In most states, it is perfectly legal to discriminate against someone on the basis of their sexual orientation or their gender identity in one or more aspects of their life, including employment, housing, and public accommodations. Explicit non-discrimination protections based on sexual orientation or gender identity do not exist at the federal level either.
Dealing
with the potential consequences of bias and discrimination – job loss,
homelessness, lack of healthcare insurance – often results in LGBTQ
people engaging in behaviors that facilitate the spread of HIV. For
example, in the face of persistent employment discrimination, many
transgender women are left with few other options but to engage in
survival sex work in order to meet their most basic
needs. According to a 2015 survey of more than 27,000 transgender people, “The rate of HIV [diagnosis] was...five times higher among those who have participated in sex work at any point in their lifetime” than among those who have not.
needs. According to a 2015 survey of more than 27,000 transgender people, “The rate of HIV [diagnosis] was...five times higher among those who have participated in sex work at any point in their lifetime” than among those who have not.
Anti-LGBTQ
bias further enables the spread of HIV by discouraging many in our
community from getting tested or treated for HIV for fear of harassment.
A 2014 Kaiser Family Foundation survey
of gay and bisexual men in the U.S. found that 15% of them had received
poor treatment from a medical professional as a result of their sexual
orientation, and least 30% did not feel comfortable discussing their
sexual behaviors with a healthcare provider. For gay and bisexual youth
who are just beginning to explore their sexuality, homophobia and other
forms of anti-LGBTQ bias help explain why so many young people in our
community are unaware of their HIV status.
Such
rampant levels of anti-LGBTQ bias is particularly worrisome when so few
PLWH in the U.S. seem to have the virus under control. Of the 1.2
million people living with HIV in the U.S. in 2011, only 30% of them had consistently taken their medication and were able to lower the amount of HIV in their bodies to undetectable levels.
While undetectable, a person living with HIV remains in good health,
and it is virtually impossible transmit the virus to a partner.
Prevention options (e.g., condoms, Pre-Exposure Prophylaxis) exist for
those in relationships where one partner is not yet undetectable.
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