A panel of LGBT advocates specializing in health and social welfare, moderated by MSNBC's Thomas Roberts, met Thursday, Nov. 21, as part of a webcast briefing for gay media on what can be done to combat a resurgence of HIV infections among young gay or bisexual men – technically termed ''men who have sex with men'' (MSM) – highlighting a need for better education and for LGBT social-justice efforts to include countering HIV among young people.
Carl Siciliano, founder and executive director of New York's Ali Forney Center, which works with homeless LGBT youth, was frank in his assessment of the factors contributing to higher incidence of HIV among youth. He pointed to homophobia and rejection by their families often forcing LGBT teens to the streets, where they turn to sex work for survival. They may also find themselves trading unprotected sex with older people for housing and other necessities. Siciliano said about 20 percent of youth seeking help at his center are HIV-positive.
''If we are not willing to find housing for homeless youth, we are consenting that they will be infected with HIV,'' he said bluntly. ''Protecting young people must become part of the 'gay rights' movement.''
Jeff Krehely, the vice president and chief foundation officer at the Human Rights Campaign (HRC), called for better messaging and moving beyond a focus on marriage equality. Tasked with overseeing HRC's public outreach and education programs, Krehely explained that the organization had some success with a recent HIV-education campaign, but that it paled in comparison to the response HRC's ''Turn the Web Red'' marriage-equality campaign received.
Organizations doing outreach around HIV-related issues, he said, must find the right messaging to reach LGBT youth. Activists also need to pay greater attention to lower-profile legislative issues, such as budget battles, Krehely added, in that initiatives aimed at halting HIV are being underfunded or cut altogether.
Panelists also cited the role of alcohol and drugs in poor decision-making or engaging in riskier sexual behavior. Daniel Driffin, chair of the Young Black Gay Men's Leadership Initiative and a project manager with the Center for Health, Intervention and Prevention (CHIP) at the University of Connecticut, said youth often use substances to cope with homophobia or depression when coming out.
Driffin also said higher HIV-infection rates, particularly among young black MSM, aren't due to riskier behavior than other demographic groups, but rather that the community is smaller and many aren't aware that they are HIV-positive.
Internalized homophobia making gay or bisexual youth uncomfortable talking to their doctors about their sexual orientation also entered the conversation. Jonathan Mermin, director of the National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention at the Centers for Disease Control and Prevention, explained that if a person's sexual orientation is not shared with a medical professional, HIV may not be addressed. Examples of this, he noted, would be whether a patient is comfortable enough to approach his doctor after potential exposure to go on post-exposure prophylaxis (PEP), or asking about pre-exposure prophylaxis (PrEP) prior to sex with a positive partner.
Both Mermin and Krehely said few medical professionals are sufficiently trained in LGBT cultural competency.
Siciliano added that there's been too little attention given to the intersection of homophobia and poverty, particularly with regard to youth.
''We need to mobilize and demand a safety net for LGBT kids,'' he urged.