HRC Issue Brief: HIV/AIDS and the LGBT Community
Recent HIV/AIDS-related blog posts can be read here.
While HIV and AIDS affect Americans across the country and from all walks of life, the epidemic continues to disproportionately impact gay and bisexual men, transgender women, youth 13-24 and communities of color, particularly in the southern U.S. While tremendous medical advances have helped people live longer, healthier lives with the virus, there remains no cure and tens of thousands of new infections occur every year. Insufficient funding for HIV/AIDS programs, ideological restrictions on prevention, and persistent stigma and discrimination continue to make it difficult to fight the epidemic and provide the best care to those living with the virus.
Epidemic continues to disproportionately affect segments of the LGBT community
According to the Centers for Disease Control and Prevention (CDC), there are over a million Americans currently living with HIV and approximately 50,000 new infections every year. Almost two-thirds of those new infections are among gay and bisexual men. Among groups identified at higher risk for infection, only among gay and bisexual men is the rate of new infections increasing – and the highest rate of new infections within that group is among young black men. While the data on the transgender community is more limited, it also shows a disproportionately high rate of infection among transgender women, particularly, again, in communities of color.
Prevention, treatment and research programs are underfunded and often hampered by ideological restrictions
Despite a long history of HIV/AIDS impacting gay and bisexual men, until relatively recently, prevention efforts have not been sufficiently focused on or funded in this community, a problem also facing transgender people at risk for infection. While Congress has provided some increases in federal dollars for prevention, treatment and research in recent years, decades of neglect and difficult economic times mean that the needs still outstrip the available resources. In one example, many state AIDS Drug Assistance Programs (ADAPs), which help provide HIV medications to underinsured and uninsured individuals, have been forced to implement waiting lists and scale back the drugs that they provide. These federal programs are also hampered by policy decisions grounded in ideology rather than science – such as providing more than a billion dollars for failed abstinence-only sex education, while barring any federal funds for scientifically-proven prevention through syringe exchange programs.
Discrimination puts LGBT people at risk for infection and burdens those living with HIV
For most LGBT people, there remain little or no protections against discrimination in employment, housing and other areas based on sexual orientation and gender identity; for minorities within the LGBT community, racial and other forms of bias compound an already challenging situation. The potential consequences – job loss, lack of access to healthcare, homelessness – can push individuals into risk behaviors that greatly increase their HIV risk and can severely limit the ability of those who become infected to obtain adequate care. Furthermore, despite societal progress in understanding HIV and AIDS, people living with the virus still regularly encounter stigma, stereotyping and discrimination at work, at school, in healthcare settings and elsewhere.
What has the Obama administration done to address HIV/AIDS within the LGBT community?
- The White House released a first-ever National HIV/AIDS Strategy, explicitly including gay and bisexual men and transgender people in its plan to reduce infections, increase access to care and reduce disparities. In 2013, the White House launched the HIV Continuum of Care Initiative, described as "the next step in the HIV/AIDS strategy."
- The President signed the Affordable Care Act into law, which expands Medicaid to permit low-income individuals earlier access to treatment for HIV and eliminates preexisting condition limitations which have prevented many HIV-positive individuals from accessing private insurance.
- The Department of Health and Human Services (HHS) rescinded regulations barring people with HIV from entering the U.S. for travel or immigration. As a result, the International AIDS Conference will be held in the U.S. for the first time in over 20 years.
- HHS is studying how to revise the current lifetime ban on blood donation by gay and bisexual men.
How is HRC working on HIV/AIDS?
- HRC continues to push Congress to provide the strongest possible federal response to the epidemic through fully-funded prevention, treatment and research programs. HRC fights policies based on ideology, not science, including the funding of abstinence-only education and bans on federal dollars for syringe exchange programs.
- HRC lobbies Congress to provide funding for science-based, comprehensive sex education, which provides all youth the tools they need to live healthy lives and reduces new HIV infections.
- HRC is pushing HHS to undertake the research necessary to revise current blood donation policy and permit willing, low-risk gay and bisexual men to donate.
- HRC is also working with HHS to ensure that the Affordable Care Act is implemented in the most inclusive way possible for LGBT people, including those living with HIV.
 For readability, the term “gay or bisexual men” is used to also include other men who have sex with men (MSM) who may not themselves identify as gay or bisexual.
 Centers for Disease Control and Prevention (CDC), "HIV among Gay, Bisexual and Other Men Who Have Sex with Men (MSM)," (2010).
 Centers for Disease Control and Prevention (CDC), "HIV among Transgender People," (2011).
 Lambda Legal, "HIV Stigma and Discrimination in the U.S.: An Evidence-Based Report," (2010).