National
2011 to bring new marriage fights across U.S.
R.I., Md. best bets for progress, while N.C., Ind. face bans
Rhode Island Gov. Lincoln Chafee, shown here at a meeting with LGBT supporters, backs same-sex marriage rights. (Photo courtesy of Chafee’s office)
With “Don’t Ask, Don’t Tell” repealed, the issue of marriage returns to center stage in 2011 as many states are poised to enact same-sex marriage or civil unions legislation — or pursue measures that would repeal or block such rights for gay couples.
With new governors or changes to their state legislatures, Rhode Island, Maryland and New York could advance same-sex marriage legislation as soon as this year.
But changes in the political dynamic after the 2010 elections also mean that marriage rights could be repealed in New Hampshire and amendments banning same-sex marriage could go forward in North Carolina, Indiana and Pennsylvania.
Meanwhile, legislation to enact civil unions could advance in Hawaii and Delaware.
Rhode Island is among the states that could see early action in passing a same-sex marriage bill.
Newly seated Gov. Lincoln Chafee (I), who supports same-sex marriage, has replaced Gov. Donald Carcieri (R), who opposed gay nuptials.
In his inauguration address, Chafee encouraged the Rhode Island General Assembly “quickly consider and adopt” a same-sex marriage bill to send to his desk.
“When marriage equality is the law in Rhode Island, we honor our forefathers who risked their lives and fortune in the pursuit of human equality,” he said.
Same-sex marriage bills were introduced in both chambers of the Rhode Island General Assembly last week. House Speaker Gordon Fox, who’s gay, supports the passage of a marriage bill through his chamber.
Kathy Kushnir, executive director of Marriage Equality Rhode Island, said she thinks the marriage bill will come before the House Judiciary Committee before the end of January.
“So we’ll be holding hearings, and then, we’ll be looking at, of course, the committee vote and the floor vote as soon as possible,” she said.
Karen Loewy, senior staff attorney for Gay & Lesbian Advocates & Defenders, said the prospects for passing a marriage bill in Rhode Island are “really fantastic” and called Chafee an “active supporter” of the legislation.
“It was part of his inaugural address,” she said. “He’s really committed to getting a marriage bill passed.”
The Senate isn’t expected to take action on the marriage bill until the House finishes action on the measure. The legislative session ends in June, so the marriage bill would have to reach the governor’s desk by that time.
Kushnir said the biggest challenge in passing a marriage bill in Rhode Island is ensuring that lawmakers address the legislation as they take on other issues facing the state.
“There are really important issues also — the economy, jobs and the budget — that are before the legislature,” Kushnir said. “But you know what? Everyone knows that passing marriage equality and treating everybody equal here in Rhode Island does very well for all of those issues.”
Loewy said passage in the Senate remains “a stronger challenge,” but support should exist in the chamber to pass a marriage bill.
“Even there, I think, you’ve got folks who are ready to understand how important this is for same-sex couples in Rhode Island,” she said.
LGBT rights supporters are also optimistic about the chances of a same-sex marriage bill passing in Maryland, where the configuration of the Senate for the first time provides a path for passage.
Last month, a majority of members who support same-sex marriage were named to Senate Judicial Proceedings Committee, ensuring for the first time that a same-sex marriage measure would clear the panel and reach the Senate floor for a vote. Up until now, the committee has blocked the marriage bill, even though the chamber was in Democratic control.
Sen. Richard Madaleno of Montgomery Country, who’s gay, last week expressed confidence about passage of the marriage bill.
“I have never been so optimistic about getting this done,” he said. “Today at lunch I sat quietly by myself with a list of the members of the new Senate going over again and again in my head where the votes are, and I’m feeling really good right now both for the floor vote and the cloture vote.”
The bill is being introduced by Majority Leader Kumar Barve (D-Dist. 17) and Del. Keiffer Mitchell (D-Dist. 44). The Senate version will be advanced by Majority Leader Rob Garagiola (D-Dist. 15) and Madaleno.
Supporters in the Senate believe they have the 24 votes needed to pass the marriage bill on an up or down vote but are less certain about whether they have the 29 votes needed to invoke cloture and stop an expected filibuster by same-sex marriage opponents.
Another obstacle could be a referendum on the marriage law. Nearly all observers of the General Assembly expect opponents to initiate petitions to call for a referendum, which would stop the bills from taking effect until after voters decide on the issue.
In New York, supporters of same-sex marriage are looking to the state legislature to approve a bill extending marriage rights to gay couples that would be sent to newly seated Gov. Andrew Cuomo’s (D) desk for his signature.
As in previous years, a marriage bill is expected to be able pass again in the State Assembly, where Democrats have retained control of the chamber, but the situation is different in the Senate, where Republicans have regained control after the election.
Still, Republican Leader Dean Skelos suggested prior to the election that if Republicans regain power in the Senate, he would allow a vote on same-sex marriage to come, even though — like all GOP senators — he previously voted against the marriage bill.
“Let me just say, when we win back the majority, there is legislation that I believe all of you interested in, that I believe should be voted on again,” Skelos said in October. “We’re not going to stifle discussion. We are not going to stifle votes. And it is truly my belief that people should be allowed to vote their consciences.”
Even if the legislation comes up for a vote in the Senate, the prospects for passage are uncertain. When the bill previously came up for a vote late in 2009, the measure failed 24-38.
Two lawmakers who support same-sex marriage were elected to the Senate since the last vote on the legislation, but that change is far from the 32 votes needed to pass a bill in the Senate.
Ross Levi, executive director of the Empire State Pride Agenda, said the “political dynamic remains very promising” for passing a same-sex marriage bill as well as a transgender civil rights bill in New York.
“The phrase that I’ve been using is that there’s a clear and credible path to victory in the not distant future,” Levi said.
Asked whether passage would be likely in the next two years given the makeup of the legislature, Levi replied, “For me, it’s not talking about timeline, it’s about the work we have to do to make sure that we can have a successful vote as soon as we can.”
Dan Pinello, a gay government professor at the City University of New York, said he’s not optimistic about passage of a marriage bill in the legislature over the course of the next two years.
“[Skelos] has said a few things suggesting that [he would bring the bill to a vote], but that’s not a guarantee,” Pinello said. “So, yeah, he could bring it up for a vote, but that’s no guarantee it’s going to pass. I just don’t see it happening, sadly.”
Pinello said the next opportunity to advance same-sex marriage could be in 2013 as a result of the redistricting this year. He said political power should shift from upstate to downstate, which would give Democrats a majority in the Senate.
“Upstate tends to be Republican and downstate tends to be Democratic, so it’s likely even though Republicans will be redrawing the Senate district lines, there’s no way they can still maintain a majority, given the demographic shifts the Census will reveal,” Pinello said.
Repealing marriage in N.H.?
While several states are poised to advance marriage rights, other places could see a rollback of relationship recognition for same-sex couples.
The most prominent of those states is New Hampshire, where opponents of same-sex marriage may have the political power to repeal the marriage law enacted in 2009.
Gov. John Lynch (D), who signed the marriage bill into law, is expected to veto the bill should it come to his desk. But after the election, Republicans now have a super majority in both chambers of the legislature and could override his veto.
Four bills have already been introduced in the legislature to repeal the marriage law.
State Rep. Leo Pepino (R), who introduced one of the bills, said he thinks there is support to repeal the marriage law, according to the Nashau Telegraph.
“I think we have the votes [to repeal],” Pepino said. “We have a lot of really good conservatives and a good conservative doesn’t believe in gay marriage. … It’s a matter of ethics.”
GLAD’s Loewy said the chances of repealing the marriage law in New Hampshire are “hard to quantify,” adding she doesn’t know whether the votes are present to take such action.
“The LGBT community in New Hampshire is very much gearing up for a fight to protect marriage the best way we know how: by talking to legislators about how taking away marriage is going to hurt their families and their kids,” Loewy said.
Loewy added she’s hoping that New Hampshire won’t go down the path of repealing the law and would instead pursue “issues like jobs and the economy that everybody knows is the priority.”
“I think, like I said, the community has a lot of work to do, but, I think, it’s absolutely fair to expect and hope that that’s not the path that New Hampshire’s going to go down,” she said.
Mo Baxley, executive director of the New Hampshire Freedom to Marry Coalition, said the Granite State has never taken away the rights of its citizen, but that is what some anti-gay lawmakers are proposing to do.
“The married gay and lesbian couples here have in no way impacted anybody else’s marriage,” she said. “Let’s move on. Marriage has been debated to death here and the priority right now is the economy and the budget.”
Other states are prepared to advance constitutional amendments that would ban same-sex marriage.
One such state is North Carolina, where Republicans swept into power in both the House and Senate following the November elections.
Ian Palmquist, executive director of Equality North Carolina, said his organization is “fully expecting” that a constitutional amendment banning both same-sex marriage and marriage-like unions will advance this year.
“I think there’s a chance of blocking it, but it’s a very tight vote at the moment,” he said.
Palmquist said he’s getting mixed signals on when the vote would come up and said it could be anytime between February and July.
In North Carolina, passing a constitutional amendment requires a third-fifths vote of approval from both chambers of the state legislature followed by a majority of voters at the ballot box.
Palmquist said the measure could be on the ballot in 2011, but he expects it would come to voters in 2012. Such a move would enable conservatives to turn out their base during a presidential election year.
“It would definitely be a challenge to defeat it at the ballot,” Palmquist said. “There is majority support in North Carolina for some form of relationship recognition. We certainly would use that to try to stop this kind of amendment from moving forward.”
Another state where LGBT rights supporters are anticipating a constitutional ban on same-sex marriage and marriage-like unions is Indiana.
In previous years, advocates had been able to block the amendment in the House because Democrats held a narrow majority in the chamber, but the situation has changed now that Republicans took control of the House and expanded their control of the Senate following the November elections.
Don Sherfick, legislative chair for Indiana Equality, said the prospects for a constitutional ban on same-sex marriage passing this year are good in Indiana.
“I guess I would be less than honest if I were to say that things were looking rosy for continuing to unequivocally being able to fight such a thing coming through,” he said.
Anticipating hearings in either the House or Senate or both chambers within six weeks, Sherfick said Indiana Equality is mounting a public relations and lobbying campaign to try to block the amendment.
“People will at least know what they’re doing and we’ll set our sights on fighting it in the next legislature,” he said.
Bil Browning, an Indiana native and editor of the Bilerico Project, said he’s 99.9 percent certain that the Indiana Legislature would pass a constitutional amendment to ban same-sex marriage.
“The two things they wanted to do most and first and foremost was a bill that would require a woman to have a sonogram three days before any planned abortion — in the hopes that she’ll see it and not want to have the abortion — and a constitutional amendment prohibiting same-sex marriage,” Browning said.
For a constitutional amendment to pass in Indiana, it must pass the state legislature twice — a first time and then again after an election — before the measure comes before voters. If the legislature passed an amendment this year, the soonest it could get to voters is 2014.
Browning said gay rights supporters can hope for a change in the makeup of the legislature after the next election as a way to block the amendment from final passage.
“Two years from now, if we can retake the Indiana House it’s probably dead, but for at least passing this session, I’d say [the chances] are 99.9 percent,” he said.
Browning said one factor working in advocates’ favor in Indiana is that all the Fortune 500 companies headquartered in the state previously testified before the legislature against the amendment.
Additionally, Gov. Mitch Daniels (R), who has called for a “truce” on social issues, is widely considered to be thinking about a run for president and may want to steer clear of marriage prior to 2012. Still, the amendment wouldn’t require his signature for passage.
A similar situation can be found in Pennsylvania, where Republicans took control of the House and retained control of the Senate.
Malcolm Lazin, executive director of the Philadelphia-based Equality Forum, said passage of a constitutional ban on same-sex marriage is “of concern” because of new Republican control of the House.
“We were able to successfully block it in the past because the House was controlled by the Democrats,” Lazin said. “That dynamic has now changed. In addition, there is now a Republican governor of Pennsylvania.”
As in Indiana, for a constitutional amendment to pass in Pennsylvania, the measure has to be approved by a majority vote in both chambers of the legislature — once and then again after an election — before going to voters as a ballot measure.
Ted Martin, executive director of Equality Pennsylvania, predicted that the amendment would be introduced in both the House and Senate, but was skeptical of lawmakers’ ability to push it through the legislature.
Martin said the likelihood of the measure passing in the House committee is high, but its passage on the House floor is less certain. For the Senate, which has been controlled by Republicans for more than two decades, Martin said he doubts the measure would make it through committee.
“The Senate, in the past, has always taken a less active tone about it,” Martin said. “They’ve become much more libertarian in their view. Just to remember, we were able to block this in committee three times before.”
Hawaii, Del. to take up civil unions
As many states take on the marriage issue — either to advance gay nuptials or ban them — two other states are prepared to enact civil unions early in 2011.
In Hawaii, LGBT advocates are ready to advance a civil unions bill that newly seated Gov. Neil Abercrombie (D) has pledged to sign.
Last summer, a civil unions bill in the Aloha State was vetoed by former Republican Gov. Linda Lingle, but with her gone, gay rights supporters see a clear path toward passing the legislation.
Alan Spector, co-chair of Equality Hawaii, said he expects that the civil unions bill will easily pass the legislature to reach Abercrombie’s desk soon after the session starts on Jan. 19.
“With the November 2010 election behind us, and a new governor and new leadership, we’re pretty confident that we will pass the bill early in 2011,” Spector said.
Spector estimated that the legislation would be introduced in the third week of January and ideally would make it to the governor’s desk by March.
“The process can go as quickly as a month or it can take the whole session — or it can on into 2012,” Spector said. “It all depends on what happens, but we’re pretty optimistic that it’s going to go quickly this year.”
Advocates are pursuing civil unions in Hawaii instead of marriage because in 1998, voters approved a constitutional amendment granting the legislature the power to ban same-sex marriage, which lawmakers then pursued.
Similarly, LGBT advocates in Delaware are ready to advance legislation this year that would enact civil unions in the First State.
Peter Schott, political vice president of Delaware Stonewall Democrats, said the “atmosphere is probably better than it’s been in a few years” for passing civil unions in the state.
“We have formed a coalition, which a number of elected officials are on — civic leaders,” Schott said.
LGBT rights supporters know they have the votes in the House, Schott said, but questions about passage in the Senate remain because leadership could refer the legislation to an unfavorable committee.
Schott said supporters of civil unions in Delaware want to pass the legislation this year so it doesn’t come up during the 2012 election season.
The White House
As house Democrats release Epstein photos, Garcia continues to demand DOJ transparency
Blade this week sat down with gay House Oversight Committee ranking member
Democrats on the House Oversight Committee have released new photos from Jeffrey Epstein’s email and computer records, including images highlighting the relationship between President Donald Trump and the convicted sex offender.
Epstein, a wealthy financier, was found guilty of procuring a child for prostitution and sex trafficking, serving a 13-month prison sentence in 2008. At the time of his death in prison under mysterious circumstances, he was facing charges of sex trafficking and conspiracy to traffic minors.
Among those pictured in Epstein’s digital files are Trump, former President Bill Clinton, former Trump adviser Steve Bannon, actor and director Woody Allen, economist Larry Summers, lawyer Alan Dershowitz, entrepreneurs Richard Branson and Bill Gates, and Andrew Mountbatten-Windsor.
One photo shows Trump alongside Epstein and a woman at a Victoria’s Secret party in New York in 1997. American media outlets have published the image, while Getty Images identified the woman as model Ingrid Seynhaeve.
Oversight Committee Democrats are reviewing the full set of photos and plan to release additional images to the public in the coming days and weeks, emphasizing their commitment to protecting survivors’ identities.
With just a week left for the Justice Department to publish all files related to Epstein following the passage of the Epstein Files Transparency Act, which requires the Justice Department to release most records connected to Epstein investigations, the Washington Blade sat down with U.S. Rep. Robert Garcia (D-Calif.), the ranking member on the Oversight Committee to discuss the current push the release of more documents.
Garcia highlighted the committee’s commitment to transparency and accountability.
“We’ve said anything that we get we’re going to put out. We don’t care who is in the files … if you’ve harmed women and girls, then we’ve got to hold you accountable.”
He noted ongoing questions surrounding Trump’s relationship with Epstein, given their long history and the apparent break in friendship once Trump assumed public office.
“There’s been a lot of questions about … Donald Trump and Jeffrey Epstein. They were best friends for 10 years … met women there and girls.”
Prior to Trump’s presidency, it was widely reported that the two were friends who visited each other’s properties regularly. Additional reporting shows they socialized frequently throughout the 1990s and early 2000s, attending parties at Trump’s Mar-a-Lago resort in Florida and Epstein’s residences. Flight logs from an associate’s trial indicate Trump flew on Epstein’s private jet multiple times, and Epstein claimed Trump first had sex with his future wife, Melania Knauss, aboard the jet.
“We’ve provided evidence … [that leads to] questions about what the relationship was like between Donald Trump and Jeffrey Epstein.”
Garcia stressed the need for answers regarding the White House’s role in withholding information, questioning the sudden change in attitude toward releasing the files given Trump’s campaign promises.
“Why is the White House trying to cover this up? So if he’s not covering for himself … he’s covering up for his rich friends,” Garcia said. “Why the cover up? Who are you hiding for? I think that’s the question.”
He confirmed that Trump is definitively in the Epstein files, though the extent remains unknown, but will be uncovered soon.
“We know that Trump’s in them. Yeah, he’s been told. We know that Trump’s in them in some way. As far as the extent of it … we don’t know.”
Garcia emphasized accountability for all powerful figures implicated, regardless of financial status, political party, or personal connections.
“All these powerful men that are walking around right now … after abusing, in some cases, 14‑ and 15‑year‑old girls, they have to be held accountable,” he said. “There has to be justice for those survivors and the American public deserves the truth about who was involved in that.”
He added that while he is the ranking member, he will ensure the oversight committee will use all available political tools, including subpoenas — potentially even for the president.
“We want to subpoena anyone that we can … everyone’s kind of on the table.”
He also emphasized accountability for all powerful figures implicated, regardless of financial status, political party, or relationship with the president.
“For me, they’re about justice and doing the right thing,” Garcia said. “This is about women who … were girls and children when they were being abused, trafficked, in some cases, raped. And these women deserve justice.”
“The survivors are strong.”
Deputy White House Press Secretary Abigail Jackson issued a statement regarding the release the photos, echoing previous comments from Republicans on the timing and framing of the photos by the Oversight Committee.
“Once again, House Democrats are selectively releasing cherry-picked photos with random redactions to try and create a false narrative,” Jackson said.
“The Democrat hoax against President Trump has been repeatedly debunked and the Trump administration has done more for Epstein’s victims than Democrats ever have by repeatedly calling for transparency, releasing thousands of pages of documents, and calling for further investigations into Epstein’s Democrat friends,”
In a press release on Friday, Garcia called for immediate DOJ action:
“It is time to end this White House cover-up and bring justice to the survivors of Jeffrey Epstein and his powerful friends. These disturbing photos raise even more questions about Epstein and his relationships with some of the most powerful men in the world. We will not rest until the American people get the truth. The Department of Justice must release all the files, NOW.”
(Photo courtesy of the U.S. House Oversight Committee)
The White House
White House deadnames highest-ranking transgender official
Rachel Levine’s portrait altered at HHS
Admiral Rachel Levine — the first transgender person ever confirmed by the U.S. Senate and the highest-ranking trans official in American history — had her official portrait in the Humphrey Building altered, with staff replacing her correct name with her deadname, the name she has not used since 2011.
NPR first reported the change, and an HHS spokesperson confirmed to the outlet that Levine’s portrait had recently been altered. A digital photograph obtained by NPR shows Levine’s former (male) name typed on a placard beneath the portrait, placed under the glass of the frame.
Levine served as a four-star admiral in the U.S. Public Health Service Commissioned Corps under the Biden-Harris administration and was appointed the 17th assistant secretary for health.
During her tenure, Levine oversaw the Commissioned Corps and helped lead national public-health initiatives, including the federal COVID-19 response and vaccination strategy; efforts to address rising syphilis infection rates; HIV/AIDS prevention and treatment programs; and strategies to combat the opioid epidemic, particularly through expanded harm-reduction approaches for the communities most affected.
The Trump-Vance administration’s decision to publicly deadname Levine is widely viewed within the trans community as demeaning and disrespectful. The move comes amid a series of federal policy reversals targeting LGBTQ Americans, particularly trans youth seeking gender-affirming care.
Those actions include: weakening workplace protections for LGBTQ employees; limiting restroom access; downgrading gender-identity discrimination cases; pressuring hospitals to end gender-affirming care; cutting HIV research and prevention funding; removing LGBTQ crisis resources; restricting access to trans-inclusive medical policies for veterans and young people; supporting trans sports bans and threatening funding for teams that include trans athletes; and forcing schools and universities to eliminate DEI and LGBTQ offices, inclusive curricula, gender-neutral bathrooms, and books or training materials addressing LGBTQ issues.
The Trump–Vance administration has also expanded federal censorship by removing LGBTQ language from surveys, agency websites, Smithsonian materials, and human-rights reports; blocking Pride recognitions; creating federal communications that misgender trans women; imposing passport and travel barriers for trans Americans; lifting protections for trans service members; limiting benefits and care for LGBTQ veterans; and pressuring states, universities, and hospitals to end trans-inclusive policies under threat of losing federal research, education, or Medicaid funds. The administration has additionally deported LGBTQ asylum seekers to unsafe conditions, removed LGBTQ issues from global human-rights reporting, and escalated anti-trans rhetoric at public events.
These actions stand in stark contrast to Levine’s public-health record. As assistant secretary for health, she worked to expand LGBTQ+ health data collection, promote equitable vaccine distribution, strengthen national health-equity initiatives, and reduce care disparities experienced by historically underserved communities, including LGBTQ populations. Within HHS, she led councils and task forces dedicated to reducing structural barriers to care and improving community outcomes.
Before joining the federal government, Levine oversaw health and safety for nearly 13 million residents as Pennsylvania’s physician general from 2015–2017 and as Pennsylvania secretary of health from 2018–2021.
Asked by NPR about the alteration of her official portrait, Levine responded that it had been an honor to serve as assistant secretary for health, adding: “I’m not going to comment on this type of petty action.”
Health
The harsh truth about HIV phobia in gay dating
HIV and stigma remain baked into queer dating culture
Uncloseted Media published this article on Dec. 9.
This story was produced with the support of MISTR, a telehealth platform offering free online access to PrEP, DoxyPEP, STI testing, Hepatitis C testing and treatment and long-term HIV care across the U.S. MISTR did not have any editorial input into the content of this story.
By SAM DONNDELINGER | In his room, 19-year-old Cody Nester toggles between Grindr profiles on his phone.
As he senses chemistry with a match, he knows he has to flag something that could be a deal breaker.
“Did you see on my profile that I’m HIV positive?” he writes.
The reply arrives instantly.
“You’re disgusting. I don’t know why you’re on here.” Seconds later, the profile disappears, suggesting Nester is blocked.
“He went out of his way to say that. People could at least be more aware, ask questions, and understand the reality [of living with HIV] instead of attacking us,” Nester told Uncloseted Media.
“I would say 95 percent of people respond that way,” says Nester, who lives in Hollywood, Fla., and works at a Mexican restaurant. “The entire conversation is going fine. They’re down to meet up and then right when I mention [HIV], it’s always, ‘Oh no, never mind.’”
Some other messages he’s received include:
“You’ll never get anything in your life.”
“Why don’t you die?”
“Why are you on here?”
More often, it’s silence, a cold “No” or a sudden block.
“It’s like you’re a white fish in a school of black fish,” he says. “You’re immediately the odd one out.”
Even though Nester’s undetectable status makes it impossible for him to transmit HIV to partners during sex, he experiences stigma around HIV, something which nearly 90 percent of Americans agree still exists, according to a 2022 GLAAD report. And a survey shared in 2019 found that 64 percent of respondents would feel uncomfortable having sex with someone living with HIV, even on effective treatment. The emotional cost of this stigma is a significant barrier to intimacy and can result in a loss of self-esteem, fear of disclosure and suicidal thoughts.
What the science says — and why it doesn’t seem to matter
“The fear comes from antiquated ideas around HIV,” says Xavier A. Erguera, senior clinical research coordinator at University of California, San Francisco,’s Division of HIV, Infectious Diseases & Global Medicine. “A lot of people who are newly diagnosed still fear it’s a death sentence. Even though we have medications now to treat it effectively, and it’s basically a chronic condition, people haven’t caught up.”
Since 1996, antiretroviral therapies have developed to where they can suppress the virus to levels so low that it is undetectable in the blood, and thus not able to be transmitted to sexual partners. This is known as Undetectable = Untransmittable, or U=U. According to a Centers for Disease Control and Prevention report from 2024, 65 percent of HIV-positive cases are virally suppressed.
Another line of defense is pre-exposure prophylaxis (PrEP), which reduces the risk of acquiring HIV from sexual intercourse by roughly 99 percent when taken as prescribed. Approved by the Food and Drug Administration in 2012, the medication launched as a once-a-day pill and was hailed as a breakthrough as it transformed the sex lives of gay men, which had been shaped by decades of fear about HIV complications and about where AIDS came from.
“Internal logic doesn’t reflect what we know scientifically,” says Kim Koester, associate professor in the Department of Medicine at UCSF. “I was very optimistic when PrEP came out. The drug works, so why wouldn’t everyone use it?”
Even with PrEP use on the rise, less than 600,000 Americans used it in 2024, and Koester says skepticism and judgments about taking the drug persist.
“The phobia is pervasive,” Koester told Uncloseted Media. “People believe that others get the disease because of their lifestyle. … PrEP was supposed to be the antidote to the threat of HIV, reduce the anxiety, and make you more open to who you are and the sex you want. It’s supposed to be liberating. It is part of the answer. But it’s not enough. We don’t have enough people using PrEP for it to make the dent in the stigma we need.”
According to a 2023 study of seven informants living with HIV, public stigma stems from problematic views from society that those living with HIV are “a dangerous transmission source,” “disgraceful” and “violators of social and religious norms who have committed deviant behavior.”
Laramie Smith, assistant professor of Global Public Health at the University of California, San Diego, says this stigma is unwarranted and fueled by misunderstanding:
“With today’s treatments, it shouldn’t be a life-altering identity shift. It should be no different than, ‘I have diabetes.’ If you’re virally suppressed, it shouldn’t matter whether you’re friends with someone, whether you’re sleeping with someone — the science shows us that.”
How HIV phobia shows up online
Nester, who contracted HIV last year from a Grindr hook-up who insisted he was negative, says he is just starting to accept his diagnosis. “I didn’t go back on the apps for a long time after that. It messed with my mental health … realizing I’d have to take medication for the rest of my life.”
Since he started dating again this year, returning to apps like Grindr and Sniffies, he has faced a new normal. He tries to do everything “right” and disclose his status early. Even on his Grindr profile, he identifies as “poz,” slang for HIV-positive.
Still, he says most people ghost him once they find out. “The second I bring it up, it’s ‘No,’” says Nester. “The amount of discrimination you get … it’s always the same pattern. … People don’t know, and they don’t want to know. It messes with you.”
This discrimination may be fueled by a deprioritization of HIV awareness programs across the country. Earlier this month, the U.S. State Department did not commemorate World AIDS Day for the first time in 37 years. HIV prevention programs have been slashed, especially in conservative districts, and only 25 states and D.C. require both HIV and sex education. In many states, health curricula often lag behind current science and omit teaching about PrEP, gay sex and concepts like U=U. Research shows that Gen Z is currently the least educated generation about HIV.
“I could go all day explaining HIV, but people don’t want to listen,” says Nester, who is part of Gen Z. “People don’t want to learn about it; they just want to avoid it.”
HIV anxiety and public stigma shaped by history
Even in more progressive areas, stigma still exists. Damian Jack, a 45-year-old from Brooklyn, remembers sitting in an exam room in 2009 as a doctor explained how low his T-cell count was, which is a hallmark of HIV infection.
“I started hysterically crying,” he told Uncloseted Media. “HIV meant death. That’s what I thought.”
In 1981, when Jack was 1 year old, the first reports of a mysterious and deadly immune deficiency syndrome, which would later be named AIDS, appeared in the U.S. Growing up, Jack saw countless terrifying images of men on their deathbeds with Kaposi sarcoma, the purple lesions the media once called “gay cancer.” Public misinformation and fearmongering spread ideas that AIDS was a disease that “only gay men and drug users get.” And politicians often equated it with homosexuality and moral failure, calling it a “gay plague.” It wasn’t until September 1985, four years after the crisis began and thousands had died, that President Ronald Reagan first publicly mentioned AIDS.
Decades later, the emotional residue of that era and the shame associated with the virus lingers.
Hours after learning of his diagnosis, Jack faced his first encounter with rejection. He already had a date planned that night, and his doctor and friends encouraged him to go.
They had a great time until the date asked him: “Are you negative or positive?”
He told the truth.
“It was just understood there wouldn’t be a second date,” says Jack. “I remember thinking, ‘This is how dating is going to be now.’ I felt so anxious telling guys. It followed me everywhere. I don’t think that anxiety ever truly goes away.”
The emotional impact of HIV stigma
For those who are HIV-negative, experts say that “stigma’s whole design is to ‘other.’”
“The ‘us versus them’ creates that false sense of safety when it comes to HIV,” says Smith. “If I can believe that someone did something to deserve their diagnosis, and I’m not that [kind of person], then I’m safe.”
This othering is painful and can lead to shame, fear and isolation, and it is linked to a higher risk of depression and anxiety.
“If I’m undesirable, and that’s what those messages are communicating, that threatens your sense of safety, your sense of belonging and the fundamental desire we all have to be loved,” Smith says. “And that starts to reinforce the thinking that ‘I am not worthy. This virus that I have means that I’m not lovable. I am not safe showing up among other men.’”
“I pretend it doesn’t hurt, but some things do sting a little bit,” Nester says. “You start thinking, ‘Am I really that disgusting? Am I really that singled out?’”
When public stigma turns inward
“Internalized stigma is what occurs when applying the stereotypes about who gets HIV, the prejudice, the negative feelings, onto yourself,” says Smith.
In 2024, 38 percent of people living with HIV reported internalized stigma. And studies show that it can predict hopelessness and lower quality of life, even when people are engaged in care or virally suppressed.
Internalized stigma can also affect how people practice safe sex and communicate about the virus. A 2019 survey of men who have sex with men found that individuals who perceived greater community-level stigma were less likely to be aware of — and use — safer-sex functions available on dating apps, such as HIV-status disclosure fields, as well as sexual health information and resources.
“[HIV phobia] is probably the most intense, subvert bigotry I think you could experience,” Joseph Monroe Jr., a 48-year-old living in the Bronx, told Uncloseted Media.
On dating apps, men have messaged him things like, “You look like you’ve got that thing” and “Go ahead and infect someone else.”
Monroe has also dealt with misinformed people who rudely opine about how he contracted the virus: “Who fucked you? That’s how you got it, right?” people will say to him.
“You end up internalizing all these stereotypes about who gets HIV — that you were promiscuous, that you didn’t care about yourself, that you did something wrong,” says Smith. “You carry that in, and then you have to relearn: ‘No, I didn’t. This is just a health condition.’”
What HIV acceptance looks like and raising awareness
For those living with HIV, acceptance feels far away.
“You’re living under this threat of HIV and the threat that others find you threatening. It inhabits you socially and sexually,” Koester says. “People are hunkering down. Not putting themselves out there and having a mediocre quality of life. To have a sense of empowerment, you have to be legitimate and seen in the world and it’s hard to do that with the stigma that exists.”
Researchers say the path forward lies as much in conversation as in medicine.
Koester says she talks about HIV and PrEP anywhere she can, including in salons, cafes and restaurants. “Whenever I get into a cab with someone, I’m going to bring up HIV so the driver gets accustomed to hearing about it. … We have a long way to go in terms of exposure and awareness and every little bit helps.”
Part of this lies in increasing awareness through targeted marketing campaigns. PrEP is still profoundly misunderstood outside major urban centers, with uneven uptake among minority groups and usage gaps in the Bible Belt. And a 2022 U.S. survey found that 54.5 percent of people living with HIV didn’t know what U=U meant, and less than half of Americans agree that people living with HIV who are on proper medications cannot transmit the virus.
While eradicating stigma is slow, there is hope for acceptance.
Years after Jack’s diagnosis, in 2021, he told a man he was on a third date with that he was HIV-positive but undetectable. His date’s reply was almost casual:
“Oh — is that it? I thought you were going to say you had a boyfriend or something. I’m on PrEP. You’re fine.”
“It felt so good to hear him say that and accept me,” says Jack. “I was like, ‘This is my person. You’re my person.’” One year later, they got married.
Back in Florida, 19-year-old Cody Nester isn’t feeling this acceptance. He still scrolls past profiles that read “Only negative guys” and tries to ignore the hateful messages.
“It still hurts, but I know it’s coming from fear,” he says. “I wasn’t too informed about HIV before I got it. … When I got it, I really jumped into the rabbit hole and began to learn. I really do think [HIV and stigma] is because people are not knowledgeable. … When people don’t know details, they tend to get scared.”
Additional reporting by Nandika Chatterjee.
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