With the LGBT community’s intense focus on gaining true equality in regards to legal rights, some people and groups are arguing that HIV/AIDS have all but fallen off the radar completely. Protection from discrimination and the right to marry are important, they agree, but health has fallen too far down the priority list.
Others, however, disagree; as some immigrant groups can attest, for example, essentially being told that you are illegal can carry a heavy stigma. In an editorial for the New York Daily News, Dr. Perry Halkitis, a gay man who has been living with HIV since the 1980s, wrote that in contrast to others’ fears that the fight for legal rights has taken away from the fight against HIV/AIDS, he feels that “Any money, time or effort directed towards creating marriage equality is also money, time and effort directed at HIV prevention.”
Halkitis points out, very reasonably, that “low self-esteem, being closeted, family rejection and internalized homophobia all contribute to increased risk for contracting HIV. Gay men who experience discrimination, who are denied their rights, and who live in societies that diminish and ridicule their existences are saddled with psychosocial burdens—burdens that in turn engender risk.”
Stigma alone is burdensome enough, but having it effectively supported by law only adds to the stress. Under the old sodomy laws, fears of being arrested for consensual sex were not the only threat; people could lose custody of children when it was argued that because they had a partner, they were breaking the law every time they were intimate.
Even without burdening external factors, internalized homophobia—when combined with being closeted or not—can lead to very low self-esteem, which in turn can easily lead to suicide or high-risk activities such as drug use.
People on every side of the debate are arguing that the government can’t legislate public opinion, but in fact, what the law says about a group does have an impact on the public. In Russia, where public opinion of LGBT people was already very low, homophobia-related harassment and violence, including murders, have gone up in the wake of new laws banning “homosexual propaganda” and adoption by couples who are LGBT or hail from countries with marriage equality, to the point of Russian LGBT activist Nikolai Alekseev saying that Russian laws have called for an “incitement of genocide.”
At Columbia’s Mailman School of Public Health, Mark Hatzenbuehler has documented that the advent of marriage equality in Massachusetts had beneficial effects to the mental health of gay men; he predicts that the defeat of DOMA will see similar results across the nation. Why? Because suddenly, the LGBT community has more rights and acceptance than it used to, and can look forward to gaining even more.
Halkitis, who holds both a PhD and a Master’s of Public Health, has seen AIDS go from an automatic, swift death sentence to a chronic condition, seen by some as hardly different than diabetes. Though he has also seen the rate of infection remain high, despite the efforts of both behavioral programs and medical advances, he sees cause to hope; his essay closes with “Marriage equality doesn’t pose a threat to our war on AIDS. It provides us with a weapon for fighting this disease — a socially constructed weapon as powerful as any behavioral program or medication.”