HIV is a Gay Disease (!?!)

These are preliminary thoughts about the ad campaign:

First off, I am very active in the LA HIV/social services community (on many task forces, consortia, CABs etc.) and heard no discussion of the campaign prior to it’s being released into the community. I find this odd, especially since there have been a number of "town hall forums" to address some of the social marketing (I hate that phrase) which AIDS Healthcare Foundation ran earlier this year, which infuriated the community.

There is a LOT of hand-wringing in L.A. HIV circles about men who have sex with men who don’t identify as gay - and how to get them HIV tested and how to target prevention to them. This campaign will not speak to them, of course.

Many of those men are purported to be men who are not white. From the opinion piece by Lorri Jean
While men of color represent the largest group of people living with HIV/AIDS in Los Angeles County, it is rarely noted that the vast majority of them are gay and bisexual men.

It is generally acknowledged that those guys do not identify as "gay" and are not seen as members of 'The Gay Community' (of course, there are many communities in LA, but 'The Gay Community' in LA – the West Hollywood, entrenched crowd who self-identify as 'The Gay Community' generally are white.) So if these posters are going up in West Hollywood or in areas where people who identify as part of the gay community are, they will miss the very population they are saying they want to reach. Also from Lorri Jean’s piece
We have so effectively de-coupled the epidemic from the word 'gay' that most of us don’t even know the degree to which we are impacted

Later, she states:
...men of color represent the largest group of people living with HIV/AIDS in Los Angeles County.

Is there a possibility that the "we" she is talking about is the white gay community? Do you think that a community of people who are HIV-positive, 75% of whom are men of color might actually not have "forgotten" how hard HIV has impacted their community, but might actually be invisible to "we", 'The Gay Community' because of underlying issues racism, poverty/classism, and different cultural values (which may not look like the ‘gay values’ represented by the Santa Monica Blvd. bar scene, the internet hook-up scene, the bath-house scene, the P&P scene, or the Silverlake leather scene – just random examples of the public face of the ‘gay community’) in the folks who are HIV+ people of color)?

Might it be that there are such deep divisions in Los Angeles that this campaign won't reach anyone it's intended to reach? Or, is it intended to reach those folks who feel represented by the ‘gay community’? If the fact of the matter is that of HIV+ men in Los Angeles County, 75% are men of color, is this ad campaign targeting the 25% of white self-identified gay men it will likely reach? And if so, why does the website profess concern about the numbers of men of color who are HIV-impacted (the majority of HIV-impacted men in LA County)? It feels to me like lip service to people of color on the site, and targeted marketing to young gay-identified white boys who hang out in West Hollywood, read gay magazines and go to gay bars in actuality. I have no problem with white, gay-identified men being targeted for HIV prevention. I support that 100%. But this feels like talking out of both sides of the mouth.

There are, in some studies, HIV seroprevelance rates of 22% in the Los Angeles transgender population. I’ve seen statistics up to 75% in other studies I’m too lazy to look up right now. We don’t see any prevention targeting them. According to the federal government, funding for transwomen at sexual risk has always come from MSM dollars. Wouldn’t it be appropriate then, to include them into a campaign which is likely being funded by prevention dollars which are supposed to target them also? There is a BRG in Los Angeles for transgender women at sexual risk, but there is no correlate at the federal level. Reaching this group might actually be the bridge between gay men; men who are bisexual or who have sex with both men and women; men who have sex with both trans- and non-trans women; and men who might cross racial lines for sex and bring HIV from one community into another. Seems like that might be a good idea. What would people think about "HIV IS A TRANSGENDER DISEASE"? Not comfortable with that? We need to go back to issues of stigma & -phobia, and how they play into this campaign, than.

There are other communities in Los Angeles who are invested in those men (men who have sex with men but who don’t identify as gay or bisexual) getting tested, but also getting targeted prevention information – especially trans- and non-trans women (mostly of color), and people who go through the criminal justice system (again, disproportionately people of color). This campaign doesn’t speak to them either.

Cluster studies have been done which indicate that there is usually a small pool of HIV+ people who are actually responsible for the majority of HIV transmission in a given area. This campaign doesn’t acknowledge the huge numbers of people who are gay and who are actively responsible about staying HIV negative, or, if positive, for making sure that they don’t transmit the virus to other people. It sends a message that "the gay community" is the HIV community" – something which has alienated HIV-negative people – especially youth - for a generation, and which has done (in my estimation) a lot of harm in trying to get people invested in staying HIV-negative, or not to transmit the virus if HIV-positive.

"HIV is a gay disease" feeds on internalized homophobia, and can really distract people from examining their behavior and instead allow folks to see HIV as an inevitability or a punishment for being gay. Indeed, it may read – especially to someone with a lot of internalized homophobia – like the way one gets HIV is by coming out, or by simply being gay. Michael Weinstein (AIDS Healthcare Foundation) said this (paraphrased): HIV is not a gay disease. It is not a woman’s disease. HIV is an immune system disease.

All of that said, if there were simultaneous, similar ad campaigns targeting specific folks in other specific areas of Los Angeles (ie: "HIV is a Black disease" in South LA, or "HIV is a Latina disease" in East LA) – it might sit better with me. Because frankly, as much as 'The Gay Community’ (and in LA that identification still tends to be pretty white) needs to wake up and deal with resurgences in infection rates, this looks from a more cynical point of view like an attempt at a white-gay money grab. The folks who the Prevention Planning Committee want to target for testing and prevention include the following: men who have sex with men (and possibly with women as well - MSMW) who do not identify as gay (who are generally assumed to be non-white); women at sexual risk (who are generally assumed to be non-white), transgender women at sexual risk (who are generally non-white – at least in the Los Angeles transgender social service community the population is primarily Latina/o and Black), and of course, MSM. I think that there is a big concern that since Los Angeles lost a lot of Ryan White money, that there is a real sense of possessiveness on the part of the entrenched "LGBT" and AIDS service providers which basically were started by gay white men, have mostly gay white men on their Boards, and are still most responsive to the needs of gay white men. I think this indicates a level of cultural racism that is so entrenched that no one even realizes that it’s there (and by "no one" I mean those who run the large HIV and "LGBT" organizations, who are generally white and gay). We can’t pretend that there are major issues of racism and sexism in Los Angeles, in gay communities and in service providers, that that in some way this feeds off of that racism and sexism.