Opinions
Sexual abuse may explain high HIV rates in gay men
We must address trauma that undermines self-esteem, good judgment
September 27 is National Gay Men’s HIV Awareness Day.
We’d been messing around since I was about 10 years old. I figured sex with him and his three younger brothers next door was just a part of our friendship, along with our hikes to Bluff Point, on Long Island Sound, and neighborhood kickball, baseball, football, and foursquare games.
Besides, I enjoyed it a lot. I never felt consciously traumatized.
It would take a 2005 HIV diagnosis to open my mind to how my experience of childhood sexual abuse, and the multiple traumas I experienced throughout my life, undermined my self-esteem and good judgment and put me in the way of the same lethal microbe that killed so many of my friends.
The American Academy of Experts in Traumatic Stress (AAETS) says that 30 percent of all male children are molested in some way. There is a well-documented correlation between sexual abuse and later promiscuity. PTSD, depression, poor self-esteem, dissociative disorders, and anxiety are among the other effects of CSA. Sexual abuse survivors often equate sexual desirability with self-worth—and use sex as an analgesic to blunt the edge of shame that is another insidious effect of CSA.
I know these things, not only from reading about them in the research literature, but because they have played out in my own life—and in the lives of so many gay men.
Behavioral scientists have wrung their hands for more than three decades trying to understand why gay men seem so disproportionately vulnerable to HIV. Recent research makes it abundantly clear that trauma, specifically from CSA, is almost certainly the long-overlooked answer.
Consider: Harvard researchers have found that up to 46 percent of gay and bisexual men who report condomless anal sex—the principal act by which HIV is transmitted between men—were sexually abused as boys.
“That is a huge number,” said Conall O’Cleirigh, a staff clinical psychologist in the psychiatry department at Massachusetts General Hospital and an assistant professor of psychiatry at Harvard. His research on gay men has found that the same mental health issues that can put someone at risk for HIV can also prevent someone living with the virus from adhering to his treatment.
In a national study of 1,552 black gay and bisexual men, O’Cleirigh and his colleagues found that men who experienced CSA—or physical or emotional abuse, or stalking, or being pressured or forced to have sex—when they were younger than 12 years old had more than three male partners in the past six months. The men who had been forced or pressured to have sex as boys were likely to have receptive anal sex.
In another study of 162 men with CSA histories, participants reporting sexual abuse by family members were 2.6 times more likely to abuse alcohol, twice as likely to have a substance use disorder, and 2.7 times more likely to report a sexually transmitted infection in the past year. Not only that, but men whose abuser penetrated them were more likely to have PTSD, recent HIV sexual risk behavior, and a greater number of casual sexual partners. Physical injury and intense fear increased the odds for PTSD even more.
“Having that history is repeatedly associated in every sample of gay men with increased likelihood of being HIV-positive,” said O’Cleirigh. He said that since CSA is “very, very common in gay and bisexual men” it appears to be one of the most significant vulnerabilities that accounts for the disproportionately high rate of HIV among gay men.
Prevention educators long have wanted to believe that handing out condoms, or, more recently, the HIV medication Truvada used as pre-exposure prophylaxis to prevent HIV infection, should suffice for men at the highest risk who engage in unprotected anal sex with partners of unknown HIV status. But increasing rates of new HIV infection among gay men—the only U.S. population with increasing, rather than declining, rates—are proof that condoms and PrEP alone aren’t enough.
The only way to arrest the spread of HIV among gay men is to address the trauma that undermines their self-esteem and good judgment.
An effective risk-reduction/health-promotion intervention that addresses the effects of childhood sexual abuse could help make gay male survivors more conscious of what they are doing and where it’s coming from in their psyche. It could also finally reduce the “hardcore” of gay men beyond the reach of more traditional prevention efforts.
At Boston’s Fenway Health, O’Cleirigh helped recruit the nearly 5,000 gay and bisexual men who participated in Project Thrive, an intervention aimed at helping gay men who experienced CSA to increase their coping skills and ability to be more present in—rather than dissociating from (a common effect of CSA)—their immediate situation, and provide specific skills to evaluate and reassess these situations.
“Treatments [counseling and therapy] are geared toward giving the men a more realistic sense of the world,” said O’Cleirigh, which is an important ingredient of resilience. “As we say to our clients, we can’t change the fact that you were abused, but you can change.”
Healed gay men protect themselves and their partners, and take their meds if they are positive.
The message for this National Gay Men’s HIV-AIDS Awareness Day should be that helping gay survivors of childhood sexual abuse to heal from trauma can profoundly reshape the way they think and make choices about sex—and about their health.
This is how new HIV infections among the “hardcore” will stop, and the surest way for those of us living with the virus to stay healthy.
John-Manuel Andriote is a Connecticut-based writer.
Independence Day, commonly known as the Fourth of July, is a federal holiday commemorating the ratification of the Declaration of Independence by the Second Continental Congress on July 4, 1776, establishing the United States of America. The delegates of the Second Continental Congress declared the 13 colonies are no longer subject (and subordinate) to the monarch of Britain, King George III and were now united, free, and independent states. The Congress voted to approve independence by passing the Lee resolution on July 2, and adopted the Declaration of Independence two days later, on July 4.
Today we have a felon in the White House, who wants to be a king, and doesn’t know what the Declaration of Independence means. Each day we see more erosion of what our country has fought to stand for over the years. We began with a country run by white men, where slavery was accepted, and where women weren’t included in our constitution, or allowed to vote. We have come far, and next year will celebrate 250 years. Slowly, but surely, we have moved forward. That is until Nov. 5, 2024, when the nation elected the felon who now sits in the Oval Office.
There are some who say they didn’t know what he would do when they voted for him. They are the ones who were either fooled, believing his lies, or just weren’t smart enough to read the blueprint which laid out what he would do, Project 2025. It is there for everyone to see. There should be no surprise at what he is doing to the country, and the world. Last Friday his Supreme Court, and yes, it is his, the three people he had confirmed in his first term, gave him permission to be the king he wants to be. The kind of king our Declaration of Independence said we were renouncing. A man who with the stroke of a pen can ruin thousands of lives, and change the course of America’s future. A man who has set back our country by decades, in just a few months.
So, I understand why many are suggesting there is nothing to celebrate this Fourth of July. How do we have parties, and fireworks, celebrating the 249th year of our independence when so many are being sidelined and harmed by the felon and his MAGA sycophants in the Congress, and on the Supreme Court. Yes, there are those celebrating all he is doing. Those who want to pretend transgender people don’t exist, and put their lives in danger; those who think it’s alright to take away a women’s right to control her body, and her healthcare; those who think parents should be able to interfere on a daily basis with their children’s schooling and wipe out the existence of gay people for them. Those who pretend there was a mandate in the last election, when it was only won by about 1 percent. Those who think disparaging veterans, firing them, and taking away their healthcare, is ok. Those in the LGBTQ community like Log Cabin Republicans, who think supporting a racist, sexist, homophobe is the right thing to do.
So, what do we, as decent caring people, do this Fourth of July. What do we say to those who are being harmed as we celebrate. What do we say to those trans people, those women, those immigrants who came here to escape their own dictators, and are now finding they have come to a country with its own would-be dictator. I say to them, please don’t give up on America. Don’t give up on the possibility decent loving people in our country will finally wake up and say, “enough.” That the majority of Americans will remember we fought a revolution to escape a king, and we fought a civil war to end slavery. That we moved forward and gave women the right to vote, and gave the LGBTQ community the right to marry. Don’t give up on the people that did all that, and think they won’t rise up again, and tell the felon, racist, homophobe, misogynist, found liable for sexual assault, now in the White House, and his sycophants in congress, and his cult, that we will take back our country in the 2026 midterm elections. That we will vote in large numbers, and demand our freedom from the tyranny that he is foisting on our country.
So yes, I will celebrate this Fourth of July not for what is happening in our country today, but rather for what our country actually stands for. Not for birthday parades, and abandonment of the heroes in Ukraine in support of dictators like Putin. But for the belief the decent people in our country will rise up and vote. That is what I will celebrate and pray for this Fourth of July. That is what I think the fireworks will mean this July Fourth. I refuse to accept defeat the same way our revolutionary soldiers wouldn’t, and the way our troops in the civil war wouldn’t till the confederacy was defeated.
I will celebrate this Fourth of July because I refuse to accept we will not defeat those who would destroy our beautiful country, and what it really stands for.
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
Opinions
Is it time for DC to have new congressional representation?
Del. Eleanor Holmes Norton will turn 89 in June
With WorldPride, Supreme Court decisions, military parades in our streets, mayor and City Council discussions about a new football stadium, it is entirely understandable if we missed the real local political story for our future in the halls of Congress. Starting this past May, the whispered longtime discussions about the city’s representation in Congress broke out. Stories in Mother Jones, Reddit, Politico, Axios, NBC News, the New York Times, and even the Washington Post have raised the question of time for a change after so many years. A little background for those who may not be longtime residents is definitely necessary.
Since the passage of the 1973 District of Columbia Home Rule Act, we District residents have had only two people represent us in Congress, Walter Fauntroy and Eleanor Holmes Norton, who was first elected in 1990 after Mr. Fauntroy decided to run for mayor of our nation’s capital city.
No one can deny Mrs. Norton’s love and devotion for the District. Without the right to vote for legislation except in committee, she has labored hard and often times very loud to protect us from congressional interference and has successfully passed District of Columbia statehood twice in the House of Representatives, only to see the efforts fail in the U.S. Senate where our representation is nonexistent.
However, the question must be asked: Is it time for a new person to accept the challenges of working with fellow Democrats and even with Republicans who look for any opportunity to harm our city? Let us remember that the GOP House stripped away millions of OUR dollars from the D.C. budget, trashed needle exchange programs, attacked reproductive freedoms, interfered with our gun laws at a moment’s notice, and recently have even proposed returning the District to Maryland, which does not want us, or simply abolishing the mayor and City Council and returning to the old days of three commissioners or the very silly proposal to change the name of our Metro system to honor you know you.
Mrs. Norton will be 89 years old next year around the time of the June 2026 primary and advising us she is running for another two-year term. Besides her position there will be other major elected city positions to vote for, namely mayor, several City Council members and Board of Education, the district attorney and the ANC. Voting for a change must not be taken as an insult to her. It should be raised and praised as an immense thank you from our LGBTQ+ community to Mrs. Norton for her many years of service not only as our voice in Congress but must include her chairing the Equal Employment Opportunity Commission, her time at the ACLU, teaching constitutional law at Georgetown University Law School, and her role in the 1963 March on Washington.
Personally, I am hoping she will accept all the accolades which will come her way. Her service can continue by becoming the mentor/tutor to her replacement. It is time!
John Klenert is a longtime D.C. resident and member of the DC Vote and LGBTQ+ Victory Fund Campaign boards of directors.
Opinions
Supreme Court decision on opt outs for LGBTQ books in classrooms will likely accelerate censorship
Mahmoud v. Taylor ruling sets dangerous precedent
With its ruling Friday requiring public schools to allow parents to opt their children out of lessons with content they object to — in this case, picture books featuring LGBTQ+ characters or themes — the Supreme Court has opened up a new frontier for accelerating book-banning and censorship.
The legal case, Mahmoud v. Taylor, was brought by a group of elementary school parents in Montgomery County, Md., who objected to nine books with LGBTQ+ characters and themes. The books included stories about a girl whose uncle marries his partner, a child bullied because of his pink shoes, and a puppy that gets lost at a Pride parade. The parents, citing religious objections, sued the school district, arguing that they must be given the right to opt their children out of classroom lessons including such books. Though the district had originally offered this option, it reversed course when the policy proved unworkable.
In its opinion the court overruled the decisions of the lower courts and sided with the parents, ruling that books depicting a same-sex wedding as a happy occasion or treating a gay or transgender child as any other child were “designed to present … certain contrary values and beliefs as things to be rejected.” The court held that exposing children to lessons including these books was coercive, and undermined the parents’ religious beliefs in violation of the free exercise clause of the First Amendment.
This decision is the latest case in recent years to use religious freedom arguments to justify decisions that infringe on other fundamental rights. The court has used the Free Exercise Clause of the First Amendment to permit companies to deny their employees insurance coverage for birth control, allow state-contracted Catholic adoption agencies to refuse to work with same-sex couples, and permit other businesses to discriminate against customers on the basis of their sexual orientation.
Here, the court used the Free Exercise Clause to erode bedrock principles of the Free Speech Clause at a moment when free expression is in peril. Since 2021, PEN America has documented 16,000 instances of book bans nationwide. In addition, its tracking shows 62 state laws restricting teaching and learning on subjects from race and racism to LGBTQ+ rights and gender — censorship not seen since the Red Scare of the 1950s.
Forcing school districts to provide “opt outs” will likely accelerate book challenges and provide book banners with another tool to chill speech. School districts looking to avoid logistical burdens and controversy will simply remove these books, enacting de facto book bans that deny children the right to read. The court’s ruling, carefully couched in the language of religious freedom, did not even consider countervailing and fundamental free speech rights. And it will make even more vulnerable one of the main targets of those who have campaigned for book bans: LGBTQ+ stories.
When understood in this wider context, it is clear that this case is about more than religious liberty — it is also about ideological orthodoxy. Many of the opt-out requests in Montgomery County were not religious in nature. When the reversal of the opt-out policy was first announced, many parents voiced concerns that any references to sexual orientation and gender identity were age-inappropriate.
The decision could allow parents to suppress all kinds of ideas they might find objectionable. In her dissent, Justice Sotomayor cites examples of objections parents could have to books depicting patriotism, interfaith marriage, immodest dress, or women’s rights generally, including the achievements of women working outside the home. If parents can demand a right to opt their children out of any topic to which they hold religious objections, what is to stop them from challenging books featuring gender equality, single mothers, or even a cheeseburger, which someone could theoretically oppose for not being kosher? This case throws the door open to such possibilities.
But the decision will have an immediate and negative impact on the millions of LGBTQ+ students and teachers, and students being raised in families with same-sex parents. This decision stigmatizes LGBTQ+ stories, children, and families, undermines free expression and the right to read, and impairs the mission of our schools to prepare children to live in a diverse and pluralistic society.
Literature is a powerful tool for building empathy and understanding for everyone, and for ensuring that the rising generation is adequately prepared to thrive in a pluralistic society. When children don’t see themselves in books they are left to feel ostracized. When other children see only people like them they lose out on the opportunity to understand the world we live in and the people around them.
Advocates should not give up but instead take a page from the authors who have written books they wished they could have read when they were young — by uplifting their stories. Despite this devastating decision, we cannot allow their voices to be silenced. Rather, we should commit to upholding the right to read diverse literature.
Elly Brinkley is a staff attorney with PEN America.
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