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LGBT groups can't act as if HIV isn't their problem

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Eight years ago, one of the nation's leading LGBT civil rights advocates shocked the community and the nation with a bold proclamation.

"HIV is a gay disease," said Matt Foreman, then executive director of the National LGBTQ Task Force, at the group's annual Creating Change conference in 2008.

Foreman was met with a firestorm of controversy, and for good reason. Directly following the initial onset of the AIDS crisis in the 1980s, gay activists and advocacy organizations spent an incredible amount of time, energy and public relations muscle trying to decouple anti-gay stigma — also the gay community itself — from HIV. Foreman's proclamation flew in the face of that years-long public stance.

In later interviews, Foreman expanded on his thoughts — stressing his ultimate point that LGBT organizations had lost focus on an important health issue for the community as rates of new HIV diagnoses among gay and bisexual men and other men who have sex with men (MSM) continued to rise.

"HIV isn't just a gay disease but it is a gay disease in the United States," Foreman said. "I would agree that we have separated HIV from the gay community over the last 15 years," Foreman said in an interview directly following the conference. "That is why HIV/AIDS is not a priority for the vast majority of LBGT (lesbian, bisexual, gay and transgender) national, state and local organizations."

In the near-decade since Foreman's warning, LGBT organizations have begun ever so slightly to address HIV and AIDS again. For example, the nation's largest LGBT civil rights group, the Human Rights Campaign, has recently put resources behind campaigns to support the use of pre-exposure prophylaxis, better known as PrEP. By taking one pill a day, those who are HIV negative can drastically reduce their risk of contracting the virus to nearly zero.

Despite some increased attention, no leading LGBT organization locally or nationally has centered HIV prevention in its portfolio of movement priorities. The majority of HIV prevention and awareness work has remained where it has nearly always been — with the tireless and dedicated advocates and prevention workers at AIDS service organizations and other groups whose missions are solely focused on HIV. There, tremendous gains continue to be made. More people are being tested and more people who are HIV positive are getting treatment than ever before.

Yet, rising transmission rates and risks continue unabated today. Just three years ago, the Centers for Disease Control and Prevention (CDC) found that as much as 10 percent of all college-aged MSM were HIV positive. In 30 years, if transmission rates remained the same, the CDC projected that those same men would find half of their peers would be diagnosed as HIV positive.

And in February, the CDC announced even more alarming trends, estimating that 1 in 6 of all MSM will be diagnosed with HIV in their lifetimes. For men of color, the alarm is more of a blaring siren. Half of all black MSM will be diagnosed with HIV. One quarter of all Latino MSM. To compare, only 1 in 473 heterosexual men face the same risk.

The new trends are so mind-bogglingly alarming that it's difficult to really put them in context. A friend and I were recently discussing the new numbers, just trying to wrap our heads around them. Imagine going to a gay club on any given night. Of the men there, at least 10, 30 or more will be diagnosed with HIV. These aren't strangers. They're not a faceless data point in a CDC report. We're talking about our friends and acquaintances. Our co-workers. Our community leaders. Our family members. Our lovers. Us.

These new numbers are unacceptable, especially given the fact that we have the tools today to end this epidemic.

"As alarming as these lifetime risk estimates are, they are not a foregone conclusion. They are a call to action," Jonathan Mermin, MD, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention, said in a press release.

If there was ever a time to act, now would be it. Eight years ago, a leading movement figure tried to wake us up from our complacency. It didn't work. Perhaps now, as each of us — gay, straight, black, white and Latino — look into the very faces of our friends and family members affected by these new trends, we will feel the urgency.

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