Posted in hiv by SCHA-LA on August 27, 2009

Thoughts on an article from the Bilerico Project

As our state has gone bankrupt and defunded virtually all HIV services, one would think that the cry for universal, single-payer healthcare – or even healthcare reform – would reach a deafening din. It hasn’t, and rather, what I have heard is that people worry that if some sort of healthcare reform is achieved, it will be at the expense of all of the non-medical services that “AIDS, Inc.” provides: housing, case management, financial assistance, food banks, mental health, treatment education, transportation, language assistance, childcare etc. We believe that people living with HIV have more needs than prescriptions alone can fill. And the utilization of services seems to confirm that belief. As did the outcry when our governor line-item vetoed funding for almost everything we provide. Our community came up with these services and built this framework for care.

Eventually, the need for these services surpassed what community could provide (which, in the beginning was advocacy, activism and emotional support, “buddy programs” and things like that), and we moved to a grant-financed (meaning taxpayer financed) system which enabled us to have the capacity to provide more, and more expensive,  services.

Why did the government start funding these programs specifically for HIV positive or at-risk folks? For the same reasons that the state requires people to wear seatbelts in the car. It’s not because they care about the value of human life, it’s because the cost of treating someone after they had a debilitating accident is more than the state/taxpayers want to (or, in some cases, are able to) bear. One can obviously not rule out homophobia or transphobia, racism or sexism when talking about how the state doles out tax dollars, especially when it comes to social services, and doubly-especially when it comes to HIV. We can easily make the case that critical services are underfunded. That isn’t the question when it comes to barebacking, though.

Is it homophobia when a low-to-moderate income earner who pays a higher rate of taxes than the superwealthy resents their tax dollars going  to provide housing to someone who seroconverted despite the presence of free condoms at every gay bar in town? Especially when that same taxpayer can barely afford his or her own housing? Or can you call it sexphobia when someone balks at having to support the cost of a lifetime of antiretrovirals rather than a short-term PEP or PrEP protocol? And if it is homophobic, what is is when the person who has decided that it is their right to have unprotected sex glories/revels in that decision? Couldn’t a case be made that this is also homophobic? At the very least, I think a case could be made that it is a slap in the face to the very notion of community.

A personal decision is simply that: a decision one makes for one’s self, the outcome for which one is personally responsible. When one turns to ADAP or MediCare or any of the other services that they need to live a long, healthy lifestyle after seroconverting, there should at least be an understanding that this wasn’t merely a personal decision. It’s now become a community responsibility. It is also a requirement that taxpayers  outside of our community are forced to take a part in. We don’t want them to be able to police our bodies or our actions. We also don’t want them to ration our healthcare. Eleanor Roosevelt said that “Freedom makes a huge requirement of every human being. With freedom comes responsibility. For the person who is unwilling to grow up, the person who does not want to carry his own weight, this is a frightening prospect.

I understand that any suggestion that people behave responsibly is often read as blaming the victim, or as sex-negative (have people framed things this way since the 90s?).  Perhaps having been raised as a girl, I was better prepared than some to expect to have to sacrifice pleasure (condomless sex) to avoid a heavy cost (pregnancy). This was drummed into my head as soon as I started learning about sex – from adults and peers. I didn’t pay that much attention, since I was a lesbian from the gate, but it must have become ingrained because it was what I went back to in my head, when I first heard my gay male friends whining about how unpleasurable and anti-passionate latex-barriered sex would be. How it is the opposite of connection.

I do understand this. I have had unprotected sex with HIV positive women. I have felt like a judgmental traitor when the thought “maybe we should use a barrier” crossed my mind in a way it never did with women I knew to be HIV-negative.  I totally get that. Maybe that’s what’s going on in the minds of some of the barebackers. Maybe not. I doubt in the case one of the posters noted in which his partner lied about wearing a condom that the issue was bonding or closeness.

Another analogy: we (the tax-paying public) might laud a firefighter who, while trying to save someone from a house on fire, becomes disabled. We pay his medical bills (actually his salary), honor his bravery, and share in the pain he & his family suffers. When, on the other hand,  someone sets himself on fire so he can have a cool video to post on youtube, we (rightly) castigate him. We resent having to pay for his stupidity, his narcissism, his utter lack of care for himself, the danger the imposes on his community etc. I  think an analogy might be made to intentional barebacking (especially when one or more of the partners is HIV+ or doesn’t know his status), versus, for example, relationships (or interactions) in which there is a power imbalance and one partner can’t protect himself.

But I don’t really think we need an analogy here. I think it should be said that we ARE a community, and we need to keep acting like it. Especially when it’s hard. Especially when the stakes are high. We need to protect ourselves and the people in our community. But more than that, we need to want to. If we can’t see the value on keeping ourselves, our partners, our friends, our institutions, our art healthy and strong, we will be left to fend for ourselves in a racist, sexist, homophobic, transphobic and ageist world. And no one will care.


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