Well, you don't really need to imagine it, because that's exactly what happened at last week's Netroots Nation in the gleaming city of Providence, Rhode Island.
As my new - and very cute, but I digress - friend Brad of the excellent HIVster.com wrote:
It’s been inspiring speaking with so many other determined conference-goers about their causes at the many panels hosted on issues like; marriage equality, trans empowerment through blogging, Occupy Wall Street, winning the war on women, battleground state caucuses and many, many more. Elizabeth Warren, Darcy Burner, Van Jones and Paul Krugman are among some of the keynote speakers. This meeting of movers and shakers is immensely important and lays out what causes, issues and campaigns the progressive movement will champion in the coming year.Allow me to suggest that this is a problem; not anyone's fault, to be sure, but something important is being overlooked. And that's a problem not just for me or cute Brad, but for you as well, certainly for the space cadets in the LGBT rights movement, and the Progressive Movement itself. I mean, really?
Inexplicably HIV/AIDS is nowhere to be seen. [emph. added]
HIV and AIDS are Progressive issues, and if we in the movement abdicate our responsibility for them, lives will be lost.
This is not a figure of speech or poetic license for effect, and I'm not being a drama queen here, either. Real lives. Maybe yours, maybe cute Brad's, maybe mine. That in turn got me to thinking, something I try to avoid, that a lot of folks just don't know a lot about this subject.
Well, hello Dolly, guess what? I do. Know a lot about HIV, that is. So let's talk about it. Pull up a chair; grab some coffee, because you're about to get a crash course in the politics of the epidemic. HIV thrives in silence, and a lot of folks have no idea how bad it still can be, so here goes.
The first point I'd make is that the demographics disproportionately affected by HIV are marginalized to begin with in our shining city on a hill: in no particular order, gay men, the poor, First Americans, transfolk, IV drug users, the uninsured, sex workers, prisoners, and people of color. An emerging demographic are young men of color, specifically young African-American and Latino men. These are people that we as Progressives are supposed to care about. They're also the people we expect to vote for us.
Moving on, somewhere quite a bit north of a million Americans -- probably closer to two million -- are infected with HIV, and of these, one in five do not know their status. Why? Because a test costs money -- and if you test positive, well, welcome to the club of pre-existing conditions. Obamacare changes all this; more on that in a bit.
My home town alone, the City of New York, has over a quarter of a million HIV and AIDS cases; to put that number into perspective, that's the casualty equivalent of seventy-five 9/11 attacks. Multiply that figure by three, and you'll have the number of people in this country with no access to treatment, 750,000.
Unless they get that access,
Within about a decade or so.
They'll join the over six hundred thousand Americans who have already died of AIDS; that's more casualties than in any war this country has ever fought. Four in ten of these deaths were African-Americans. It's this god-awful slaughter -- there really is no other word for it -- that launched the modern gay rights movement. It wasn't always happiness, weddings, two cute guys with a dog and a kid -- it was misery, agony and the pain of too many cruel deaths. That's where we come from, our Book of Genesis.
Meanwhile, every year, about 50,000 Americans are newly diagnosed with the virus. Half of these new diagnoses are, wait for it, of African-Americans, while two thirds occur via male homosexual intercourse. The number of actual new infections may be up to twice that; we don't really know. What we do know is that young people are an exploding share of them. It's entirely possible that we are, right now, losing another generation. And why is that, you ask?
Because the estimated cumulative lifetime risk of contracting HIV for a sexually active gay man is roughly 44% -- and this not because we're irresponsible sluts who can't competently slap on a rubber, but due to a deadly confluence of bigotry, ignorance and institutionalized discrimination. In major metropolitan areas, one in five gay men is infected. Here in New York City, I hear it's one in three. Call me a starry-eyed idealist, but I think those catastrophic numbers are a gay rights issue, too. You can tell me otherwise after you've held a sobbing, newly-diagnosed queer kid in your arms and told him everything was going to be all right.
Lastly, the disease carries a stigma, an irrational fear that in itself is a health crisis; to give just one example, suicide rates for HIVsters are triple those of the average population. Until the Obama administration changed the relevant rule in 2010, people with HIV could not enter the United States. Another fun fact: there are HIV-specific criminal laws on the books in 36 states of the union. Nor is any of this all that historically new:
Leprosy was viewed as divine punishment for moral misconduct in centuries past, and persons infected with Mycobacterium leprae were forcibly excluded from both civil and religious society. Those who became ill with cholera in the early years of our American republic were publicly decried as intemperate, lazy, and vice ridden. Even after the germ theory became widely accepted, discrediting divine wrath, miasma, and other incorrect theories of disease, negative attitudes lingered.If you want an example to neatly crystallize the countless abject failures of our bizarre healthcare system, our freakishly unfair economy, our disaster of a criminal justice system, and the imperfect polity they serve, HIV/AIDS would be it. As Susan Sontag remarked, AIDS is more than a disease, it is a metaphor.
This metaphor, and the stark realities it illustrates, are subjects Progressives need to care and talk about. Because if we don't, nobody will. Mitt Romney? The teabaggers? Give me a damned break. Oh, they'd like to cure us, all right: of being dirty f-----s in the first place. That, they have clinics for. Everything else, you're on your own, buddy. Just like it was back in the eighties and early nineties, when, to be exquisitely blunt, the American right from the President on down was perfectly content to just sit back as various undesirables literally fucked themselves to death. Fewer queers, more room for Jesus, I guess.
Not everything, however, is doom and gloom. We have many of the tools we need, with more on the way, to break the neck of this scourge. Some people are even talking about an end to AIDS. We can save a new generation. Past does not need to be precedent.
If we have the right leadership, that is. And that's one really good reason why this election is so freaking important.
Let that sink in for a minute: it took over three decades and five Presidents for this country to develop a national response to an epidemic that has already killed more Americans than the Civil War.
ONAP - that's the 'White House Office of National AIDS Policy' is one of those scary new bureaucracies in the belly of the Obamacare beast that Saint Mittens wants to slay on his first day in office. Nor is this even some throw-away department tucked away in some forgotten cube farm at Commerce, it's a part of EOP, the Executive Office of the President, established by Executive Order on July 13th, 2010.
Vision for the National HIV/AIDS StrategySee that? "Gender identity". "Sexual orientation". "Free from stigma and discrimination". You go, Mr. President. This is the same President, by the way, who launched and funded the first ever HIV initiative targeted specifically at gay men and transfolk. Never been done before.
The United States will become a place where new HIV infections are rare and when they do occur, every person regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.
A large part of the success of the NHAS will rest on whether or not the Affordable Care Act goes into effect as planned, not least because prevention and testing -- which the ACA makes available without cost to the consumer, saving you fifty bucks right there -- is orders of magnitude more effective at saving lives than treatment after infection. Simple and glaringly obvious, one would think.
The Obama administration has pioneered an interesting new approach to healthcare -- and other government services -- whereby different models of action are tested competitively for efficacy, not least because funds are short (and Congress is run, by and large, by idiots). One example of this new approach is UCHAPS, that is, the Urban Coalition for HIV/AIDS Prevention Services. Member organizations across the country share data and best practices, which directly impacts costs and effectiveness. This is critical, because budgets are shrinking on the local, state and Federal levels, and they're already inadequate.
Quite a few of these innovations are online, for example, this site dedicated to High Impact Prevention or HIP. It offers nationwide, local, specialized trainings for care providers. Meanwhile, AIDS.gov, the Federal government's central hub, collects every single damned relevant resource across the Federal government. This is unprecedented. It's also what smart government looks like.
Compare this integrated and culturally sensitive approach, and yes, President Obama deserves enormous fucking boatloads of credit for making this fight a priority, with Ronald Reagan's, who didn't find it particularly urgent to even say the word 'AIDS' in public until near the end of his second term. Of course, Reagan is dead -- how deeply unfortunate -- and we're now dealing with one Willard "Mitt" Romney and his teabagger caucus. God alone save us all if they win in November.
But we're not there -- yet.
So I don't know about you, but I'm going to vote as if my life depended on it. Because it does.