A Year After Windsor, Let's Finish What We Started: The Fight to End HIV/AIDS

The United States Supreme Court's landmark decision in my client Edie Windsor's case last summer was the legal equivalent of the Battle of Normandy in the decades long struggle for gay civil rights. As a result of Windsor, the marriage equality movement has moved forward at a pace none of us either expected or could have predicted. Yet sadly, despite so much progress in terms of the equality of gay people under the law, we have not seem the same kind of improvement in connection with the very issue that provoked the most recent wave of the LGBT movement in the first place -- the fight against HIV and AIDS.

Huge segments of our community remain in the grips of an epidemic that just won't go away. Over 50,000 people become infected with HIV in the United States every year. And that number has remained virtually unchanged for the past decade. Even worse, thousands more Americans lose their lives every year due to AIDS-related illnesses and complications.

What's especially troubling is that new HIV infections have been disproportionately concentrated among low-income gay and transgender people of color. Infections among women of color have risen dramatically as well, and nearly 1 in 4 new HIV infections are among youth aged 13-24. In other words, those who are most impacted by the disease are the least likely to have access to the kind of affordable, stable health care -- not to mention the food, housing and economic security - necessary to stay healthy.

Back at the peak of the epidemic in the late 1980's and early 1990's, so many in our community who were not infected by HIV/AIDS -- lesbians and gay men alike -- made the decision to fight on behalf of those who were. As my client Edie Windsor has explained, prior to AIDS, "lesbians lived in one world, and gay men lived in another world. Then, when the AIDS crisis happened, that wall came down."

Once the wall between gay men and lesbians came crashing down, a new generation of gay people became engaged in the struggle, raising money, organizing politically, and participating in protests. Our community should be so proud of the fact that we refused to stand by and let the tragedy happen without doing everything we possibly could to stop it. HBO's recent powerful adaptation of Larry Kramer's play the "The Normal Heart" tells this remarkable history of the early days of the AIDS epidemic when GMHC (an organization that I am privileged to Co-chair) was founded to help those who were turned away by hospitals, doctors, family members, even their own government.

Today, however, our commitment to those less fortunate -- especially those infected with or at risk of HIV -- seems to have fallen by the wayside. Donations to AIDS walks nationwide have declined significantly in recent years. As we have fought (and almost won) the battle for equality in the courts, we have forgotten those who do not enjoy the health or resources that they need in order to fully enjoy our legal victories.

The situation in our community today is even more disturbing when you consider the recent major medical advances in treating and preventing HIV/AIDS. The latest drugs can and do keep HIV-positive people alive and healthy for decades, and they have become easier to take, with fewer negative side effects. Just this past May, the federal government issued sweeping new recommendations urging at-risk groups (particularly gay men) to use pre-exposure prophylaxis (commonly known as PrEP). Taken daily, PrEP is over 90 percent effective in preventing HIV infection. When taken within 72 after exposure to HIV, nPEP can also be used to prevent HIV infections. In other words, as a result of these significant scientific advances, we now have the ability to accomplish what we started so many years ago -- ending AIDS/HIV as an epidemic.

When my client Edie Windsor filed her case in 2010, only five states allowed gay couples to marry and that did not include our home state of New York. Today, marriage equality is now a reality in 19 states and the District of Columbia, with court victories in another 14 states that are currently stayed pending appeal, and a decision that just came down in Florida.

It is time for us to bring the same energy, creativity and resources that we devoted to winning the battle for equality for gay people under the law to the struggle on behalf of the neediest members of our community. We now have a way to end the epidemic of HIV/AIDS in the United States within our lifetimes. The only question is whether we have the will to do so.