The world has changed. Gay life in America has changed. Since 1981, when the first reports of AIDS came out -- and I came out as a gay man -- this reporter has witnessed and documented stunning changes over the last three decades.
Foremost, I've seen HIV infection commuted from a death sentence to a life sentence of pill-taking and regular doctor visits. Since my own 2005 diagnosis, this transformation is central to my own life.
At the same time I've also seen, and contributed to, the transformation of a disjointed jumble of people -- united by their grief and rage about the government's neglect in the early years of the epidemic -- into a politically powerful minority group. I've chronicled how our advocacy groups have channeled our early AIDS organizing into what has become a strong national movement for full LGBT equality that has achieved remarkable results.
It was clear when President Obama spoke in his second inaugural address of the LGBT movement for equal rights alongside African-Americans' and women's civil rights struggles.
It was evident when the U.S. Supreme Court on June 26, 2013, struck down the Defense of Marriage Act and opened the way for California to join the 12 other states and the District of Columbia that by then already offered legal same-sex marriage.
It's impossible to ignore as the media have shined a brighter spotlight on bullying while also raising awareness of the diversity of LGBT American lives and relationships.
These are extraordinary changes for a segment of the American population who, only forty years ago, were considered mentally ill simply for being homosexual. The changes offer further proof that history's moral arc indeed bends toward justice.
But being equal in the eyes of the law isn't the same as being seen in neighbors' eyes as deserving of equal human kindness and respect. And legal equality isn't the same as treating yourself as though you believe yourself to be equally deserving of good health, healthy relationships, and a voice in the political arena.
The higher rates of depression, suicide, substance abuse, and risky sexual behavior among gay men seem to suggest that a significant percentage of us don't equally value our health and well-being. Consider these statistics:
• Studies have found 10 to 40 percent of gay men used methamphetamine, 10 to 40 times the one percent found in the general population.
• The Centers for Disease Control and Prevention (CDC) reports that in 2010, gay and bisexual men accounted for 63 percent of new HIV infections in the country, and 78 percent of all new infections among men in general.
• Studies show that rates of depression, alcohol dependence, and self-harm are double the rates among heterosexuals.
The numbers are, and should be, alarming. But it should surprise no one that people taught from a young age to hate themselves don't always make healthy choices and treat themselves the way well-adjusted people do.
Emerging research suggests that, contrary to right-wing accusations and popular stereotypes, it's not hedonism that drives so many addictions and HIV infections among gay men: It's a lifetime of being treated as second-class and disposable that leads too many of us to behave as if we believe the homophobic lies about us.
What is actually astonishing is what we don't hear about, despite the overwhelming evidence. It's plain as day when we flip the data on their head: Ninety percent of gay men do not use meth. The majority of gay men are not HIV-positive.
How can it be? How do most gay men bear the burden of stigma heaped on us merely for being different--without abusing alcohol or drugs, without being depressed, without engaging in high-risk sex? Where do we find the hope and optimism that make us victors rather than victims of our circumstances?
In a word, resilience.
Leading behavioral researchers and clinicians, religious leaders, and others who work to support gay men's health say the best way to protect us from the harmful consequences of internalized homophobia -- also called "self-stigma" -- is to build in us a sense of hope, the foundation of resilience and good health.
Harvey Milk understood the power of hope in gay lives. Milk in the 1970s used to say in his public speeches as a San Francisco selectman and America's first openly gay elected official, "You have to give the people hope." He understood that nurturing hope in a gay boy's heart could mean the difference between his growing into a healthy gay man, or killing himself.
As Ron Stall, a medical anthropologist who directs the University of Pittsburgh's Center for LGBT Health Research, told me in an interview about gay men's resilience for The Atlantic, it's obvious that getting a population of people not to hate themselves is good for their health.
It's up to us to choose to live empowered lives and claim the full measure of our equality. Each man among us, and all of us together, have the opportunity to find hope and strength in the resilience that has kept us -- and gay men before us -- alive, despite the odds that at times can seem pig-piled against us.
Let's talk a moment about the "together" part.
For much too long, the obsession with youth and physical beauty -- fueled by a sheer terror of death -- has segregated our gay generations from one another. Insecure young men worry that older gay men want to know them only because they hope to prey on their young flesh. Older men, some interested in doing precisely that but most not, denigrate their own value because they no longer fit the mold of what supposedly defines a gay man -- when in reality they simply outgrew the constricting mold of someone else's idea of what "gay" means. They have, in a word, matured.
Somehow, despite our well-known generation gap, gay culture has continued to be passed down the ladder of years from older to younger. Even without traditional families -- with their designated roles as say, grandfather and grandson -- the culture continues. Of course, we finally have an impressive library of books and video to document our history. I am very proud that I have helped to preserve our history, particularly in Victory Deferred.
But it's up to each of us to extend a welcome to gay men younger, older and different from ourselves in our circles of friends and local communities. Linked to each other by claiming joint ownership of our gay American history, the heroic legacy of courageous men and women who shaped it, we have examples of gay pride put to fearsome good use in ways that reverberate across the globe and in our daily lives.
Building a future worth living for, giving our people hope, has a great deal to do with remembering and drawing strength from our individual and collective past. This is a sure foundation for HIV prevention. If we'll let it, it can motivate us to care for our health -- whether we are HIV-negative or positive, whatever our age.
In Habits of the Heart, sociologist Robert N. Bellah and his colleagues observe that a group of people become a genuine community by sharing a past and looking together to the future. "For this reason," note the authors, "we can speak of a real community as 'a community of memory,' one that does not forget its past." In order not to forget that past, they said, a community continually retells its story, "its constitutive narrative," offering examples of the men and women who have embodied and exemplified the meaning of the community. Besides tying us to the past by reminding us of our shared history, they said, genuine communities "turn us toward the future as communities of hope."
For this Gay Men's HIV/AIDS Awareness Day, let's remind ourselves of all we have lost in the thirty-three years of the epidemic. But let's also remember all we've gained, how we've grown as individuals and a community, and why we have so much to live for.