HIV testing fails

While new HIV-infection rates stabilized or fell in Wisconsin among other demographic groups between 2001 and 2008, they tripled among young black men who have sex with men in Milwaukee. This increase came despite an aggressive HIV-testing program targeting the city’s African-Americans.

Epidemiologists from the U.S. Centers for Disease Control and Prevention came to Milwaukee to investigate the problem. Their first order of business was to determine whether the high numbers truly reflected a rising infection rate or were instead the result of increased testing efforts finding cases that had previously gone undiagnosed.

The CDC found that the infection rate is indeed rising at an alarming rate, offering evidence that a new wave of the epidemic could be forming. Investigators also found that young African-American men were tested a median of three times before becoming HIV-positive.

Both of these findings show that HIV testing failed to prevent a resurgent epidemic in a target community. That’s a matter of great concern, because Wisconsin, following guidelines set by the CDC, puts the lion’s share of its scanty HIV-prevention dollars into testing and treatment.

It appears that treatment is also failing as a prevention strategy, since access to HIV care in the African-American community expanded at the same time that infection rates were climbing. Conventional wisdom is that reducing a patient’s viral load decreases his or her likelihood of spreading the infection to sexual partners. But this has never been proven conclusively, and the CDC findings in Milwaukee argue to the contrary.

In the wake of the findings, federal, state and local health officials must rethink prevention. They can begin by exercising leadership that brings together HIV/AIDS service providers to share information, expertise and resources. Stakeholders who attended the CDC’s presentation of its findings in Milwaukee on March 2 commented that it’s rare to see so many of them together in one room. They should be working together on a regular basis.

Increasing HIV-prevention will also require more money, and stakeholders must seize this opportunity to lobby for it. Wisconsin’s HIV-prevention budget is about $4 million, and it costs approximately $2 million to care for a single person infected with HIV.  Advocates should use these numbers to argue that prevention dollars save not only lives but also taxpayer money.

Courage on the right

The gay conservative group GoProud showed courage and commitment in co-sponsoring the recent Conservative Political Action Convention in Washington. Although many in the LGBT community might differ with the group on a number of public policy issues, we can all applaud them for daring to be out and proud in the very lion’s den of right-wing activism.

While GoProud leaders said they were well-received by libertarian Republicans, far-right Christians at the event were openly hostile. GoProud was subjected to harshly anti-gay rhetoric from the podium, and its members were sometimes marginalized behind the scenes. A representative from the National Organization for Marriage shook GoProud members’ hands in front of CNN cameras, but fired off a scathing press release about their presence behind their backs.

Some evangelical groups went so far as to boycott CPAC over GoProud’s presence.

It would be easy to dismiss the members of GoProud as unrealistic wannabes, vainly seeking acceptance in a club that doesn’t want them. But the LGBT community benefits from their willingness to take the message of gay inclusion where it most needs to be heard. Like the black civil rights pioneers who sat at whites-only lunch counters in the Jim Crow South, GoProud is helping to expose the ugliness of bigotry to the world at large.

Gay Republicans are often scoffed at for supporting a party that is, on the whole, homophobic. But their work is vital. As the healthcare reform debacle has shown, neither party can accomplish change on big issues alone. We need Republican support to succeed.

The truth is that few Democrats at the national level are pushing our civil rights agenda forward either. In fact, Democratic leaders often welcome our campaign contributions at election time, then proceed to forget about us shortly afterward.

If gay conservatives can succeed in pushing Republicans forward on our issues, it will move the entire debate toward the center. Civil rights should not be about right versus left, but about right versus wrong