Can President Obama’s Affirmation of Same Sex Marriage Save Lives?

By: Lisa Holbrook, JD, MBA

lholbrook@aya.yale.edu

In 2008, Barack Obama proved to young Black men that the color of their skin could not prevent them from achieving any dream, including becoming the President of the United States. This week, President Obama sent another message: gay Americans deserve dignity.

This message might save the lives of African Americans at risk of contracting HIV/AIDS. African Americans comprise 13% of the population, but they account for 49% of HIV/AIDS cases. (1)  Men who have sex with men (MSM) account for 50% of AIDS diagnosis and are the single largest group of individuals in the US who have become infected with HIV/AIDS. (2)  African American MSM are disproportionately affected with a 32% infection rate compared to a 7% infection rate in Caucasian MSM ages 23-29.(3)

We have proven that HIV/AIDS infection rates can be reduced with simple strategies such as 1) knowing your HIV status, 2) practicing safe sex and 3) engaging in harm reduction activities such clean needle exchange.  African American MSM have shown a dramatically low knowledge of infection rate with 67-91% of infected men unaware of their status. (4)  One possible explanation for the low knowledge rate regarding HIV status is gay stigma in African American communities.   Studies have shown that African American MSM have higher rates of internalized homophobia than other racial groups. (5)  African American MSM are more likely than Caucasian MSM to perceive that their friends and neighbors disapprove of homosexuality (6) and have greater rates of secrecy regarding their sexual orientation than other racial groups. (7)  By declaring that gay Americans are entitled to dignity and marriage, Barack Obama crushed the homophobic voice. In his statements this week, sitting in the Oval Office, the President of the United States made being gay okay.  This legitimization of gays and their relationships by our first African American President may free African American MSM from stigma and encourage them to be tested and know their HIV status.  This knowledge can save lives.

In 2008, Barack Obama inspired a nation to believe that no dream was too big, including the dream of a nation that would embrace all of its citizens regardless of the color of their skin.  This week, President Obama extended that embrace to include not just color, but sexual orientation as well.

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(1)Center for Disease Control and Prevention. “Cases of HIV Infection and Aids in the United States, by race/ethnicity 2000-2004.” Supp. Rep.2005.
(2) Kaiser Family Foundation, based on CDC, Presentation by Dr. Harold Jaffe, “HIV/AIDS in America Today,” National HIV Prevention Conference, 2003; CDC, HIV Surveillance Report, Vol. 22, 2012.
(3)HIV incidence among young men who have sex with men — seven US cities, 1994-2000.” (MMWR Morbidity and Mortality Weekly Report) 50 (2001): 440-444.
(4)Unrecognized HIV infection, risk behaviors, and perceptions of risk amoung young black men who have sex with men — six US citites, 1994-1998, (2002).
(5)Peterson, John L, and Kenneth T Jones. “HIV Prevention for Black Men Who Have Sex With Men in the United States.” (American Journal of Public Health) 99, no. 6 (June 2009).
(6)Peterson, John L, and Kenneth T Jones. “HIV Prevention for Black Men Who Have Sex With Men in the United States.” (American Journal of Public Health) 99, no. 6 (June 2009).
(7)Peterson, John L, and Kenneth T Jones. “HIV Prevention for Black Men Who Have Sex With Men in the United States.” (American Journal of Public Health) 99, no. 6 (June 2009).

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