The White House’s new HIV Policy: “In the begining it was known as the gay disease”

So although this blog will have a “global” focus, some of the issues will just be whatever is on my mind relating to HIV and how it influences us men who have sex with men.  Some of the issues will not be relevant to all readers, but that being said I hope that all posts provide enlightening information.  

Recently, Obama has announced the White House’s new policy to help curb HIV infection in the US.   The strategy is three-pronged: reducing new HIV infections, ensuring care for HIV positive individuals and narrowing health disparities.   

His announcement comes with a commitment of $30 million in funding to help decrease HIV infections.  Currently, I work on a $600 million USAID funded international maternal and child health program, and having supported PEPFAR international HIV programs, this is absolutely a drop in the bucket. The new Global Health Initiative, also initiated by Obama calls for $63 billion USG investments in global health over 6 years.   However, that’s not my man concern about what all this means.  

If one watches the 12 minute announcement below, you will note how little is said about the largest face of the epidemic in the US: gay men and other men who have sex with men.   Most of us gay men know that we form the largest group of new HIV infections: According to the CDC incidence statistics we are responsible for over half of all new cases (and this is on the rise. We know there are racial disparities to this too if you look at the second chart).  And according to a nifty June 2010 CDC fact sheet, MSM are the only group in the US in which new infections are increasing. Yet, in the announcement all I heard were the terms “gay, homophobia and partner”  mentioned briefly in passing.  While Obama mentions that “in the beginning HIV was known as a gay disease” he fails to mention that it still is.  

So, if this is such a problem, why was HIV and gay men not significantly mentioned during Obama’s introductory speech regarding his new HIV/AIDS policy (which mind you developing countries receiving aid under PEPFAR have had for years)?  Only at the end (9 minutes in) does Obama state that the policy will affect “communities  where the need is greatest” and mentions gay and bisexual men.  However, there is no elaboration of this, and no discussion about how exactly this plan will increase access to testing, counseling and treatment for gay men (and all African-Americans).   

Credit: CDC, http://www.cdc.gov/hiv/topics/surveillance/incidence.htm

Men who have sex with men are the group with the most new HIV infections

 Yes, a comprehensive approach to reduce the number of infection is great.  But I wish Obama would have signaled specifically what we would do to curb the (only) GROWING epidemic among MSM.     When was the last time we have seen a PSA targeted toward young gay men, gay men of color, etc? Actually, when was the last time we have seen a PSA about HIV in general? Obama does mention the need to use media and Internet to promote HIV and AIDS awareness.  This is great in theory but need to be put into action through social marketing campaigns.  

Obama mentions that this new strategy must parallel the international AIDS strategy.  However, having worked for various international organizations that receive tons of PEPFAR money, I can tell you preventing HIV in “most at risk populations” (refered to MARPs in the international community) is probably the lowest priority of US government funders and rarely, if ever hits the radar screen of donors and policy makers.  While millions get poured into preventing  heterosexual transmission of HIV through male circumcision in sub-Saharan Africa, no attention (or funding) is paid to the rising MSM epidemic in Malawi, South Africa, etc.  Apparently the International Women’s Health Coalition agrees with me that PEPFAR needs to address MSM (see Goal 7).  

Yes, there are good points of this HIV strategy which seems like it should have been announced 20 years ago.  All HIV positive individuals, gay, straight, black and white do need access to drugs and treatment and HIV positive individuals absolutely need access to health insurance. Let’s hope that the mantra of the Vienna AIDS Conference, “Right Here, Right Now”comes to fruition.  

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