Op/Ed: Trump’s rhetoric fuels HIV epidemic

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Written by Rob Stephenson, a UMSN professor and Director of the Center for Sexuality and Health Disparities at the University of Michigan

ANN ARBOR, -- December 1 marks the first World AIDS Day under the Trump presidency. Created in 1988 to raise awareness about the HIV/AIDS epidemic and to mourn those lost to the disease, World AIDS Day provides an opportunity for us to reflect on the work that still needs to be done in the progression towards an AIDS-free generation. In 2017, World AIDS Day also provides an opportunity for us to stop and take a critical look at how Trump is actively fueling the continued growth in the U.S HIV epidemic.

Not since Reagan’s silence on the emerging HIV epidemic has a president done more harm to our progress in fighting the HIV epidemic.  Each step backwards in LGBT rights pokes the fires of hatred and discrimination, creating levels of stigma that research shows can prevent individuals from seeking prevention and treatment services, while encouraging the very maladaptive health behaviors that contribute to HIV.

From his public platform, Trump is telling the country that the rights of the LGBT community will not be respected. Ilan Meyer, a senior scholar at UCLA's School of Law, created the "Theory of Minority Stress," describing how negative health behaviors, such as drug use, may act as coping responses to stigma-related stress, positing that the health of LGBT individuals is rooted in their experience of discrimination. My research found that gay men who hear statements such as "being gay is not normal" are more than three times as likely to have unprotected sex. In a survey of over 1000 gay men, I found that gay men who report experiencing homophobia were more than four times more likely to binge drink, use recreational drugs, and to report symptoms of depression. These associations were heightened for gay men of color.

Trump rhetoric and actions have fueled these stressful conditions of the kind that lead to and pose a particular health threat to gay, bisexual and other men who have sex with men (GBMSM)–– populations who’ve been disproportionately burdened by the AIDS epidemic. According to the Centers for Disease Control and Prevention, approximately two-thirds of new HIV infections occur among GBMSM, with increasing incidence of HIV among youth and men of color. GBMSM now account for 72 percent of new HIV infections among people ages 13 to 24 and African American GBMSM experience a six-fold increase in the risk of HIV acquisition over white GBMSM – despite no evidence of differences in risk behaviors. There also is a wealth of data showing that gay men are more likely to engage in smoking, alcohol and drug use, and experience poorer mental health, each of which has been shown to be linked to an increased risk of acquiring HIV. Despite recent gains in HIV prevention – for example, the availability of pre-exposure prophylaxis (PrEP), which can reduce the risk of acquiring HIV by up to 90 percent if taken consistently – there remains a lot to be done as the incidence of HIV continues to grow among vulnerable sexuality minority groups in the U.S.

In less than twelve months, the Trump administration has rescinded bathroom rights for transgender students, defended religious-freedom laws that are used to discriminate against LGBT individuals, has tweeted a ban on transgender individuals serving in the military,  and Trump has refused to acknowledge June as LGBT Pride Month. But perhaps his most blatant display of anti-LGBT sentiment came when he addressed conservative activists at the Value Voters Summit in Washington DC, an anti-LGBT organization classified as a hate group.

It is still too early in Trump’s tenure to quantify the exact impact his anti-LGBT actions will have on the U.S HIV epidemic, but as he continues to create a climate of discrimination all signs are that his presidency has the potential to significantly reduce the significant advances that have been made in the fight against HIV/AIDS.

At the U.S. Republican National Convention, Trump declared, “As your president, I will do everything in my power to protect our LGBTQ citizens from the violence and oppression of a hateful foreign ideology — believe me.”

It turns out, it is his own home-grown ideology we should be more worried about.

For questions/comments, please contact Stephenson: rbsteph@med.umich.edu, or UMSN Communications Lead Jaime Meyers, jmeyers@med.umich.edu.