HIV is a gay disease. That's what former National Gay and Lesbian Task Force Executive Director Matt Foreman said in his "state of the movement" address at his organization's 2008 conference in Detroit.

"We cannot deny this is a gay disease," Foreman said of the American HIV epidemic. "We have to own up to it."

Foreman's assertion wasn't merely rhetorical — he used facts and numbers to back it up. Then, as now, the majority of all new U.S. HIV infections are among men who have sex with men. Then, as now, the majority of all people living with HIV or AIDS in the U.S. are men who have sex with men.

Foreman's words caused an eruption of controversy. Leaders with anti-gay groups, including the American Family Association and Concerned Women for America, used Foreman's remarks to paint all LGBT people as sick and unclean. Fury raged inside the LGBT community. Some wondered if Foreman's assertion might hamper continued HIV prevention efforts and partnerships among non-gay communities or damage the movement for LGBT equality.

But what Foreman saw in 2008 is what many people continue to fail to see now: HIV in the U.S. is and will likely remain a disease that primarily affects men who have sex with men (MSM).

At that same Task Force conference, five years later in 2013, the Centers for Disease Control and Prevention released new numbers and projections. Currently, MSM are 40 times more likely to be HIV-positive than are heterosexuals; only one in 50 high-risk heterosexuals are HIV-positive. Compare that to the gay and transgender community, where one in three black MSM, one in five Latino MSM, one in six white MSM and anywhere between 10 percent to 30 percent of transgender people are HIV-positive.

And the epidemic is nowhere near its end. In fact, it's only getting worse.

The CDC estimates that as much as 10 percent of current college-aged gay, bisexual and MSM men are HIV-positive. In 30 years, when these men are in their 50s, half of their peers will be HIV-positive, if current infection rate trends continue unchanged. For black MSM, 70 percent of their peers will be HIV-positive.

In much the same way we associate breast cancer with women, we must begin to face the stark reality of HIV and its current and future impact on MSM and gay and bisexual men.

This is a reality I do not believe most LGBT people, their community leadership or the government are willing or able to recognize yet.

LGBT people, myself included, often feel that we have been given the short end of the stick. And rightly so. We are often left to deal with our own issues in solitude and without the proper support that might actually enable us to live healthier lives. We are at higher risk of suicide, joblessness, homelessness, drug and alcohol abuse, tobacco use and more. In many places, including Charlotte, there are not enough resources to fully address our needs.

When and where the bulk of our recognized community leadership could make a difference, they rarely do, their attention too often pulled away to "sexier" advocacy issues. I place most of that blame on corporate gay rights activists and organizations. In their quest to be "just like straight people" and normalize our community, established gay leadership has tossed out a rich, deep history and culture of gay male sexuality and intimacy. These activists picked up on the organizing power and public awareness built by legendary ACT UP (AIDS Coalition to Unleash Power) activists and nearly immediately began to whitewash the LGBT and queer community.

For at least the past two decades, these established gay leaders — mostly white, mostly male and mostly wealthy — have worked to make our lives palpable for acceptance by a heterosexual society — the same society that ignored our community when AIDS first began to ravage it, literally killing off nearly an entire generation of gay men. These "we-are-just-like-you" campaigns have neutered our abilities to adequately discuss and engage on issues like sexuality and HIV. Instead of addressing the reality of gay sex and sexual culture, these advocates have chosen to portray a near Victorian Era-esque image of monogamous, marriage-worthy gay couples as the gay norm that completely and utterly silences and shames people in our community who do not fit that ideal.

Will our leaders embrace the fact that, yes, we have sex and often quite a lot of it, or will we become good gays who slut-shame our peers and smile pretty for a gay marriage news story, all while our leaders eagerly clamor to step inside the four walls of a strict, heterosexist box of sexuality that has both defined us against our will and oppressed us for centuries?

I do not deny the very real complexities in these issues. LGBT people and those living with HIV continue to face stigma that can result in daily discrimination. Racism, even within the LGBT community, also prevents us from seeing the full picture of today's HIV epidemic. Government remains unable to adequately intervene and create solutions, as AIDS service groups see significant cuts year after year and local and state governments and school systems keep LGBT and queer young people uneducated about their own sexual health and well being.

If we expect to make a difference, we have to begin fighting the same way ACT UP fought in the '80s and '90s. We have to be united. AIDS service organizations cannot carry the torch alone. Other community organizations and leaders have to speak out, making health, sexual and otherwise, as much a priority as anti-discrimination laws. Can you imagine what kind of impact we might have on LGBT health if we spent as much time, energy and money on it as we do gay marriage campaigns?

HIV today isn't a death sentence. For that, I am thankful. I cannot possibly fathom living through the absolute, unimaginable horror that my older gay friends recount from their and their friends' lives in the 1980s. Today, HIV drugs are, thankfully, keeping my friends and peers alive. But HIV is no walk in the park, and treating it is not as simple as "just taking a pill." The drugs are expensive and have significant side effects — we do not yet know all of the long-term effects associated with their use. Medical and legal bureaucracies are intimidating. Stigma and discrimination against those living with HIV are still astoundingly rampant, even among our own community.

In 30 years, I will be 57. If projections hold true, as many as half of my peers just a few years younger than me will be HIV-positive. Our government and our community leadership is not prepared for the new health crisis coming our way. Individually and collectively, we have to begin making health and access to health care a top priority again, just like we did during the early days of the AIDS crisis. The in-your-face passion of early AIDS crisis activist groups drastically changed the way society viewed and responded to HIV. In the decades since, we've lost our vision. Now it is time for the gay community to ACT UP again.

HIV advocacy and the priorities of community organizations are explored further in QNotes' Nov. 22-Dec. 5 print edition commemorating World AIDS Day. Read more at goqnotes.com.