tight Gently: Michael Callen, Essex Hemphill, and the Battlefield of AIDS, published by The New Press Reprinted here with permission.

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