November 6th

Left Field by Patricia Nell Warren

Will the Election day be a turning point for people living with AIDS?

When AIDS exploded on the world scene in the early 1980s, it blew open a sharp political crevasse across the United States. On one side of the gap crowded the non-sympathizing among conservatives, most visibly President Reagan and his refusal to even say the word “AIDS” in public. On the other side, liberals and a few compassionate conservatives banded together, including countless thousands who became caregivers for the first waves of sick and dying people. During the three decades since, we’ve seen fluctuations of AIDS policy on both sides, along with some bipartisan cooperation.

But the U.S. is fast approaching a re-defining moment on November 6th. The election will change the course of our country’s history—and our AIDS policy as well.

If Barack Obama is re-elected, and he has enough votes in Congress, it’s a safe bet that the U.S. will continue to prioritize the domestic AIDS effort in some way—within the constraints of budget capability, of course. Recently Obama already sent a clear message by finding $75 million to throw at faltering ADAP programs across the country. Result: By July 2012, the waiting list dropped—at least temporarily—from over 9,000 PLWHIVs to just 1,958.

If Mitt Romney wins, however, he has already said that he’ll immediately grant a national waiver from implementation of the Affordable Care Act. As part of that threat, he can’t be counted on to keep AIDS a priority.

This summer, when the International AIDS Conference opened in D.C., Romney did make the pro forma statement that “we must overcome the global challenge of AIDS.” But anything that Romney’s administration does for PEPFAR is likely to be the minimum needed for grandstanding aimed at developing countries. He is not likely to do the right thing for U.S. PLWAs and their families—not only because of avid GOP budget-busting but because of extremist Bible-beating that now drives the Republican Party.

By “extremist,” I mean the far-righters who aim to hammer their personal interpretation of “Christian teaching” into laws that every American must obey. “Extremist” ranges from lobby groups like the American Family Association and Family Research Council to the politicians that these lobbies find most docile. Romney may be a Mormon, but he’ll have to go along with any powerful non-Mormon extremists who support him. And
that interpretation definitely clouds how all of them view HIV/AIDS.

As for Republican vice-presidential candidate Paul Ryan, his track record on AIDS is not inspiring either. In 2003, he did vote in favor of global AIDS funding, but backtracked in 2008 by voting against reauthorization of PEPFAR.

A big influence on future AIDS policy will be the twelve-member Congressional super-committee, whose job it is to cut $1.5 trillion from the budget. Its membership includes Republican Sen. Jon Kyl, who supports what he calls “values and liberties” of the Family Research Council and voted no on reauthorizing Ryan White. ADAP, HOPWA and Ryan White could all look like potential cuts to Kyl. In spite of earlier years’ cutting, federal AIDS funding still totaled $27.1 billion in fiscal year 2011. According to CDC figures, fifty-two percent was for care, ten percent each for research and housing assistance, three percent for prevention, and twenty-four percent for the international epidemic. Cutting that $27.1 billion is an easy way to get closer to a $1.5 trillion goal.

True—till now, a handful of Republican Congressmembers have avoided being “extremist” on AIDS. Example: Sen. Tom Coburn (OK), a Southern Baptist who advocates the death penalty for abortionists. Yet, when it comes to AIDS, Coburn introduced a bill making it illegal for insurance companies to discriminate against individuals being HIV-tested. He was also a leading sponsor of the 2000 Ryan White CARE Act re-authorization. Another example: Florida’s Sen. Marco Rubio, a favorite with the Tea Party. Yet Rubio told activist hecklers at the 2012 International AIDS Conference that he was not in favor of cutting AIDS funding. “It’s in the national interest of the United States to eradicate AIDS,” Rubio said. Others can be named as well—like Alabama’s Sen. Jeff Sessions, who recently worked with Democrats to organize a Congressional roundtable on how to improve the South’s ramshackle HIV-treatment infrastructure. According to Sessions, “Infection rates in the rural South are among the fastest-growing in the country.”

Indeed, according to the Human Rights Watch, half the Americans living with HIV/AIDS are crammed into the South. This is where AIDS infection rates are highest…and it’s also where moralistic policy runs strongest. In those states, needle exchange is not allowed. Prevention is stubbornly limited to “abstinence till marriage” programs, even though those programs have been scientifically proven to be ineffective. In Raleigh, North Carolina, recently, the local “ab only” pols must have had a fit when the AIDS Healthcare Foundation’s “Condom Nation” eighteen-wheeler rolled into town in the course of its national tour, loaded with activists and free condoms, ready to help with a local prevention event.

HMW says: “Medicaid eligibility set by Southern states is the most restrictive in the nation, leaving many people with HIV unable to afford health care. In Alabama, Arkansas, South Carolina, Louisiana, Mississippi, and Georgia, 40–65 percent of people diagnosed with HIV are not in regular treatment, compared with the national average of 30 percent.” Given the extremist sentiment driving so much of Southern politics, it’s no wonder that infrastructure is lacking there. And it gives us a look at what the future holds for the rest of the country if Republican religion carries the day on November 6th.

What is the GOP’s public “excuse” for targeting AIDS? Their platform puts into print a fierce bias towards Americans whose illness is a result of “lifestyle,” such as smoking, obesity, substance abuse. While AIDS is not mentioned in the platform in connection with “lifestyle,” Republican leaders like Rep. Larry Brown of North Carolina have already trumpeted that people who get HIV through sexual behavior or drug use should not be treated at taxpayer expense.

But the extremist righters won’t stop there. Going by comments I’ve seen, they would like to see the U.S. define AIDS as exclusively a “gay disease.” Thus Tennessee state senator Stacey Campfield assures us that “it is virtually…impossible to contract AIDS through heterosexual sex.” Bryan Fischer, talk show host, follows suit with his notion that AIDS in gay men is the result of using poppers and recreational drugs. Positionings like this, if they become policy, will make it possible for government to fight AIDS with criminal prosecution rather than medical practice.

The Family Research Council, now listed by the Southern Poverty Law Center as a “hate group,” has long taken the position that homosexuality should be re-criminalized. But recently Peter Sprigg of FRC announced an additional wrinkle. The United States (he says) can stop the spread of AIDS by “discouraging anal intercourse and sex with multiple partners.” No doubt this would mean a state-by-state return to the old sodomy, fornication and adultery laws, since the best way to “discourage” is to arrest “offenders” and destroy their lives with long prison sentences.

If Romney wins, this draconian new Republican direction would be a radical departure even from the policies of George W. Bush. After all, Bush created PEPFAR, ended the ban on HIV-positive visitors to the U.S., and favored bipartisan support for AIDS policy. I never thought I’d see the day when Dubya looked moderate on any issue. Indeed, Bush’s AIDS policy prompted the Family Research Council to denounce Bush as having “advanced the homosexual agenda.”

Congresswoman Maxine Waters (D-CA) got it right recently when she said: “We need to tell our Republican friends in Congress to stand up to the extremists in their midst and support the HIV/AIDS programs they’ve supported in the past. And we need to tell everyone in Congress not to balance the budget on the backs of people living with HIV/AIDS.”

Otherwise—if the Republicans win on November 6th, PLWAs and their families and advocates may experience that awful clarity of disbelief on seeing the advances of thirty-one years rolled back. But they shouldn’t be surprised. The religious right has already skewed the United States of America into walking backwards on reproductive rights—not just abortion, but birth control as well. And they did it without even having a President in the White House.

Author of fiction bestsellers and provocative commentary, Patricia Nell Warren has her writings archived at Reach her by e-mail at [email protected]

Copyright © 2012 by Patricia Nell Warren. All rights reserved.

October 2012