The Center for HIV Law and Policys (CHLP) legal and policy outline for advocating for sexual health and HIV prevention programming for youth in state custody. Youth in the state welfare and juvenile justice systems, especially lesbian, gay, bisexual, transgendered and questioning youth, are at alarmingly high risk of becoming HIV-infected. There is a critical need to address discriminatory treatment and the lack of policies, staff training and services that endanger and stigmatize these youth. Targeting advocacy in this direction has a potentially significant impact for the health of at-risk youth and the communities to which they return. The outline highlights various strategies for addressing the states failures; for example, policy and regulations reforms and using existing state laws governing adolescents autonomy and sexual orientation discrimination, as well as state and federal privacy, equal protection, substantive de process and first amendment guarantees to gain legal inroads to securing statesponsored sexual health care services for detained youth.
New York Civil Liberties Union, Reproductive Freedom Project, Financing Ignorance: A Report on Abstinence-Only-Until-Marriage Funding in New York (September, 2007), assesses the result of an extensive study of the abstinence-only-until-marriage programs In New York that received federal funding through 2006. Since1998, New York has received $3.5 million a year for abstinence-only education, and the state had spent an additional $2.6 million annually on it over the past decade. After reviewing more than 33,000 pages of state and federal documents from 39 funded programs, the NYCLU concluded that ab-only programs across the state contain serious medical inaccuracies and fear-based approaches to health issues; demonstrate bias against LGBT persons and engage in negative gender stereotyping; in many cases redirected money to other after-school activities not directly related to sex education; relied on instructors with no training or expertise as educators; were neither required to, nor on their own, and engaged in evaluation of program effectiveness. In addition, 53 % of abstinence program funding goes to religious groups without real safeguards against the incorporation of religious content in ab-only programming; religious content was in fact included in the programming of some of these groups .
On September 20, 2007, New York State Department of Health Commissioner Richard Daines announced that New York would no longer accept federal abstinence-until-marriage-or-death funding. Since 1998, New York has received $3.5 million a year for abstinence-only programming, and the state had spent an additional $2.6 million annually on it over the past decade. That money will now be used for actual sex education programming, according to Commissioner Daines, whose statement can be found in this section of the Resource Bank.
This study compared health indicators, health status, behavioral risks and access barriers among self-identified African American, Hispanic, Asian-Americana and white lesbian/bisexual and heterosexual women in Los Angeles county. Among the racial groups, regardless of sexual orientation, African American, Hispanic and Asian American women had worse health outcomes than white women for example, less access to preventative services. Hispanic and African American women overall had lower life expectancies, higher death rates from heart disease and greater levels of overweight and obesity than white women. The effect of sexual orientation across racial groups, however, is that self-identified lesbians and bisexuals are less likely to receive preventative health services, more likely to be overweight and more likely to engage in risky behavior such as smoking and heavy alcohol consumption than their heterosexual counterparts. The results of the study underscore the importance of considering factors that are not recognized as influential in womens health such as sex, social, cultural and economic power. More studies that capture sexual orientation as a health factor are needed.
This 2006 Kaiser Family Foundation national survey found that more than one third of Americans still don't know that HIV isnt spread through kissing, and nearly one fourth don't know it cant be spread by sharing a drinking glass. More than one fifth of those surveyed said they would be uncomfortable having a co-worker who is HIV-infected, and 30% of parents surveyed expressed discomfort at the prospect of their child having an HIV-positive teacher.
Hereks research indicates that support for quarantine was less about fear of HIV infection than it was about using the AIDS epidemic as an opportunity to express preexisting prejudices against lesbians and gay men. In this survey Herek conducted with his colleague John Capitanio, he found that most heterosexuals continued to associate AIDS primarily with homosexuality or bisexuality, and this association was correlated with higher levels of sexual prejudice. In addition, although everyone who contracted AIDS sexually was blamed to some extent for becoming infected, gay and bisexual men were blamed more than heterosexual men and women. Moreover, sexual prejudice was correlated with both misconceptions about HIV transmission and discomfort with HIV-infected people. See Hereks website dealing with homophobia and sexual prejudice at http://www.beyondhomophobia.com/blog/category/hivaids/ Herek believes that the link between AIDS attitudes and sexual prejudice impedes HIV prevention efforts and threatens civil rights.
More women than men reported that their health care provider usually presumed that they were heterosexual; this kind of attitude among health care providers is an important factor in the selection of a provider, particularly among women. Providers need to change their assumptions and approaches to interviews of potential patients, replacing heterosexist assumptions with integrated questions about sexual identity and ensuring that all aspects of the assessment and treatment process are safe for LGBT people.
Another study that shows that homophobia is a real health hazard and directly undermines important public health initiatives. One impact of homophobia is that many men who have sex with men, particularly young and minority men, dont disclose their sexual orientation in order to avoid social isolation, discrimination or abuse and violence. These young gay and bisexual men may be at higher risk for HIV infection as a consequence of low self-esteem, depression, and lack of peer support and related services available to those who are more open about their sexual orientation and identity. The data summarized in this report found, among other things, that non-disclosing MSM are less likely than their disclosing counterparts to access HIV testing services and related health care.
This article may be useful in considering the regularly-revived call to shut down bathhouses to reduce the rate of HIV transmission among men who have sex with me. The following abstract is taken from the article: Objectives. This report investigates differences in risk behaviors among men who have sex with men (MSM) who went to gay bathhouses, public cruising areas, or both. Methods. We used a probability sample of MSM residing in 4 US cities (n = 2881). Results. Men who used party drugs and had unprotected anal intercourse with nonprimary partners were more likely to go to sex venues than men who did not. Among attendees, MSM who went to public cruising areas only were least likely, and those who went to both public cruising areas and bathhouses were most likely to report risky sex in public settings.
Conclusions. Distinguishing between sex venues previously treated as a single construct revealed a significant association between pattern of venue use and sexual risk. Targeting HIV prevention in the bathhouses would reach the segment of men at greatest risk for HIV transmission.
The authors state in conclusion, in part: We know that baths are places where prevention efforts can actually find a majority of the men who have risky
sex, and they are places where sex occurs, sometimes unprotected sex. This fact is particularly noteworthy, given that HIV prevention programs have not successfully reached men at highest risk for HIV transmission. Further, HIV interventions proximate to sexual activity probably have the best chance of being successful. Conducting HIV prevention in baths would reach bathers, but also the men who report the most risky behavior, multivenue users. Although we know that many US baths distribute condoms, lubrication, and HIV information, and a few provide counselors and special events related to safer-sex skills building,3 there is no evidence of the efficacy of these interventions. More important, we need to begin to investigate how manipulating
the physical structure of the environment. Although the data suggest an interaction between the environment and the individual, they are not sufficient to identify the particular characteristics that contribute to the interaction. Until these are identified, we cannot develop, implement, or test those prevention efforts that are most likely to be
effective in reducing HIV transmission among MSM. Thus, although prevention programs that address the individual need to continue, the challenge in the next generation of prevention efforts is to unravel the complex interaction between individual characteristics and the environment.
For more information about the complete report, please submit an inquiry to info@hivlawandpolicy.org.
A meeting of African lesbian, gay, bisexual, and transgender organizations, with fifty-five participants from twenty-two groups representing sixteen countries across the continent, adopted a statement addressed to African member governments of the United Nations Commission on Human Rights and of the United Nations. The statement authors seek support of a resolution before the Commission on sexual orientation, gender identity and human rights. Among multiple other abuses and forms of extreme bias and discrimination, LGBT Africans are denied access to health care and basic health information targeted to their lives and needs. They are blamed unjustly for the spread of HIV/AIDS yet are omitted from HIV prevention programs. The brave contributions of LGBT Africans to HIV prevention and treatment are ignored or actively harassed. The statement makes plain the connection between homophobia, and education programs which deny or condemn the existence of gay people, and the fueling of serious health and safety issues, including HIV.
In this letter, Human Rights Watch addresses the damage done by the current U.S. administrations insistent export of abstinence-until-marriage HIV programs in Uganda and the Uganda presidents view that, We don't have homosexuals in Uganda. The letter points out the unassailable evidence that these programs deny young people accurate information on HIV transmission and on sexual health and intrinsically discriminate on the basis of sexual orientation. With a legal ban in place against gay or lesbian relationships, the programs promote only permanent abstinence and are uniformly silent about safer sexual practices. Promoting abstinence until heterosexual marriage evidences a continuous will on the part of your government to drive lesbian, gay, bisexual and transgender people underground, or deny that they exist.
People with lesbian, gay, bisexual or transgender orientations have long been stigmatized. Psychologist Gergory Herek, a professor at University of California, Davis, provides a synopsis of the above terms and references to related articles. His site also provide multiple resources on the connection between homophobia and HIV, and the impact of homophobia on HIV prevention.
Click on the link below to view.
Also, Hereks defintions of sexual prejudice, homophobia and heterosexism can be found at: http://psychology.ucdavis.edu/rainbow/html/prej_defn.html
