Marriage Equality Is Good for Public Health

Marriage is unequivocally a health issue. Marriage is also an HIV prevention issue. Research demonstrates that bans on same-sex marriage correlate to increased rates of new HIV infection.
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This is a watershed week for the LGBT community and its allies. The Supreme Court is considering two cases on marriage equality -- the first a challenge to California's Proposition 8 and the second a challenge to Section 3 of the so-called Defense of Marriage Act (DOMA). Considerable -- and merited -- attention has been devoted to the fairness, dignity, and equality at stake in these cases. And while these reasons alone should be sufficient to ensure same-sex couples' right to marry, it is important to note that marriage equality also promotes LGBT health and strengthens our ability to combat HIV/AIDS.

Marriage is unequivocally a health issue. A study published in the American Journal of Public Health found that gay men in Massachusetts were in better physical and mental health after that state became the first to recognize same-sex marriage in 2003. Notably, researchers concluded that both partnered and single gay men in Massachusetts experienced health benefits to the tune of a 13 percent reduction in clinic visits for medical problems in the 12 months after the marriage law passed. Another report published in the American Journal of Public Health held that legally married gay men are less likely to be depressed, a key factor influencing HIV vulnerability. These findings suggest that when institutionalized forms of stigma are eliminated, such as gay marriage bans, a reduction of intolerance and the frequency of mental health stressors that gay men experience follow.

Marriage is also an HIV prevention issue. Research demonstrates that bans on same-sex marriage correlate to increased rates of new HIV infection. Two Emory economists concluded that states' constitutional bans on gay marriage escalate new HIV infections at a rate comparable to four cases per 100,000 people. The groundbreaking study was the first to survey the impact of social tolerance levels for gays -- through representative marriage restrictions -- on HIV infection rates. The economists further calculated that rising tolerance for gays in the decades from the 1970s to the 1990s reduced HIV cases by one per 100,000 individuals.

Nearly 7,000 gay men die of AIDS each year in America, while nearly 30,000 become newly infected. The potential for same-sex marriage to ameliorate new HIV infection rates among gay men, by legally affirming committed unions and removing codified intolerance to impact public perception of gays, should be heralded by all supporters of same-sex marriage. The public and individual health benefits associated with reduced stigma accompanying legalized same-sex marriage should complement arguments for fairness and equality so regularly espoused by national gay rights groups. We hope that supporters of same-sex marriage will also cite the attending health benefits to gay marriage and its contribution to reducing gay and bisexual men's chances of contracting HIV. While fairness and dignity are undeniably core components of marriage equality, treating gay men unequally has lasting repercussions on their health and vulnerability to HIV.

Personally, I never thought the Supreme Court would hear a case on marriage equality in my lifetime. I also never thought I would have the opportunity to vote for, and witness the first African American president take the oath of office. If these two milestones can be achieved during my life, I cannot help but wonder if I will have the similar fortune to witness an end to the HIV/AIDS epidemic. The last five years have offered unprecedented moments to reflect on our role and contribution to our country's progress: What are you doing to support marriage equality? What are you doing to ensure equality for all Americans, regardless of race, gender, sexual orientation or gender identity? And what are you doing to end the HIV/AIDS epidemic?

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