Ask an LGBT person around my age, and they'll probably tell you that President Bush is not on our side. Even if we have little interest ourselves in getting married, those of us in our teens and 20s got the message, last Feb. 24, when he declared he wants our second-class citizenship written into the nation's founding document. And yet, somehow, it seems to me that many of us still interpret Dubya's antipathy toward homosexuals as a silly electoral ploy, a cartoonish gesture on the part of a dimwitted politician. After all, the Federal Marriage Amendment's backers couldn't even muster a simple majority in the Senate.
But it's a dangerous misperception. It's true that we've made great progress in recent years, but permanently banning us from the right to marry is a serious threat—and it's only one of many threats that we face if Bush is reelected. While the FMA has been this year's high-profile LGBT issue, other stories have gone underreported. In his second term, Bush would work to defeat the Employment Nondiscrimination Act, and he would continue appointing anti-gay judges. He opposes our right to adopt children and he opposes hate-crimes laws. On his watch, even in wartime, the Pentagon has fired record numbers of LGBT servicemembers.
Still more egregious, though, is the quiet, extreme, and profoundly dangerous revolution that the Bush administration has engineered in domestic HIV/AIDS policy, one that literally prioritizes theology over our health and welfare. This revolution will hurt gay men, and other men who have sex with men, more than it will hurt anyone else. It deserves to be outed, and it deserves our outrage. As in so many other areas, this administration will pull out all the stops in its effort to drive up corporate profits, please fundamentalist zealots, and keep the rest of us in the dark.
The President gets a lot of credit for his modest support for the 'global' HIV/AIDS struggle, which conservative strategists see as a safe way of showing 'compassion' toward third-world people who may have been infected through heterosexual transmission or childbirth. Bush, in fact has done almost nothing to advance the international struggle, and the credit is undeserved. Bush even dramatically reduced the number of federal health officials who were allowed to travel to this year's global AIDS conference.
Yet Bush's domestic HIV/AIDS agenda is, if anything, even worse. It's critical that we keep that agenda in mind in those all-important conversations with our friends and family members that often make the difference between showing up at the polls and not making the effort. Today, Americans under age 25 make up fully half of new HIV infections in the U.S.
On a very basic level, if Bush is reelected, he won't ask for the money we need. We know this because, during his presidency, funding for domestic HIV prevention has remained stagnant, or even decreased. Between 1999 and 2002, new diagnoses among men who have sex with men increased 17 percent—the only group to see an increase—at least in the 30 states with long-standing reporting of HIV infection. A staggering proportion of young HIV-positive Americans don't even know their status. Yet in the first three years of the Bush presidency, the CDC's budget for domestic HIV/AIDS prevention increased by only 5 percent, less than the rate of inflation.
The dollar amounts, however, are not nearly as disturbing as where Bush wants the money to go. So far, he has directed that fully one third of federal prevention funds go to programs that emphasize abstinence from sex. These programs aren't just unproven, they're proven not to work. The religious right's favorite tactic is to promote abstinence 'until marriage,' still a meaningless concept for most gays and lesbians. Bush is also pressing for new guidelines that will effectively muzzle hundreds of state and local community agencies, the foot soldiers in the domestic struggle against the epidemic. Prevention messages will be screened to make sure they're not 'sexually suggestive.'
Broadly speaking, Bush's reelection would likely lead to further ideologically based interference with science, medicine, and public health projects, which will impact our lives in ways large and small. Those free condoms that you can pick up at so many LGBT events, after all, are frequently made available by federally funded programs. Bush wants to require local agencies to emphasize to young people that condoms won't completely protect them from HIV/AIDS, even though scientists know that condom use is the single most effective means of reducing the epidemic's spread. If Bush has his way, new prevention models deemphasizing sexual content will continue to proliferate.
In a second Bush term, you're likely to encounter fewer surveys and studies asking about your sexual health practices. That's because administration officials are joining with right-wing Congressmembers to intimidate scientists. Scientists, for whom grant funding is the sine qua non of professional success, are being told to use 'code words' in asking for HIV funding if they study anything or anybody Jerry Falwell wouldn't approve of. Urgent research needs face the unprecedented fate of being denied federal funding for purely theological reasons, as Bush bends to the demands of his extreme religious-right base.
The other part of his base, however, isn't being left out of the picture. Drug companies haven't exactly had it rough in the Bush years—after all, even though we can't get access to basic health information, gay men are bombarded with glossy advertisements promoting one HIV medication over the others, while obscene executive salaries and advertising costs divert vast sums of money from next-generation drug research. In a second Bush term, the full weight of the executive branch would be put behind the drug companies' efforts to push their profits ever higher.
We already know, from the global AIDS struggle, that the drug companies will do anything to protect their profits. They claim those profits are necessary to fund their research activities, but they did nothing to test or challenge totally groundless, bigoted claims that mask their profit motives—such as a U.S. official's assertion in 2001 that cheap generic AIDS drugs 'wouldn't work' in Africa because Africans 'don't know what Western time is.' In truth, when somebody finally studied the question, it turned out African HIV patients were generally better at adhering to their treatment regimens than were Americans. If Bush wins, don't count on the government to create any incentives or pressures for Big Pharma to speed drugs to those who need them.
Instead of looking for ways to make drugs affordable, the administration would search for ways to allow companies to gouge us. Abbott Laboratories did just that in December when it decided suddenly to quadruple the price of the popular protease inhibitor Norvir, and although some legislators called for an investigation and even the private insurer Aetna briefly sued Abbott to block the change, Bush did nothing. In fact, last year he took the unprecedented step of appointing a former Eli Lilly executive and major campaign contributor as his global AIDS coordinator. While governments around the world try to rewrite patent laws to make generic drugs available, Bush instead would fight tooth and nail to protect pharmaceutical patents, many of which were made possible in the first place by taxpayer-supported research.
Even our existing AIDS Drug Assistance Program (ADAP), which makes lifesaving drugs available to uninsured Americans, is crumbling. The Bush administration has done nothing to alleviate the dire fiscal crisis that many states have faced in the current recession, which has led many of them to create waiting lists for ADAP. Over 1,500 HIV-positive Americans with no health insurance are currently on waiting lists, in nine different states, to receive the drugs they need under this crucial federal program. Other states are instituting enrollment caps and limiting treatment options. In a second Bush term, count on the problem worsening as the healthcare crisis continues to spiral and more of us lose our health insurance.
I've heard from quite a few young gays and lesbians that since John Kerry opposes same-sex marriage, there's no difference between the candidates on gay issues. Quite literally, nothing could be further from the truth. On domestic HIV/AIDS policy, Sen. Kerry was a cosponsor of the critical Ryan White CARE Act, wrote significant portions of more recent expansions of federal funding, and has consistently supported funding increases for treatment and research. He opposes faith-based bans on needle-exchange programs and wants to end the federal government's discrimination against HIV-positive immigrants. And he's pledged to double Bush's promised spending on the global fight against AIDS.
There are understandable reasons why so many young gay men have failed to recognize the danger posed by Republican domestic HIV/AIDS policy. After all, we weren't exposed to the plague years of the 1980s. Often, we don't even register the profound absence of so many of our elders, who were killed early in the epidemic's course. Yet, appallingly, Bush's plans would once again make government consistently a part of the problem rather than part of the struggle.
In this sense, it's truly fair to say that Bush wants to take us back to the 1980s. On a symbolic level, some of his appointments are literally insulting. Bush appointed, as co-chair of the President's Advisory Commission on HIV and AIDS, a former Congressman who proposed legislation to make anonymous HIV testing illegal and who has declared, 'no one stands harder against homosexuality than I do.' Another of his nominees to the commission called homosexuality a 'death-style.'
The prospects for HIV-positive Americans have improved dramatically in the last 10 years, and there are important advances on the horizon, but at the same time, new HIV infections among young people may have already exploded to levels we haven't seen since before there were protease inhibitors. As HIV has come to be perceived as a manageable disease like diabetes or asthma, many young men have adopted a blasé attitude about unsafe sex. And crystal meth has begun to devastate America's largest urban gay communities, leaving growing numbers of young gay men, in particular, with a debilitating addiction and a new diagnosis.
For all these reasons, with our health and welfare on the line, we must do everything we can to turn out the gay and lesbian vote—and the votes of our families and friends—to help defeat the President. There's still time to get involved. Volunteer to use your cell-phone minutes to call voters in swing states. If you can scrape together the time and the money, spend an October weekend in Ohio, where numerous registration, education, and mobilization efforts are underway.
Even more importantly, talk to your relatives and friends. Don't forget the power of coming out—the best way we have to influence people's attitudes on gay-rights issues, including our right to accurate, scientific health information. Our issues, after all, are really everyone's issues: equality, healthcare, and the well-being of America's young people. It's just that we, more than many groups, have an awful lot at stake this time around.
Stewart-Winter is a Ph.D. Student, Department of History, The University of Chicago.
