Over the past few years we have witnessed a number of advances in science-based HIV prevention and care policy and LGBT health policy in the U.S.
We have a first-ever National HIV/AIDS Strategy that prioritizes reducing the disparity affecting gay and bisexual men—who were 64% of new infections in 2009, although just 2% of the adult population. We repealed a number of counterproductive policies dating back to the dark days of the 1980s and Senator Jesse Helms, such as ending the HIV entry ban, ending the ban on using federal funds for syringe exchange, and ending funding for abstinence-only-until-marriage education. Unfortunately, the latter two changes were short-lived. And we’ve seen long overdue increases in funding for Ryan White care, the AIDS Drug Assistance Program, HIV prevention through the CDC, and research at NIH, including promising biomedical prevention research.
In LGBT health policy—an overlapping area of concern as about 600,000 people living with HIV in the U.S. are gay and bisexual men and transgender women—we’ve got a public health strategy, Healthy People 2020, that prioritizes for the first time ending LGBT health disparities. President Obama has guaranteed hospital visitation rights for same-sex partners, offered domestic partner health insurance to civilian federal employees, and Secretary Sebelius is adding a sexual orientation question to the National Health Interview Survey. This is all great news, and we are grateful to our allies in government who have worked with community leaders to accomplish these important advances.
However, as the HIV epidemic among gay and bisexual men, and especially Black gay men, rages—with 30,000 gay men newly infected each year, 60% of them Black and Latino—federal government funding targeted toward gay and bisexual men and transgender women is not matching the demographics of the epidemic. Furthermore, critically needed, bold policy initiatives that address key structural drivers of vulnerability among gay men are lacking.
A White House study released last year found that only 34% of Ryan White care funds are going to “men who have sex with men (MSM).” Of CDC and SAMHSA funds, 90% was multi-targeted; of the 10% targeted to specific risk groups, 33% went to MSM. At NIH, 61% of research is multi-targeted or basic research that benefits all at risk of or living with HIV; of the 39% that is targeted to specific groups, 16% of that was targeted to MSM.
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