September 22, 2006
The Centers for Disease Control and Prevention (CDC) has formally called for a dramatic expansion in HIV testing, such that medical patients between 13 and 64 will be routinely tested unless they opt out. Separate written consent won’t be required and pre-test prevention counseling (which ensures that the patient understands how HIV is transmitted and prevented) will be dropped.
Knowing one’s HIV status is a good thing, provided the patient can effectively use the information. HIV-infected people need to be able to obtain ongoing treatment (including, but not limited to medications), and need to be able to take steps to protect their sexual partners from infection. Those who test negative need to understand that they can still get infected, e.g., if they engage in unprotected sex or share needles.
An important question to ask about the new CDC guidelines is whether they’ll meet these needs. By eliminating written consent and pre-test counseling, it’s all too easy to imagine that patients in busy emergency rooms will be tested without really agreeing to it and without being adequately prepared for the results.
Here are some other important facts about the social realities of HIV.
- HIV and AIDS are still stigmatized in the United States. In a 1999 national survey, I found that one-fourth of the US public believed that people with AIDS have gotten what they deserve. 30% would feel uncomfortable having their children attend school with another child who has AIDS, and 22% would feel uncomfortable around an office coworker with AIDS. The proportion saying they felt afraid of people with AIDS was one in five.
- That same 1999 survey revealed that misinformation about HIV transmission actually increased during the 1990s. 41% erroneously believed they could get AIDS from using public toilets. 50% believed they could get AIDS from being coughed on by a person with AIDS. About half believed they could get AIDS by sharing a drinking glass, and one third believed that AIDS can be contracted by donating blood. This sort of misinformation leads all too easily to avoidance and ostracism of people with HIV.
- More recently, a 2006 Kaiser Family Foundation national survey found that only 63% of Americans knew that HIV can’t be spread through kissing, and only 77% knew it can’t be spread by sharing a drinking glass.
- The 2006 KFF survey also found that 1 in 5 Americans would be personally uncomfortable having a coworker with HIV/AIDS, and 30% of parents would be uncomfortable if their child had a teacher with HIV. 45% of Americans believe there is “a lot” of prejudice and discrimination against people living with HIV/AIDS, and another 36% believe there is “some.” Only 11% believe that people with HIV/AIDS face “only a little” prejudice or none at all.
- The KFF poll found that AIDS is still perceived as a gay disease, with Americans more likely to associate it with gay/bisexual men than any other group. My own research has shown that this perception translates into the use of AIDS stigma as a vehicle for expressing prejudice against sexual minorities.
- Although the CDC wants to make HIV testing completely routine, the consequences of a positive HIV test are quite different from those of other routine tests. As Robert Allen, director of HIV policy for Kaiser’s Permanente Group, observed in a San Francisco Chronicle interview, “No one is ever fired from their job for having high cholesterol. Nobody got divorced from a cholesterol test.”
- Money to pay for expanded testing and its consequences doesn’t appear to be forthcoming. The same week the CDC issued its new guidelines, the US House of Representatives moved to shift millions of dollars in Ryan White funds away from California, New York, and New Jersey to other states. All of the states need money for AIDS treatment and the logical solution is to increase overall AIDS funding. However, given the huge federal budget deficit, the cost of the war in Iraq, and the President’s zeal for tax cuts, it is difficult to imagine that Congress will allocate more AIDS funding in the coming fiscal year.
Is the CDC’s plan a good one? In principle, it probably is. But it appears to give insufficient attention to the importance of informed consent, pre-test counseling, and the reality that AIDS remains a stigmatized disease.
September 19, 2006
The continuing problems of hate crimes, discrimination, and hostility targeting sexual minorities make one thing evident: We need effective strategies for eradicating sexual prejudice. Exactly what form such strategies should take, however, is far from clear.
In this and future entries, I’ll highlight some promising ideas for reducing prejudice, based on data and theory from the social and behavioral sciences.
To begin, let’s ask what has been shown to work. There’s a fairly simple answer to this question. Research consistently shows that heterosexuals tend to be significantly less prejudiced against sexual minorities to the extent that they have a personal relationship with a gay man or lesbian.
It’s not enough simply to know someone who is gay, however. Rather, heterosexuals’ contact experiences are more likely to reduce their sexual prejudice when:
- the gay person is a close friend or an immediate family member, rather than a distant relative, acquaintance, or stranger;
- they know several gay or lesbian people, rather than only one;
- they have talked openly with their friend or relative about what it’s like to be gay.
While data haven’t yet been collected to determine whether the same patterns hold for heterosexuals’ interpersonal contact with bisexual men and women, it seems reasonable to assume that they do.
There are many explanations for why personal relationships are so effective in reducing sexual prejudice. Certainly a key reason is that such relationships provide an instigation for the heterosexual person to change. Getting rid of one’s prejudices isn’t a quick or easy process. It involves learning new ways of thinking and acting, and can be challenging and uncomfortable. Most people don’t make personal changes like this unless they are strongly motivated to do so.
By coming out, gay men and lesbians give their heterosexual relatives and friends such motivation. When preserving a valued relationship means overcoming one’s sexual prejudice, many heterosexuals rise to the challenge. The gay friend or relative typically helps in this regard by providing information about sexual minorities and advice about how to act appropriately in novel situations. Perhaps most importantly, all of this happens within an ongoing relationship in which each party feels a strong emotional bond and sense of commitment to the other.
Of course, interpersonal contact doesn’t always reduce prejudice. Personal relationships may be less influential when a heterosexual’s prejudice has a strong foundation in religious or political ideology.
Nevertheless, the research data (not to mention the personal experiences of many sexual minority individuals) are clear and consistent in this regard. They strongly reinforce the value of coming out as a strategy for reducing hostility toward sexual minorities. Any campaign to eradicate sexual prejudice should build on this fact.
September 18, 2006
In a new paper published in this month’s issue of American Psychologist, I review behavioral and social science research to assess the validity of key factual claims in the debate about whether and how civil society should recognize committed relationships between same-sex partners. In brief, the data indicate that:
- same-sex and heterosexual relationships do not differ in their essential psychosocial dimensions;
- a parent’s sexual orientation is unrelated to her or his ability to provide a healthy and nurturing family environment; and
- marriage bestows substantial psychological, social, and health benefits.
I conclude that same-sex couples and their children are likely to benefit in numerous ways from legal recognition of their families, and that providing such recognition through marriage will bestow greater benefit than civil unions or domestic partnerships.
The article, Legal Recognition Of Same-Sex Relationships In The United States: A Social Science Perspective, is based on my work on the American Psychological Association’s amicus briefs in marriage cases in New Jersey, Washington, and other states. A copy can be requested on my website.
September 16, 2006
Yesterday marked an historic milestone in Spain. Two male soldiers were married in a civil ceremony presided over by the mayor of Seville. According to the Associated Press, “the Defense Ministry has said it considers the wedding a personal matter and the men will be allowed to continue with their careers.”
The Spanish military’s response makes sense. As documented in several reports by the Center for the Study of Sexual Minorities in the Military at UC Santa Barbara, openly gay and lesbian personnel have been successfully integrated into the militaries of England, Canada, Australia, and other countries without major problems. Similar conclusions were reached in a 1993 study by the RAND Corporation.
The wedding in Spain is a reminder that a national government can successfully grant equal marriage rights and allow sexual minorities to serve in its armed forces if it chooses to do so. The 4500 same-sex couples who have wed in Spain during the past year don’t pose a threat to the marriages of heterosexual Spaniards, And although some of the newly wedded soldiers’ comrades in arms might not like the fact that they’re married (or gay), their personal disapproval won’t make the Spanish military less able to accomplish its mission.
September 15, 2006
Yesterday the New York Times reported on renewed efforts to repeal the US military’s ban on openly gay and lesbian personnel (“Don’t Ask, Don’t Tell,” or DADT).
Despite strong public support for allowing sexual minorities to serve, and even though most of our allies no longer restrict service in their militaries on the basis of sexual orientation, the Department of Defense (DoD) continues to argue that DADT is necessary. As in the past, its current justification for the policy is that the presence of openly gay and lesbian personnel would interfere with the military’s ability to accomplish its mission.
The essence of the DoD’s rationale is that the problem isn’t really about homosexual personnel. Rather, it’s heterosexual servicemembers and military leadership. Heterosexuals have so much antipathy for gay people, so the Pentagon believes, that they’d be unable and unwilling to serve alongside them. Moreover, the DoD claims it is powerless to prevent this hostility from interfering with the military mission. Read the rest of this entry »
September 14, 2006
Welcome to Beyond Homophobia, a blog by Gregory Herek. I’ll be commenting here on recent news events and public policy related to sexual orientation, with a focus on how research from the social and behavioral sciences can inform current debates and discussions in this arena.
Why “Beyond Homophobia”? Homophobia was coined in the 1960s by psychologist George Weinberg. The term proved to be tremendously influential in reframing society’s thinking about sexual orientation. It helped many people to articulate their newfound understanding that homosexuality wasn’t the problem; rather, the real problem was prejudice against those who aren’t heterosexual.
Despite its importance, homophobia has serious limitations as a term and a concept. Primary among these are the assumptions it conveys. Homophobia implies that hostility toward sexual minorities is a disease rather than a form of prejudice, and that its ultimate source is irrational fear (a “phobia”). Although fear can play a role in prejudice, many other emotions are involved as well. And prejudice is not purely a matter of emotion. It can reflect deeply felt values and belief systems, as well as power struggles and conflicts among groups in the larger culture.
Today, four decades after the creation of homophobia, we need a new way of thinking about the prejudice and stigma that are still directed at sexual minorities. In my own writings, I have begun to utilize the terms sexual prejudice and sexual stigma to describe these phenomena. I’m not crusading to have these terms replace homophobia in popular discourse, but I believe they can be useful in pushing us to think about the problem of hostility against sexual minorities in new ways.
I plan to use this weblog to share my thoughts about sexual prejudice and its relationship to cultural events and public policy. I will also report interesting findings from behavioral and social science research — my own and that of others — in a way that I hope nonresearchers will find informative and useful. I hope my comments here can contribute to the work of advocates and activists who are trying to eradicate sexual prejudice.
Please stay tuned!
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