Statewide View: We can end HIV today; why are we ignoring it?
From the column: "The answer is simple: racism, homophobia, transphobia, and the lack of health equity. We can do better."
Most of us don’t see coworkers or famous people dying from HIV anymore. Once HIV dropped out of the spotlight, people moved on. Those at risk, unable to live that privilege, are forgotten and continue dying. The lack of attention and progress is dumbfounding because we have the medical technology to end HIV. We can save so many lives.
So, why haven’t we eradicated HIV?
The answer is simple: racism, homophobia, transphobia, and the lack of health equity. We can do better.
The Minnesota Department of Health says sex between men remains the main risk factor for men to acquire HIV, and 69% of new HIV cases are among BIPOC. In the 1980s, before HIV/AIDS had a name, it was called GRID, or Gay-Related Immune Deficiency. People falsely believed they couldn’t get it if they weren’t gay. Since day one, HIV/AIDS was not a medical condition but a stigma. Homophobia, transphobia, and racism continue to exclude LGBTQ+ and BIPOC communities from equitable health care and treatment.
In 2012, the FDA approved PrEP, a pill that’s 99.9% effective in preventing HIV. If PrEP was around in the 1980s and 1990s, we would’ve handed it out to everyone, sparing no expense to eradicate HIV. But today, cost, availability, and a lack of health awareness stand in the way of widespread distribution.
Without insurance, PrEP costs $2,000 per month. An estimated 17% of LGBTQ+ adults don’t have health insurance, and, at 32% , transgender folks of color have the lowest insurance rate of any population. Stats like these are why HIV is still around.
You can’t get PrEP over the counter; you must talk to a physician. However, studies show most physicians, even those specializing in HIV, don’t bring up PrEP because they don’t feel comfortable discussing sex. Some doctors treat patients requesting PrEP as sexually careless when the very act of asking displays the opposite.
Medical schools don’t adequately prepare future doctors to understand LGBTQ+ needs, much less initiate conversations about HIV and sex.
HIV training wasn’t mandated for Minnesota health care professionals and service providers until 2019. While doctors and nurses are still learning the basics about HIV transmission, LGBTQ+ and BIPOC folks continue experiencing compounded forms of stigma and encounter substandard care, harsh language, and even physical mistreatment. Systematic racism in Minnesota prevents BIPOC and LBGTQ+ from getting care.
We must address the racist and transphobic biases in society if we want to end HIV. Rainbow Health, formerly the Minnesota AIDS Project, was founded in 1983 as Minnesota's first AIDS organization. We provide the most comprehensive HIV care in Minnesota, offering HIV testing and medical assistance, syringe-service programs, and mental health and COVID-19 services. We lead critical, trauma-informed training for health care professionals and service providers to learn sex-positive language with which to engage the LGBTQ+ community. We also provide housing and financial assistance to low-income Minnesotans with HIV. The majority of people with HIV are now over age 50. Our aging initiative supports elders and the aging LGBTQ+ community. Even with this holistic approach, the work of groups like Rainbow Health is not enough.
HIV has been a disease of injustice since day one. Ending HIV will not happen through scientific advancements or isolated education for LGBTQ+ and BIPOC folks. We all have a responsibility to educate ourselves about our implicit biases and the negative impacts racism, homophobia, and transphobia have on our health care system. We will only end HIV and AIDS when we choose to take this issue out of the shadows. I believe we can.
Jeremy Hanson Willis is CEO of Rainbow Health in St. Paul, which, for nearly 40 years , has been advocating for and serving the LGBTQ+ community, those living with HIV, and those facing barriers to equitable health care. He wrote this for the News Tribune.