How LGBT History Can Inspire Hope, Support Health, and Even Prevent HIV

"A people deserves a history."

That's how Larry Kramer--Tony and Emmy-winning playwright, author, and America's best-known HIV/AIDS activist--spoke about the just-released first volume of his two-volume novel The American People. Kramer has labored over the book for decades, fine-tuning his sometimes fanciful American history from a gay point of view.

"I want every gay person to be aware of our history," Kramer told me, "whether or not I've fictionalized it."

He added, "You should know your history. I want gay history taught in schools. And they don't teach it."

I interviewed Kramer in his Manhattan apartment on July 29 for the Los Angeles Review of Books and for my forthcoming book about building gay men's resilience.

Being familiar with, and drawing inspiration from, our history as LGBT people can contribute tremendously to our personal resilience.

We are heirs of what I call "LGBT America's heroic legacy," the acts and words of men and women who chose to stand up for their humanity, integrity, and fully equal American citizenship--rather than accept the shame and silence they were told was their lot in life for being "different."

They often paid a steep price: Diagnosed by psychiatrists as mentally ill because they weren't heterosexual. Condemned by religious institutions. Disowned by families. Even left to fend for themselves in the face of a terrifying new disease called AIDS.

Before President Ronald Reagan's health department in 1982 declared AIDS the nation's "number one health priority," Larry Kramer and five other gay men in New York began raising money for research and formed Gay Men's Health Crisis (GMHC), the world's first--and still largest--organization to advocate and care for people living with HIV/AIDS.

Nursing homes, used to caring for elderly patients, were not prepared in the early eighties (or today) to care for young men in their twenties, thirties, and forties. So gay men and their friends created from scratch a parallel network of health care and social service organizations, like GMHC, to care for their own.

Back then advocacy included arguing with ambulance drivers to take deathly sick people with AIDS--mainly gay men--to the hospital. Care meant doing errands and arranging doctor visits for clients who were terminally ill, at some stage of cancer, dementia, or pneumocystis pneumonia.

By the end of 2011, HIV/AIDS had already killed an estimated 311,087 gay and bisexual American men. Fifty-seven percent of the estimated 500,022 persons living with an HIV diagnosis at the time were gay and bisexual men.

Two-thirds of all Americans living with HIV, and newly infected each year, are still gay and bisexual men--even though we account for only an estimated two percent of the population. (Centers for Disease Control and Prevention)

Black gay and bisexual men accounted for the largest number of new infections (10,600, or 36 percent) in 2010. Among them, young black males between age 13 to 24 made up nearly half the total--a 20 percent increase from 2008.

For any of us who lived through the dark years of the 1980s--and particularly for those of us living with HIV, including myself--despair can seem a natural response to numbers like these.

They certainly make one thing very clear: America is still failing to stop the spread of HIV and is far from achieving the 'AIDS-free generation' envisioned by the Obama administration.

As I examine HIV prevention education aimed at gay and bisexual men for my new book, one thing is clear: to work, prevention education must go beyond PrEP and condoms. It has to address the drivers of risk behavior--the feelings and needs in our hearts and minds that compel us to engage in sex the way we do, even to attribute meaning to particular sexual acts.

Earlier prevention efforts, growing out of a desperate wish to arrest the spread of HIV as quickly as possible, were based on a "deficit" model. They told us simply "use a condom every time." No questions asked. They assumed we couldn't be trusted to make healthy choices based on factual information, and frequently invoked fear to douse our libidos.

Newer efforts, in contrast, draw upon what is referred to as a "strength-based" or "resilience-based" model, aimed at strengthening our confidence, pride and resilience.

Starting from a place of respect and validation, these interventions work essentially to build hope. Their premise is simple, really: Men who are hopeful about their future will naturally want to protect themselves to be here for it and healthy enough to enjoy it.

"You've got to give them hope," is how Harvey Milk, America's first openly gay elected official, put it in a 1978 speech. Milk understood that inspiring hope in a gay boy's heart could mean the difference between a happy future--and suicide.

In this LGBT History Month, claiming as our own the powerful legacy of people like Harvey Milk and Larry Kramer, who stood up and now stand out in our history, offers a powerful source of hope and resilience, a solid foundation for HIV prevention and for good health.