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Homophobia May Be to Blame for Rising Heterosexual HIV Rates

The lingering impact of the 'gay plague' stigma and poor sex ed are doing everyone a disservice.
Jake Hall
Written by

Jake Hall

For the past four years, 32-year-old sex worker and former health educator Mia Woods has been volunteering at her local sexual health clinic.

"When I ask people if they'd like an HIV test, I cannot tell you how many times I've heard the response, 'I'm not gay, so I don't need one,'" she said. "HIV does not discriminate. People of all races, genders and sexual orientations are equally susceptible to contracting it…The only way to protect yourself is by knowing what you're up against."

This misinformed idea of HIV being a "gay virus" is rooted in decades of homophobic stigma, but the disease is taking a toll on the sexual health of straight people, too. In 2020, 49 percent of new HIV diagnoses in the United Kingdom were recorded by straight people, compared with 45 percent by gay and bisexual men––the first time heterosexual rates have been higher in more than a decade. The Centers for Disease Control and Prevention (CDC) found 23 percent of 36,801 new HIV diagnoses were recorded by straight people, according to 2019 statistics. It's not a majority, but it's not an insignificant number, either.

LGBTQIA+ communities, drug users and communities of color remain hardest hit by the virus, in terms of rates and healthcare inequities. However, the myth that straight people somehow aren't affected by HIV has a global impact on sexual health.

HIV stigma's homophobic origins

In 1981, doctors began recording the United States' first cases of what we know as HIV, predominantly among young, gay men in large, coastal cities. In May of that year, biweekly gay newspaper the New York Native first reported on the virus, but news slowly trickled into the national mainstream media, too. Doctors at the time were puzzled and needed a name for the virus. Quickly, they settled on the acronym of GRID, for "gay-related immune deficiency."

It didn't take long for media coverage to become laced with stigma. The revelation that GRID could be sexually transmitted tied into homophobic portrayals of gay men as promiscuous. As a result, the language began to shift. The virus became known as a "gay plague," and the government largely turned a blind eye. The implication was that the marginalized people being ravaged by the virus were essentially disposable. By the time GRID was renamed "acquired immunodeficiency syndrome" (AIDS) in 1982, the damage had already been done. In 1984, researchers discovered the cause of AIDS was human immunodeficiency virus (HIV).

It took millions of deaths, decades of activism and determined, grassroots campaigns by marginalized activists worldwide, but an HIV diagnosis nowadays is no longer a death sentence. Antiretroviral therapy (ART) medication can be taken by HIV-positive people to suppress their viral loads down to undetectable levels, meaning they can't transmit the virus, even through unprotected sex. PrEP can be routinely taken to protect against HIV transmission, whereas PEP is the morning-after pill of HIV health care.

Society has come a long way since the "die-in" protests of the 1980s. Nobody knows this better than LGBTQIA+ communities, who have the fear of HIV drummed into them from a young age. As a result, these communities are often better informed and better equipped to deal with HIV.

Despite progress, stigma still lingers

Woods explained that there's a "hyperawareness of sexual health" within queer communities, yet there's still a lingering stigma around discussions of HIV.

"There's a lot at play, including religious beliefs, internalized and outward homophobia, as well as stigma surrounding HIV and STI testing in general," she said. "As a result, so many people face barriers to care."

Sex education is still deemed controversial, too. Dozens of states, including Florida, where Woods volunteers, still favor the archaic "abstinence-only" model.

"I see adults all the time that still have no idea how you contract HIV or other common STIs," Woods said.

LGBTQIA+ folks might learn about HIV through community centers, which often offer sexual healthcare advice. As for straight folks, Woods explained sex education is usually obtained through word of mouth or misinformation spread among friends because of the lack of proper education. If this misinformation includes myths that straight people are somehow immune to HIV, straight people are being failed by narrow-minded views, too.

In the United Kingdom, legislation was implemented in September 2020 to ensure secondary schools across England are required to teach relationships and sex education (RSE).

"That was a milestone in changing how young people learn about relationships and sex," said Lucy Emmerson, chief executive of Sex Education Forum (SEF), a U.K.-based charity that lobbies for comprehensive sex education.

However, there's still work to be done. "Young people want RSE lessons to be comprehensive and inclusive of the topics they need to form healthy, fulfilling relationships," Emmerson said. "Sadly, issues such as HIV are not being taught in all schools."

In a recent SEF poll, 19 percent of young people said they learned nothing about HIV in school. This absence of HIV education in school curriculums is glaring, especially as Emmerson described HIV as "misunderstood and heavily stigmatized."

Moving forward: HIV and harm reduction

According to Woods, the way forward is through "harm reduction" and a focus on educating all people about HIV, regardless of gender and sexuality.

"The undertaking of breaking down existing barriers is a lot more than most grassroots organizations can take on," she said, echoing Emmerson's emphasis on sex education. "I think the concept that's lost in translation of sexual health is harm reduction. There are lots of ways to have safer sex without using condoms, but when we drill 'You have to use condoms to have safe sex' into people's heads, they instinctively resist that."

Harm reduction takes a broader approach; instead of focusing on abstinence or prevention only, it takes a more nuanced perspective and encourages a holistic, risk-reduction view of sexual health care. "Safer sex can mean being open with someone about the last time you've been tested or being honest about your condom use with others," Woods explained.

Emmerson said sex ed lessons aren't connecting the dots between what is spoken in the classroom and how young people can access services and support. This information can lead people of all demographics to sexual healthcare professionals, who can take a hands-on approach to myth-busting and destigmatizing the likes of HIV.

Activists have fought tirelessly to resist the "gay plague" smear of HIV. It's only fair to their legacies that their earned breakthroughs can be used to ensure everyone has access to vital HIV treatment. The only way that can happen is through the dismantling of stigma, once and for all.