If countries are judged by the health and wellbeing of its children, then our country is unwell.
Even schools, which many of us expect to be safe environments, have become dangerous places for many young people—especially gay, lesbian and bisexual teens. Gay, lesbian and bisexual youth are three times more likely than straight students to have been raped and they skipped school far more often because they do not feel safe, according to a recent study by the Centers for Disease Control and Prevention (CDC). Tragically, a third of these youth have been bullied on school property and they are twice as likely to have been threatened or injured with a weapon on school property. Gay, lesbian and bisexual teenagers are at far greater risk for depression, bullying and other types of violence than their straight peers. The study also found that more than 40% of gay, lesbian, and bisexual teens had seriously considered suicide and 29% had made attempts to do so in the year before the survey.
At a time where same-sex marriage is legal and transgender rights are part of the national conversation, it would be easy to rest on the laurels of these achievements—but there is so much more to do to create a safe and equal environment for lesbian, gay, bisexual and transgender (LGBT) individuals.
According to Youth.gov, LGBT youth experience higher rates of mental health challenges and, as a result, increased health complications. Studies also show LGBT youth are more likely to use substances to cope with bias and stress, and as way to deal with increased rates of depression and anxiety than non-LGBT peers.
The result is a dire one that stays with adolescents even as they grow. As Health Resources and Services Administration (HRSA) Acting Administrator Jim Macrae recently stated, the consequences of bullying extend well into adulthood and can be more severe than physical violence.
The result is a perfect storm. The collision of epidemics: bullying and negative health outcomes, including HIV.
As a black, gay man who is HIV-positive and a long-term survivor, I have paid witness to the great strides we have made in combatting HIV. We are at a point in history where we have the tools to both prevent and end the HIV epidemic. However, despite the prominent response of the gay community in the early days of HIV, the momentum has waned and the impact has not. While new HIV infections are decreasing across the country in virtually every population, there is but one group for whom infections are rising: young men who have sex with men.
CDC-funded research estimates that in some major cities 1 in 5 men who have sex with men are now HIV-positive. And, if broken down by race, the chance of a young black gay or bisexual man becoming HIV-positive in his lifetime is close to 1 in 2. For gay, black men in the South, the vulnerabilities and challenges are even greater.
Homophobia and silence around adolescent sexuality further marginalizes this population and increases their vulnerability for exploitation and unhealthy relationships. Stigma—stemming from shame, fear of discrimination, or lack of understanding about HIV—too often prevent individuals from getting tested or into lifesaving care and treatment.
We need to do better. We need to create an environment of acceptance and support for LGBT youth.
How can we value and validate LGBT youth, particularly gay and bisexual men of color who are so disproportionately affected by HIV?
I know how much I could have benefitted from a nurturing environment when I was coming of age as a gay youth and the importance these years have in establishing a healthy adulthood. So as we celebrate National Gay Men’s HIV/AIDS Awareness Day on September 27, let’s engage everyday ‘influencers’ who have a direct line of communication to at-risk youth and empower them to launch conversations about HIV.
Let’s support—or continue to support—gay marriage and healthy same-sex relationships, as they are in themselves a type of health initiative. Stay educated about bullying and access bullying-related resources and tip sheets. Create safe spaces for LGBT and questioning youth and promote HIV awareness campaigns like the CDC’s Act Against AIDS campaign.
Gay men need to be aware of their vulnerability and should test for HIV and, if positive, seek care and treatment immediately. As the assistant commissioner for the Bureau of HIV/AIDS Prevention and Control at New York City’s Department of Health and Mental Hygiene has explained, when someone consistently takes their HIV medications and maintains a consistent undetectable viral load, HIV transmission is negligible. Moreover, an HIV-infected youth could live roughly the same life expectancy as the general public if they stay medication adherent.
If gay and bisexual men are HIV-negative, they should link to education programs and talk to their care provider about pre-exposure prophylaxis (PrEP)—a medication that HIV-negative people can take to lower their risk of contracting HIV by over 92%.
Let’s create a catalyst for change in letting LGBT youth know that they are valuable and that their health matters. Will you join me?