Tablets of Truvada, a tenofovir/emtricitabine combination used for HIV pre-exposure prophylaxisIn the time between writing my last blog, which covers the upcoming Supreme Court case over the ACA’s preventative care mandate to cover PrEP, and this one, there was a blast of related HIV/AIDS news. So consider this Part II, and let’s all hope I don’t need to write a Part III any time soon.
In case you somehow missed it, the Trump administration appointed Robert F. Kennedy Jr. as the Secretary of Health and Human Services. This was a distressing move for anyone who cares about public health policy that’s based on actual medical science instead of disreputable internet message boards. RFK Jr. has for some time now been a massive proponent of the anti-vaccine movement, raw milk, decreasing the number of mental health prescriptions, and removing fluoride from our drinking water, among other conspiracy-minded policies.
But what you might have missed among all of the other anti-science policy stances is the secretary’s beliefs about HIV/AIDS and how to best prevent its spread. Kennedy’s book, “The Real Anthony Fauci,” expressed “neutrality” at the idea that HIV causes AIDS. Video of his remarks at previous speaking engagements show that he believes that AIDS may not be a virus at all and instead has environmental causes. He has also, on more than one occasion, made claims that the “homosexual lifestyle” and, in particular, the use of a type of recreational inhalant drug containing amyl nitrite, more commonly known as “poppers,” as the primary cause of HIV/AIDS infection.
I will take a moment to say that you can have whatever opinion you want on the ethics of recreational drug use. That is beyond the scope of this blog. But the idea that HIV/AIDS is caused by poppers, the “homosexual lifestyle,” or the environment is incontrovertibly false.
HIV/AIDS is caused by a virus, full stop.
HIV most likely made the jump to humans through the exposure to the blood of chimpanzees that had been infected with HIV’s precursor, SIV (Simian Immunodeficiency Virus), in areas where chimp “bushmeat” is common, primarily in West Africa. While viruses jumping from animals to humans is not necessarily uncommon (see both COVID-19 and the increasingly relevant avian flu for just two examples), SIV was particularly primed to make the jump to humans thanks to first developing in our evolutionary cousins.
HIV does not only impact LGBTQIA-plus communities but its early emergence in the United States was associated with men who have sex with men, to the point that one of its early names was “Gay Related Immune Deficiency” or “GRID.” This prevalence has a few causes. First is that HIV transmission occurs via specific bodily fluids, namely semen, vaginal and rectal fluids, pre-seminal fluid, breast milk and blood. Unprotected receptive anal sex is generally considered to be the most risky sex act in terms of HIV spread, as the lining of the rectum is thin and can be susceptible to micro-tears. As anal sex is most common among (though not limited to) men who have sex with men, that leaves gay communities the most at risk. The second cause is cultural, but not in the way that RFK Jr. might present it.
Christian-manufactured moral panics around sex and sexuality have always heavily impacted LGBTQIA-plus individuals. Coming out as anything other than heterosexual and cisgender presents an inherent risk. LGBTQIA-plus youth experience disproportionately higher rates of homelessness due to being kicked out of their homes and disowned by family or running away due to (often religiously justified) abuse. On the streets, LGBTQIA-plus youth, as well as adults, disproportionately turn to “survival sex.” Most frequently this refers to engaging in commercial sex work to meet basic needs such as housing, food, drugs and toiletries. Drug use also plays a major factor in HIV spread, as sharing needles is another major area of transmission. Like anal sex, this is not exclusive to people in LGBTQIA communities, but the trauma related to familial rejection, homelessness and economic insecurity are all major risk factors for engaging in drug use as a way to cope.
Much like the ethics of recreational drug use, I am also not here to debate the ethics of sex work, only to state that it is a risk factor for HIV/AIDS that impacts LGBTQIA-plus people at, once again, a disproportionate rate.
Lastly, having multiple partners does seem to occur more often among LGBTQIA-plus communities, and in particular, men who have sex with men, who are generally considered to be the most at-risk group for HIV/AIDS infection. Studies show that men who have sex with men typically have a longer window of partnership formation, engaging in sex earlier and showing a more gradual decline in partnership formation as they age compared to their heterosexual counterparts. If I were to hazard a guess, this is likely because once the religious fear of homosexuality goes out the window, it often takes with it other cultural concerns, such as “saving oneself for marriage,” becoming less valuable by having multiple sexual partners, and an emphasis on monogamy.
The AIDS crisis, especially before much was known about it, also carried an apocalyptic feeling in many communities. Humans of all genders and sexualities often engage in sex during dark times to feel a sense of intimacy and joy, and LGBTQIA-plus communities are no exception. But it wasn’t only the need for intimacy and joy in those times that led to this phenomenon. The AIDS epidemic also led to a rise in what is now called “barebacking,” which most often refers to intentionally engaging in unprotected sex in HIV-positive contexts. This can seem like an odd choice at first glance, but when you consider the reality of the epidemic, there’s a sort of backward logic to it. In an environment where everything seemed out of control, and infection felt like an inevitability, it would absolutely make sense that some people would decide to rip the proverbial band-aid off on their own terms rather than waiting in fear for it to happen at some unknowable moment.
Does all of this mean that HIV/AIDS infection is a result of a “homosexual lifestyle”?
No.
Instead, biological realities, the ripple effects of Christian sexual purity culture and a healthy dash of this country’s failure to provide comprehensive sexual health education combined to create a perfect storm in which LGBTQIA-plus communities were ravaged for decades, leaving ghosts in its wake.
The myth that the “homosexual lifestyle” causes AIDS is nothing new and has always carried religious undertones. In 1993, mega-Reverend Billy Graham famously said to an audience: “Is AIDS a judgment from God? I could not say for sure, but I think so.”
Though he later retracted the statement and apologized, it still typified much of the rhetoric surrounding AIDS during the height of the crisis. Jerry Falwell Sr., of “Moral Majority” fame, also referred to AIDS as a punishment from god, going so far as to lobby against the use of government resources being spent on the research and treatment of HIV/AIDS. In 1985, Christianity Today published an article noting that unlike the more common response of care from Christian organizations to people suffering from disease, “. . . Christian ministry to AIDS sufferers has been limited to organizations that do not regard homosexual behavior as sinful.”
Even among Christians from gay-affirming denominations, there has always been an undertone of “gay promiscuity” being the cause of HIV/AIDS infection, with monogamy via same-sex marriage sometimes being proferred not as a matter of equal rights and dignity but as a means of infection prevention. As noted by Professor Anthony Petro in his book “After the Wrath of God: AIDS, Sexuality, and American Religion,” under the mainstream Christian worldview, which vilifies having multiple sexual partners, HIV/AIDS-positive status still carries an implication of moral failure.
This cultural assumption of moral failure is now making its way through the executive branch.
In mid-March, the National Institute of Health announced massive cuts to HIV/AIDS research funding and patient care programs as a part of the ongoing initiative to reduce “wasteful spending” by the federal government. Doctors and researchers have mentioned that the impacts of these cuts are going to be catastrophic, leading to increased infection and death rates and potentially creating a new public health crisis in a moment of growing distrust in the healthcare system. These researchers also noted that their work was likely targeted as a part of the “anti-DEI” movement in the federal government, which is slashing funding for any research remotely related to “woke” terminology like “woman,” “race,” “sexuality” and “gender.” This attack on funding was a major part of the Christian nationalist Project 2025, which called for these exact types of funding cuts.
But it’s not just government-funded research that’s being targeted. Privately funded businesses also seem to be in the sites of the federal government, as demonstrated by the closure of Double Scorpio, an Austin-based poppers manufacturer, which posted on its website that it was ceasing all operations after reportedly being raided by the Food and Drug Administration. While poppers are technically illegal, regulations regarding them have been rarely enforced, and it is contextually apparent that the reported raid was motivated by its connection to LGBTQIA-plus party culture and promiscuity and the growing governmental hostility toward it.
Let me be absolutely clear: Much like how we know that abstinence-only sex education is ineffective at preventing teen pregnancy and bans on abortion are ineffective at preventing abortion, government efforts to “discourage the homosexual lifestyle” are ineffective at preventing HIV/AIDS. The most effective strategy for AIDS prevention is easy access to condoms, medications like PrEP and PEP, open and honest conversations between partners, frequent testing, and non-sexual strategies like needle exchange programs and the screening of donated blood, in conjunction with honest, stigma-free education efforts. No amount of government-enforced morality, monogamy or muzzling of medical research will prevent the spread of HIV/AIDS. The end consequence of presenting homosexuality as a moral failure is death and a possible return to the darkest days of the AIDS crisis, with pages of obituaries documenting the mass loss of friends, family members, and partners in life.
We cannot return to those days. It will take all of us not just standing up against an increasingly anti-science administration but engaging with our communities to provide the resources we once could trust the government to provide. Community-based sexual health, drug education, and HIV/AIDS testing programs are going to be more important than ever to support as we fight to survive the next four years and beyond. It will also be up to us to continue to advocate for the truth that HIV/AIDS was never some “curse from god” that represents a moral failing but an unfortunate coincidence of biology that we have the knowledge and means to prevent and, one day, consistently cure.
Disclaimer: The views in this column are of the author and do not necessarily reflect those of the Freedom From Religion Foundation.
