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HIV Is Not a PR Stunt for Marriage Equality

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It's an exciting time for LGBT advocates and activists organizing for marriage equality. With a president in office who has stated support for extending marriage benefits to same-sex couples and a cascade of states legalizing same-sex marriage, it seems a likely conclusion that decades of work and millions of dollars spent on campaigns will someday make it possible for anyone in the U.S. to get married regardless of sexual orientation.

There are myriad stated reasons that advocates push for marriage equality, ranging from hospital visitation rights to immigration benefits for binational couples. Recently, however, in a HuffPost blog post, Neil Giuliano, executive director of the San Francisco AIDS Foundation, came up with a rather creative reason to urge the Supreme Court to rule on the side of marriage equality:

Any day now, the Supreme Court is expected to release its decisions on Prop 8, California's ban on gay marriage, and the federal Defense of Marriage Act (DOMA). We hope the justices do the right thing and strike down these unjust bans on same-sex marriage. The health of our nation depends on it, because the fight to legalize gay marriage is about more than just equal rights; it's vitally important to ending the HIV epidemic in the United States.



A study published in 2009 by Emory University finds that bans on same-sex marriage can be directly tied to a rise in rates of HIV infection. Researchers estimated that constitutional bans on gay marriage -- which are currently in place in 31 states -- raise the infection rate by four cases per 100,000 people. As one of the study researchers plainly states, "intolerance is deadly." This is simply unacceptable.

This was something of a head scratcher for me. I've been living with HIV for four years now and have been active in the blogging and activism community for almost as long. While I've worked on many different issues, from "don't ask, don't tell" to income inequality, HIV issues have been close to my heart, and I've been lucky enough to be included in a community of activists talking about HIV and the various problems that exacerbate the epidemic.

Here's the thing: Before reading Giuliano's post, I had never, ever heard anyone suggest marriage equality as a solution to the transmission of HIV. In fact, many in our community routinely decry the huge expense put forward to achieve marriage equality to the detriment of other life-and-death issues -- such as HIV. So imagine my confusion when the director of one of the larger AIDS advocacy groups in the country made this assertion in the marriage narrative.

There are many reasons that this factually problematic statement is a misstep. For one, even though HIV/AIDS is certainly an issue that disproportionately affects queer men, there are demographics in non-queer communities that are seeing alarming increases in rate of infection. Essentializing the struggle against HIV/AIDS down to marriage equality makes those demographics invisible.

For another, his assertion is easily refuted. The data he presents simply does not show a strong causal relationship between marriage equality and decreased infection rates. The numbers cited in the study he quotes are statistically nearly insignificant. Four cases out of 100,000? It's a stretch to suggest a relationship, and one would expect the head of the San Francisco AIDS Foundation to treat transmission statistics with a little more seriousness.

In fact, in a 2011 study of men who have sex with men (MSM) in five different U.S. cities, it was actually estimated that 68 percent of new infections involve long-term partners (Sullivan et al. 2009). Were we to apply Giuliano's logic, perhaps we could make an argument that instead of legalizing gay marriage, we should be banning committed relationships entirely?

Of course we shouldn't, but there's almost as much causality in that idea as in his. Yes, combating stigma is important, and no doubt there will be more HIV patients who can access treatment thanks to benefits accorded them by marriage, but there are better solutions and causes that Giuliano and other advocates could champion. For instance, HIV decriminalization would increase the number of people getting tested for HIV. Increased funding to agencies that work in HIV/AIDS would assist thousands attempting to access treatment. So why is Giuliano suddenly using HIV as an argument for marriage?

I reached Sean Strub, the founder of POZ magazine and current director of the Sero Project, for his comments on the piece, and here's what he had to say:

The study Giuliano cites I think is ultimately best understood as indicative, in the most general terms, of how inequality fuels poorer health outcomes, not so much about marriage equality specifically.



I hope Neil Giuliano, who heads the highly influential SF AIDS Foundation, puts as much effort into advocating for criminalization reform, which would have a more immediate and measurable effect on HIV prevention, as he is into advocating for marriage equality in the name of HIV prevention.

In the end, I don't think Giuliano has done any great harm to the narrative of HIV/AIDS in this country, but I can't help but think that he is exploiting his position and our community in an attempt to further a political issue almost entirely unrelated from the issue of HIV. We are used to this treatment by our enemies, as evidenced by the frequently used meme of "gay men are all diseased" by conservatives. Do we really need our struggle co-opted by our friends?

Dear Neil Giuliano, HIV is not a PR stunt for marriage equality. We should not be using bad science and false narratives to achieve our goals, and we certainly shouldn't be hijacking a deadly disease so that people can get married.