Historic U.S. Election Could Shape the Future of Gay Men's Health and Rights

U.S. voters exercised their democratic rights in last week’s general election and Joe Biden and Kamala Harris are projected to be the next president and vice president of the United States. Harris will make history as the first woman, Black person, and South Asian American to ascend to the vice presidency. As a global gay men’s organization, MPact is inspired by the victories of Biden, Harris, and many other pro-equality candidates elected to federal and state offices.

2021 is a critical year for gay men to reclaim the HIV response as UNAIDS, the Global Fund, and U.S. PEPFAR update their program and funding strategies. As recently as 2019, 23% of all adult HIV infections globally were among gay men, who accounted for more than 64% of new infections in Western and Central Europe and in North America. While the strategic directions and 90-90-90 goals set by UNAIDS in 2016 and agreed to by all United Nations member states are appropriate to the tools we now have in hand, we are far off-track to meet global HIV targets. This is because of woefully inadequate investments directed at community-led responses to HIV and at structural interventions designed to tear down barriers to HIV-related services.

Without centering communities in the response and adequate funding, the Biden-Harris campaign’s ambitious pledges to end HIV by 2025, to expand engagement with LGBTI communities, and to ensure healthcare access for LGBTI people will remain mere rhetoric.

As the incoming administration prepares to take office, MPact makes the following recommendations to President-elect Biden and Vice President-elect Harris to ensure that the U.S. can demonstrate leadership in advancing gay men’s health and rights worldwide:

Increase funding for gay men’s sexual health needs

A recent study reported that less than 1% of total HIV funding reaches gay men in low and middle-income countries. This is unacceptable given that HIV disproportionately impacts gay men and given that the necessary technologies to combat the disease are now available. As the single largest HIV funder, the U.S. must sharply increase funding for the global HIV response and specifically earmark funding for gay men through PEPFAR, the Global Fund, and other federal and state mechanisms. Funding should help create access to the latest prevention options and also account for the broader sexual and mental health needs of gay men, including those of gay men who use drugs.

Fund structural interventions that address barriers to access

Gay men worldwide have been systematically denied rights, equity, and justice in the HIV response. Structural racism, homophobia, transphobia, and xenophobia have kept many Black, Brown, indigenous, and migrant gay men from accessing lifesaving HIV prevention and treatment services both in the U.S. and outside its borders. The COVID-19 pandemic has exacerbated the vulnerabilities of these groups, leading to even poorer health outcomes, especially among poor gay men and gay men of color. While increasing funding for the global HIV response, the incoming administration must adequately prioritize structural interventions to improve the quality, availability, affordability, and safety of HIV services for gay men.

Fund community-led organizations and networks

For too long, the bulk of global HIV funding for gay men has been controlled by large international implementers who often lack the necessary expertise on gay men’s health to meaningfully prioritize community-led responses. MPact echoes the call of our partner organizations in the Council for Global Equality to evaluate, stabilize, and instruct the Key Populations Investment Fund (KPIF) to seek community-led partners around the world that are capable of mounting effective challenges to criminalization statutes, stigma, and discrimination targeting gay men.

Participate in global decriminalization and pro-LGBTI efforts 

At least 69 countries around the world still criminalize consensual same-sex relationships between adults and up to nine countries may punish such relationships with the death penalty. The incoming administration must meaningfully participate in multilateral efforts, including through the Global Equality Fund (housed in the State Department) and in civil society efforts to overturn criminalization laws, ban so-called “conversion therapy”, ban discrimination on the basis of sexual orientation or gender identity, take action to halt crackdowns on gay men overseas, and support efforts to end violence against all LGBTI people.

Re-engage with bilateral and multilateral partners

We echo the call of our partners to abandon the Trump administration’s short-sighted, unilateral, and ethnocentric outlook that underpin the “America First” and “Make America Great Again” policies. To repair the damage done by these xenophobic policies, the U.S. should re-engage with United Nations agencies, other donor governments, and other multilateral bodies to promote and advance the health and rights of gay men and other vulnerable populations. The U.S. should promptly rejoin and restore full funding for the World Health Organization. It should also actively collaborate with other governments and with civil society actors to promote global health and security for all.

Center Black, Latinx, and indigenous communities, and women

Social justice and racial equity should be put front and center in U.S. foreign and domestic policies to right the past wrongs done to marginalized communities, including women. We join like-minded organizations to call for the immediate repeal of the so-called Global Gag Rule. This rule has deleteriously affected HIV and health services for women and also for gay men and other key populations that seek HIV and sexual health services in family planning clinics.

For too long, and especially in the last four years, many U.S. foreign and domestic policies have undermined the health and human rights of marginalized communities. LGBTI people, women, Black people, Latinx people, indigenous people, Muslims, and immigrants have all been harmed by the Trump administration’s harsh rhetoric and cruel actions.

As we approach 2021, MPact is prepared to hold the incoming administration accountable to their campaign pledges to advance LGBTI health and equity. As a global network headquartered in the U.S., we are poised to engage with the incoming administration and to redouble our efforts to advocate for the rights of gay men and to increase their access to HIV prevention and treatment services.