Don’t Forget About AIDS

Last week Jennifer Mumaugh and A. J. McDaniel became the first same-sex couple to marry in Wyoming. They celebrated their union in Cheyenne, just miles away from where Matthew Shepard was left to die only 16 years ago. Wyoming thus became the 32nd state to allow gay marriage — explicitly or, by refusing to appeal court decisions, implicitly. Alaska. Arizona. Idaho. All have fallen this month.

These are great advances, and there is no question that those who believe in marriage equality must be vigilant in protecting them. But as engaged as the gay community and civil rights activists have been in the fight for marriage equality, we have lost ground on the fight that so intensely galvanized the gay community to begin with: H.I.V. and AIDS.

We need the same coalition that brought about marriage equality — from gay activists, human rights champions and social justice advocates to legal experts and courageous policy makers — to address the spiraling AIDS crisis again.

Why? Because 30 years after the AIDS epidemic began, rates of infection in the United States are still at unacceptable levels. One in eight gay men is H.I.V.-positive, and yet a majority of gay and bisexual men say they are “not concerned” about H.I.V., according to new research from the Kaiser Family Foundation.

Just a third of the men surveyed even knew that H.I.V. infections were increasing in the United States. Thirty percent said they had never been tested, and a majority reported that they hadn’t been tested in the last year, going against recommendations from the federal Centers for Disease Control and Prevention.

Many view the drug Truvada — often used in pre-exposure prophylaxis, or PrEP — as a miracle drug that will end AIDS. I share in this excitement, and have great hope for PrEP — and praise for leaders who advocate its wider use. But only a quarter of those men surveyed by Kaiser had ever even heard of PrEP.

In short, as the gay community celebrates the march of marriage, we are failing to maintain the kind of basic awareness and education that is needed to save lives.

Of course, the continued prevalence of H.I.V. should shake the conscience of all Americans — not just those in the gay community. For example, today AIDS is among the leading causes of death for African-American men.

In the South, new infections are at rates rivaling the 1980s, fueled by a toxic mix of homophobia, poverty and poor choices by policy makers, like the refusal of many Southern governors to expand Medicaid.

What, then, can be done?

First, the gay community needs to take a hard look in the mirror and start to address these concerns in our own backyard.

Last week my organization, the Elton John AIDS Foundation, announced a series of grants to lesbian, gay, bisexual and transgender organizations to promote testing and prevention, spread awareness and fight anti-H.I.V. stigma. I hope other organizations will join us in identifying the groups at the greatest risk of contracting H.I.V. and working with people in those groups to find stability and hope. And while I hope that groups outside the lesbian and gay community join us, I do believe that those of us within the community have a special obligation.

Second, all Americans need to recognize the AIDS epidemic for what it has become: a crisis of stigma, marginalization and inequality. Medical advances and treatments like PrEP can get us close to the end of AIDS, but only if enough people can afford them. That means going beyond AIDS itself to attack the root causes of these rising infection rates, like poverty, homelessness, addiction and limited access to health care.

Finally, as a society we need to learn to view the AIDS crisis with compassion. What helped to win marriage equality were the images of loving couples being given a chance to exercise their humanity and their basic rights. So, too, can telling the stories of those with H.I.V. and AIDS striving to live with dignity help us reach the end of AIDS.

Within just a few decades, we have moved from a nation with laws against consensual sex into a place where members of the gay community can marry, adopt children and expect to live a good life. That’s a wonderful thing, but we have to remember that it’s not the only thing.

I came out publicly in 1976, just before the beginning of the AIDS crisis. The gay community I inhabited in those years never dreamed of marriage equality — we simply wanted to live, and to stop the terrible epidemic that kept killing our loved ones. We’ve come a long way. But as we celebrate these victories, we must also come together and redouble our efforts to end H.I.V. Only then will we truly have won freedom and equality.

Elton John is a recording artist and the founder of the Elton John AIDS Foundation.

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