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The Looming LGBTQ Health Crisis

Jun. 27, 2017
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With the focus on Pride, the LGBTQ community has largely ignored June as Health Awareness Month. The recent resignation of six experts on the current administration’s HIV/AIDS Advisory Council was an unfortunate reminder. Their announcement came just in time for National HIV Testing Day, Tuesday, June 27. 

One former council member, Scott Schoettes, explained their departure, saying the president “simply does not care” and that there is no official HIV strategy (the White House website for the Office of National AIDS Policy was deleted on inauguration day). He also stated that the 40% of people with HIV receiving care through Medicaid would be “devastated” by Medicaid cuts proposed in the Republican replacement for the Affordable Care Act (ACA). His frustration should have LGBTQs very worried.

Even before the current regime, HIV/AIDS funding had been diverted in order to pursue the “Southern strategy” in which financial resources are concentrated on Bible Belt states where increased HIV/AIDS infection rates have soared to epidemic proportion. “We are following things closely” says Kofi Short, lead coordinator for community and program development for Diverse and Resilient (D&R). The Milwaukee-based agency for health equity and wellbeing of Wisconsin’s LGBTQ people works to address health disparities in different areas, but HIV/AIDS remains a primary concern. 

According to Short, officially the state’s current infection rate is concentrated among gay and bisexual men: 33% are African American, 9% and 4% are Latino and Caucasian, respectively. Of that, 50% are in Milwaukee County. However, he admits the true infection rate is impossible to know because up to 50% of infected young African Americans do not know their status. “Due to stigma, lack of health care access, lack of awareness and cultural barriers, people are not comfortable being tested. Whether out of fear or because people don’t feel ill, they don’t seek services.” He cited similar issues for PrEP (Pre-exposure Prophylaxis) strategies. Those at the highest risk are not finding out about it. “Even if they get on PrEP, the problem is adherence. It’s challenging for those with HIV to be adherent but even more so for youth who are less conscientious. As opposed to someone on medication and aware of the impact of not taking it, PrEP doesn’t have the same impulse,” Short said.

He also agrees with Schoettes’ prognosis. Asked how ACA changes will affect HIV/AIDS, Short replied, “Our work focuses on prevention, but a big concern is Medicaid because it covers people with pre-existing conditions. If a shift in ACA care occurs, the 40% covered by Medicaid are easily identified as HIV-positive based on the medications they take.” Still, organizations like D&R are responding to the crisis. 

“The situation has forced us to develop innovative ways of working with partners like ARCW, 16th Street Clinic, Milwaukee Health Services, Wisconsin’s HIV/AIDS program and the Milwaukee Health Department. We’ve come together to effect change as a unit. And a big part of what we do to close disparities is to develop leadership among LGBTQs using health promoters to spread the message,” Short said. Meanwhile, the gay Log Cabin Republicans recently reposted a June 2016 New York Times Op-ed titled “The L.G.B.T. Case for Guns” by trans gun advocate Nicki Stallard.

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