Reproductive Justice Matters on National Black HIV/AIDS Awareness Day
February 7 marks National Black HIV/AIDS Awareness Day, and with it a strengthened
resolve to rise up against the broad attacks on reproductive health, rights and justice by Congress and the current Trump Administration.
The HIV epidemic’s disproportionate toll on the Black community in the U.S. endures in spite of significant biomedical advances. Today, treatment methods exist that can reduce transmission rates to almost zero. Yet for many in the Black community – and particularly Black LGBTQ people – access to those methods remains out of reach. Black transgender women are disproportionately vulnerable to HIV, and Black women overall are 16 times more likely to acquire HIV than white women – and five times more likely than Latina women. Last year the CDC released the startling statistic that Black gay and bisexual men in the US are estimated to have a 1 in 2 risk of acquiring HIV in their lifetimes, and the numbers of new diagnoses are increasing among young people. The disproportionate
effect of this epidemic is unsettlingly clear, and the cause is structural: systemic racism prevents people from accessing sexual and reproductive healthcare, including HIV care.
Unequal access to HIV prevention, treatment, and the holistic wrap-around care, services and education/information necessary to maintain sexual and physical health are the drivers of HIV/AIDS in the U.S. This is a country where the infrastructure exists to roll out effective preventative measures, but social constructs like stigma, racism, homophobia, transphobia, sexism, and classism keep us from progressing past this epidemic. The fact that HIV/AIDS persists predominantly among historically marginalized and disenfranchised communities is an indicator of the deep-seated structural inequality facing people of color in the U.S. today.
Black AIDS Day is a day to remember and center the leadership of people of color in the struggle against HIV/AIDS – and that all of us need to keep fighting like hell against efforts by Congress and the new administration to limit access to basic necessities and constitutional protections even further.
The 115th Congress is on a path to repeal the Affordable Care Act (ACA) and in doing so leave 18 million people without health insurance in the first year – eventually increasing to 32 million uninsured Americans. The ACA was an incredible breakthrough for people living with and affected by HIV: it prohibits insurance providers from refusing insurance to people with pre-existing conditions like HIV/AIDS; it disallowed lifetime caps or annual limits on insurance benefits, something that people living with HIV (PLHIV) and people with other chronic conditions would quickly surpass; Section 1557 of the ACA put forth a number of non-discrimination protections on the basis of race, ethnicity, gender identity and against sex stereotyping, providing a way to seek remedy when a healthcare or insurance provider does implement discriminatory practices; and, the ACA ensures folks have access to preventative care, including HIV testing, at no co-pay cost. Most importantly, under the ACA, 32 states expanded eligibility for Medicaid, allowing previously uninsured low-income people to gain access to quality healthcare, reducing vulnerability to a number of health related issues including HIV. The Medicaid expansion also permits those with an HIV diagnosis to receive care earlier. Before the ACA, PLHIV would have to wait until they received an AIDS diagnosis before they were eligible for Medicaid.
Though some members of Congress have promised us that there will be no repeal of the ACA without a replacement, there has been no assurance that the ACA’s protections for people affected by HIV will meaningfully remain in place. Furthermore, rightwing members of Congress and the new administration’s mission to defund Planned Parenthood and other clinics that provide reproductive and sexual health services will further reduce healthcare options, and likely lead to devastating health consequences.
Planned Parenthood clinics provide testing for HIV, as well as for other sexually transmitted infections (STIs), which can increase a person’s vulnerability to HIV if left untreated. Many Planned Parenthood clinics also provide access to or information about the HIV prevention medication PrEP (pre-exposure prophylaxis), and Planned Parenthood is one of the largest providers of transgender healthcare in the country. We need to support providers that recognize the linkages between HIV care and reproductive health services, since access to contraceptives, in-vitro fertilization, cancer screenings and abortion care are likewise integral to many people’s overall health, wellbeing, and reproductive future, including many LGBTQ people. Stripping away these services will leave low-income communities–and predominantly Black, Brown and LGBTQ people, including immigrants and undocumented persons–limited in their family planning choices and vulnerable to a variety of sexual and reproductive health concerns.
We are experiencing a political trend toward taking away necessary health-related services in an effort to control people’s bodies, restricting our right to self-determination, and criminalizing people for being who they are. It’s evident in attempted 6-week abortion bans (and successful 20-week bans), efforts to ban transgender folks from using the restroom aligned with their gender identity, and Trump’s outrageous Muslim ban fueled by Islamophobia, racism, and a disregard for the plight of refugees—particularly those who are LGBTQ and may be escaping life-threatening persecution. It is imperative right now to center marginalized communities and collectively speak out against political activity that disregards the needs of people of color, PLHIV, and LGBTQ people, and folks living at the intersections.
To learn more about barriers to healthcare as a form of structural violence keep an eye out for a webinar hosted by the National LGBTQ Task Force and Positive Women’s Network-USA for Women and Girls’ HIV/AIDS Awareness Day in March!
You can learn about the National LGBTQ Task Force’s health advocacy work by reading our fact sheet “10 Key LGBTQ Health Advocacy Priorities” here!
By Sabrina Rewald, If/When/How Reproductive Justice Fellow