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Andrea Lach Dean MD'11 and Rory Merritt '09 MD'13: A place for HIV in queer dialogue

There is no shortage of queer dialogue at Brown University. Curious minds flock to the Department of Gender and Sexuality Studies to engage in cerebral discussions of gender and identity formation. Students make annual statements about anti-normative behavior and social assumptions at Sex Power God. With our gender-neutral bathrooms, effective Queer Alliance and progressive administration, we are leaders of the queer movement among universities and campuses nationwide.

Unfortunately, this passionate, valid, but often esoteric dialogue misses and perhaps intentionally ignores the pressing reality of HIV and its disparate impact on gay men. Whereas 20 years ago, AIDS mobilized the Lesbian, Gay, Bisexual and Transgender community, LGBT and HIV activists now often make a point of distinguishing themselves from one another. As a result, our generation has all but forgotten, without regret, that AIDS was once called the Gay-Related Immune Deficiency.

The images of young, white men in San Francisco hospice centers that once defined the disease have been replaced by those of poverty-stricken African orphans. Domestic HIV testing campaigns proclaim HIV the "equal opportunity disease," avoiding the risk of offending marginalized groups. The message: HIV does not discriminate.

But HIV does discriminate. According to the Centers for Disease Control and Prevention, over half of new domestic HIV infections are among men who have sex with men (MSM). We cannot dismiss this fact as a remnant of the 1980s, hyper-inflated by our middle-aged MSM predecessors in New York City and San Francisco. We cannot ignore that MSM are the only group in the United States which has seen increasing numbers of new HIV infections since the 1990s. We must acknowledge that it is gay and bisexual men who are affected by the recent significant number of new HIV infections at Rhode Island campuses.

These statistics make us uncomfortable, and frankly, the reality is awkward. The stigma attached to HIV is uninvited in the queer dialogue. The fear in addressing these issues is rooted in our desire to normalize LGBT identities and to challenge societal assumptions about sexual minorities. Addressing this issue feels like regressing into a tragic history we did not write and one we have fought to overcome in order to write our own story of celebration and liberation.

Admittedly, in comparison to debating theoretical motives behind anti-LGBT rhetoric or fighting for marriage rights, the facts about HIV seem strikingly unromantic and almost offensively simple. MSM are 44 times more likely to contract HIV in their lifetimes than men who do not have sex with men; the relatively thin layer of cells in the rectum is highly susceptible to viral penetration, making unprotected anal intercourse a substantial risk for HIV infection.

We are facing a public health crisis among college-aged MSM in Rhode Island. The liberal impulse to handle AIDS in a delicate, neutral fashion, and our fear of reducing a marginalized population to such corporeal concerns, have allowed this topic to escape discourse at centers like Brown.

However, the persistence of the AIDS epidemic in gay men in the United States not only belongs in LGBT discourse, but reflects the entire premise of queer dialogue. The relationship between gay men and HIV is a symptom of inequality, of patriarchy and misogyny, of valuing normality while fearing deviation. It is a direct consequence of discrimination, lack of self-worth, isolation and loneliness. It is about choices. It is about sex. Our hesitation to be open and honest about HIV in the gay and MSM community is not only dangerous, but also limits our examination of complex social realities to which the queer movement is committed.

The Brown community should take great pride in its many contributions to the queer movement. We are comfortable with what makes others uncomfortable, which allows us to break the silence surrounding tough issues and push boundaries without apology.

Now it is time to open the dialogue further, to challenge ourselves to face that which makes even us uncomfortable, to talk candidly about the staggering rates of young gay men becoming infected with HIV. If we do not do so, no one will. And if no one will, all our other queer dialogue will be hollow and our story, once again, will be written for us.

Andrea Lach Dean MD'11 is a fourth-year Brown medical student. Rory Merritt ‘09 MD'13 is a second-year Brown medical student and president of Gays, Lesbians and Allies Advancing Medicine.


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