Sept. 27 is National Gay Men’s HIV Awareness Day. It seems a bit ironic that a single day is dedicated to HIV awareness for gay men when all of our lives have been closely linked to the epidemic for the past 36 years. Gay men are the group most disproportionately impacted by HIV in the United States. The majority of new infections in the U.S. are among gay and bisexual men; the majority of all infections have been gay and bisexual men; and the majority of deaths have been gay and bisexual men. HIV is incidental to our lives.
I am not dissing HIV awareness days. They are an excellent opportunity for us to have conversations about HIV and gay men’s health, and there is plenty for us to talk about.
A great place to start is in regards to what it means to live with HIV today. Gay men are still scared and anxious that testing HIV-positive will bring anguish and despair. One of the most common reactions to a diagnosis is shame. That is a learned behavior, and it’s something we can unlearn.
One way to do that is to speak openly and honestly about what it means to live with HIV today. Hornet’s recent video that integrated HIV into a general marketing campaign (below) was able to depict the lived experience of gay men and HIV. It wasn’t a public service announcement or a cautionary tale; it was simply a reflection of gay men’s experience with HIV on social networking apps.
When we talk about living with HIV today, there is one very important piece of information we must continue to talk about. If an HIV-positive individual goes on medication and achieves an undetectable viral load, they will be healthy and live a normal life span. That is the primary function of treatment.
The secondary function of treatment is as prevention. If an HIV-positive person is undetectable it’s virtually impossible to transmit the virus. You may have heard of the grassroots movement U=U: Undetectable equals Untransmittable. This grassroots movement is the perfect example of how a community response can alter the HIV narrative for the better.
PrEP is the other major topic that requires our ongoing conversation. PrEP stands for Pre-Exposure Prophylaxis, and it’s the daily HIV prevention pill. When taken as directed it’s 98% effective at preventing HIV. It’s a science success story, it’s great news for the gay community and we must ensure that more gay men know about it and that we reduce all barriers to access. We must also ensure that all of our community has PrEP information and resources. That means we need continued PrEP education and activism for gay men of color and our trans brothers and sisters.
The epidemic has lasted more than 35 years, and while there have been great successes in terms of scientific advancements, it has also been an epidemic of homophobia, racism, poverty and all sorts of social determinants of health. Black gay men have a 1 in 2 lifetime risk of getting HIV. Latino gay men have a 1 in 4 lifetime risk, and all gay men have a 1 in 6 lifetime risk. This is the reality if current rates stay the same.
Fortunately, we have the ability to change current conditions.
We can work to reduce HIV-related stigma by affirming the experience of people living with HIV and by helping people understand the value of being undetectable. We can ensure that all gay men fully understand all of their prevention options so they can make informed decisions about their health. And we can stay committed to fighting for justice and equality for all communities — ending homophobia and white supremacy, ensuring health care is a right, immigration reform, championing the rights of trans people and remaining committed to the basic principal that human sexuality is good and has value and that every individual has the right to determine how they will pursue pleasure and intimacy.