As we round out the last month of 2016, it’s become evident that we are not as progressive a country as we once thought. The nation elected a president whose candidacy ran on repealing the Affordable Care Act, which gave millions of Americans once-unattainable health care coverage. The Trump-supporting alt-right reared its ugly, white supremacist head and everywhere, marginalized groups reacted with fear and anger.
The same could also be said of our ostensibly progressive college campus. At supposedly forward-thinking UCLA, HIV-positive individuals still feel the need to hide in the shadows. The LGBT Campus Resource Center’s People Living With HIV, a community support group for HIV-positive individuals, holds meetings at an undisclosed location in order to ensure participant safety and confidentiality.
When the first few cases of AIDS – the final immunocompromised state of HIV infection – were identified at the erstwhile UCLA Medical Center in 1981, those diagnosed as HIV-positive were paralyzed by the uncertainty that came with the deadly and little-understood virus. Since then, drug developments have curtailed HIV’s progression in those who have the virus, enabling its shift from lead-up infection to terminal condition to lifelong manageable disease. But while researchers may have developed drugs that prevent HIV from turning into full-blown AIDS, a shift in mainstream thinking about what it means to be HIV-positive, specifically within the context of the LGBT community, has yet to occur.
No longer faced with the once fear-inducing prospect of developing AIDS, the HIV-positive community still faces stigma, judgment and continued misconceptions from the general public. Lack of turnout at People Living With HIV’s first meeting may be a reflection of this continued stigma. This quarter, only one third-year student, who wishes to remain anonymous, showed up to the first meeting.
Like many other HIV-positive individuals today, the student has an undetectable viral load, which is when HIV cannot be detected via blood test. At that level of virus in the body, it becomes near impossible to transmit the disease through sexual contact or other modes of transmission. This does not mean that he does not have HIV, but it is the next best place to be healthwise when diagnosed with a disease for which we have yet to find a cure.
More HIV-positive individuals having UVLs can be attributed to the availability of cheaply accessible retrovirals with manageable or few side effects. In addition, pre-exposure prophylaxis, a daily low-dose retroviral treatment commonly known as PrEP, has helped reduce transmission rates among the population of people who may be at high risk of contracting HIV. PrEP can be used in tandem by HIV-positive individuals and people who are at a high risk of contracting HIV in order to protect the uninfected partner from transmission if the pair have sex, unprotected or otherwise.
We’re not in the ’90s anymore, the anonymous student said when remarking upon his daily routine of retroviral medication. Contracting HIV is no longer a death sentence, or even a sentence of sexual abstinence.
“I’m on my once-a-day pill. I’m going to be fine as long as I am on my pill and I maintain my UVL,” he said.
Nevertheless, while we’ve moved beyond the doomsday era of the HIV/AIDS epidemic, the fragments of a society that once called AIDS “gay-related immune deficiency” persist. One of the continuing reminders of the stigma that surrounds men who have sex with men, or MSM, and HIV/AIDS is the FDA’s blood donor policy, which bans MSM who have been sexually active in the last 12 months from donating blood.
While the FDA’s policy may be seen as perpetuation of the false de facto conflation of homosexuality and increased HIV/AIDS risk, one should also note that gay and bisexual men still form the largest population of HIV-infected individuals, a carryover from the initial HIV/AIDS epidemic of the late ’70s and continuing into the ’80s, which most prominently affected the gay male community in that the first few cases of AIDS manifested as rare cancers in MSM and MSM were overwhelmingly overrepresented among the first few hundred terminal AIDS cases.
Though HIV may be relegated to the realm of a manageable nuisance despite once being a death sentence, it is still transmitted across all sections of the general public, not just within the MSM population. People of color of varying sexual orientations are currently the second most affected population after the MSM population.
Blacks are overrepresented among the HIV-positive US population, accounting for 44 percent of HIV diagnoses in 2014. Similarly, individuals who identify as Hispanic/Latino are also somewhat overrepresented, consisting of only 17 percent of the general population, yet making up 23 percent of 2014’s HIV diagnoses. Institutionalized racism may play an indirect role in affecting the education and health resource levels of people of color, in turn affecting the disproportionate spread of the HIV-positive population among US racial and ethnic groups.
However, a large part of this disparity in transmission rates among blacks and Latinos can also be attributed to continued mainstream ignorance about HIV. Regardless of race or ethnic identity, people continue to be unaware or misinformed about who is capable of contracting HIV and what the methods of transmission are, among both those who identify as gay and those who identify as straight.
`In other words, there are tons of straight people out there who think they are safe from contracting HIV. The main reason for this perceived immunity among those who identify as heterosexual is the perpetuation of the idea that HIV/AIDS is an MSM-specific disease. Despite society’s growing acceptance of the LGBTQ community, there are still subconscious strands of thought that pervade, spreading bigoted and erroneous ideas about differing rates of HIV susceptibility among the gay and straight populations.
This belief stems from the initial AIDS epidemic, which was thought to have begun with Patient Zero, a Canadian flight attendant and gay man who was reported to have hundreds of sexual partners, though this origin story was later discredited. In the United States, this mistaken belief of “It won’t (or couldn’t) happen to me because I am not a gay male,” persists despite the fact that 30 percent of people diagnosed with HIV in 2014 contracted the disease through heterosexual sexual contact or intravenous drug use.
The anonymous student said when he disclosed his HIV status, people would take an automatic step back.
“They don’t want to be a part of it,” he said.
Perhaps, for these people who he has confided in, HIV is just a thing that happens to somebody else, a continued reminder of a terrible disease for other (read: LGBTQ) people.
In general, HIV-positive individuals tend to refrain from disclosing their status due to justified fear of stigma, prejudice and discrimination. They also fear objections and judgments passed due to their individual choices about safe sex practices.
When asked about any prejudice that he faced, the anonymous student said that his choices regarding sex were the only area in which he felt most marginalized in comparison to the population who do not have HIV. In his case, the worst slur he was ever called came not from a straight friend, but instead from a potential partner when he informed the person of his condition.
Another instance displaying continued mainstream prejudice and judgment towards HIV-positive individuals happened at UCLA itself. When he informed his doctor at UCLA’s Arthur Ashe Student Health & Wellness Center that he was having unprotected sex with his boyfriend who was on PrEP, the doctor responded, flabbergasted and in shock, “Aren’t you scared of infecting him?”
Even if the doctor’s fears of transmission are justified on a statistical level – after all, PrEP is not 100 percent effective – his reaction is evidence that being HIV-positive is still a position mired in stigma. It has only shifted in focus from outright ostracism of those who are HIV-positive to manifesting as judgmental speculation about how people have contracted the condition, or moral appraisals about being sexually active while being HIV-positive.
We might think in 2016 we are more progressive on LGBT issues and HIV/AIDS compared to the 1990s, but it’s evident our thoughts on some issues still remain stuck in the past, even as they hide under a veneer of acceptance – an acceptance which will cost us in progress toward destigmatizing HIV if not made sincere.
If you are HIV-positive and feel like you need a support system, UCLA’s People Living With HIV meet at least once a quarter in a secure and undisclosed location. For further information, contact uclaPLWH@gmail.com.