HIV-testing and Quakerism

What happens when an entrenched system faces competition?

We found some of this out last week. For years, I have been working with a diverse group of people to promote that all people know their HIV-status as the starting point for stopping the spread of HIV (see www.mosaicinitiative.org for more about this work). We have worked with HIV/AIDS organizations in Illinois, DC and western Kenya. I have seen people who want to volunteer their time to helping stop the spread of HIV, and be told that they can deliver meals once a week. I’ve met with senators, elected officials, and other government folks to see what we can do to make testing more accessible – including making tests more portable, and removing the pre-test history questions from the process. All to no avail, despite conflicting messages and policies between federal and state authorities. There has been a protective nature to tests and testing that borders on territorial. I have seen people turned away because there are not enough tests, while also hearing that testing is being under-utilized in other areas. I’ve seen “Catch-22’s” where there are no laws against distributing HIV-tests, but no access to acquiring tests. And I’ve seen panel discussions where organizations blame everyone else and call for National Strategies, but resist change. No wonder HIV continues to spread – the institutions need it to stay viable.

A chink in all of this took place last week. A few weeks ago, I heard about a home test kit that can be purchased on-line (http://www.anytestkits.com/hiv-aids-test-kit.htm). It’s not FDA-approved, but I ordered some anyway. We started to promote that we were going to be distributing these tests. Out of the blue, last week 8 FDA administrators got on a conference call to tell me to cease and desist. I responded that, unless there could be some kind of movement (speeding up FDA approval of home-test kits or removal of pre-test questions to name two possibilities) that I did not see why I should. Plus, after years of trying to reach people to see how we can make a difference, it took possession of these tests to catch attention. Now, a week later, there has been a meeting with one of these FDA people, plus the head of the White House office on AIDS and an MD within CDC who has done research to support greater access to and portability of tests. In talking with these folks, one thing is clear: the current system is not working. The other thing that is clear is that “AIDS, Inc.” is as entrenched in maintaining the status quo as anything else that is out there. Perhaps what has been most interesting is the extent to which people have been forthcoming with information, although there is tacit agreement that much of this information is “off the record”.

Interestingly, as we promoted and collected signatures for home-based HIV-testing (or, perhaps more appropriately, since we are really looking to promote a creative dialog, we should call it “portable testing”), it has been mostly the white gay community that has been the least receptive to this idea. I think there are two possible theories: the gay community still very much carries the scars and trauma of AIDS, and/or AIDS was the first legitimate social institution to have openly gay people leading. It has also been gay people that have said we have to do testing within the law. I maintain: when did any good laws come about without the bad laws being broken?

So, what to take from this:
• Viable options creates more opportunities for change than simply staying within the status quo.
• There has not been a real new idea regarding HIV-prevention. “Portable testing” might be just the ticket to spur new, creative dialog. Look at the doors possession of such tests opened.
• When you can catch people’s attention, you can take a 30 second conversation and turn it into a 5 minute conversation. For example, when someone says he/she is against home-testing, consider where these might be useful (i.e. for women who take home-pregnancy tests, or for repeat testers, or for couples where one partner is positive). I like to envision doing college classes, with visualizations of testing, and then giving options for testing.
• For HIV-testing organizations that say they want to empower people, I say you don’t empower by limiting options.
• On the sly, I was also told by a reliable source that the US-approved HIV-tests are inferior to what are used in other parts of the world.
• I have also now seen research that shows:
o 93.6% of people who do home-sample collections can do it accurately. 95% of clinics do it accurately. So the issue of poor sampling at home is minimal.
o The majority of people who do home-sample collections (the Home Access mail-in tests) are people who would not go to an MD or clinic for an HIV-test).
o People who have access to testing of any type are 47 times less likely to contract HIV.

Where do we go from here? I’m going to be following up with exerting pressure to speed up and open up approvals for options. I’ll also see how we can help facilitate community dialogs and pilot programs. One of the messages is that we don’t need a multi-million dollar marketing campaign to raise awareness; we need a 2 year campaign to get everyone to know his/her status, and we need to change the starting pronoun from “them” to “us”, including all of us.

Gays in the Military

In this morning's Washington Post, some military folks wrote an editorial about gays in the military - and how they should not be allowed (see http://www.washingtonpost.com/wp-dyn/content/article/2009/04/14/AR2009041402704.html). What is most interesting for me is not so much what these writers adhere to (and the amazing loopholes in their thinking - it's not as if you can tell who's gay by his/her skin color, and it is not uncommon for people to come to grips with their sexual orientation at about the same time they would be in the military); what is most interesting are the comments made by readers. They are a clear example of the desperate need for the art of dialog. I have written before that love and logic will be the means through which our world will come together; both of these are necessary. Unfortunately, we too often start with logic; I think we need to start more with love, and then engage in dialog. Maybe we could also ask ourselves to consider supporting the ban on gays as a starting point to get all people out of the military?

I also think learning, practicing and engaging in dialog that is led by love is something that those of us who are truly passionate about non-violence and doing what we can to remove the occasions for future violence should start to embrace. Anywhere we turn in the world, it seems that there is an edge of violence in the air, and we can expect more as people become more fearful, and more vulnerable. I know that for many, glbt issues are not at the forefront of people's minds but, as with HIV-prevention, I think that how we can engage in these issues can be good opportunities for practicing how to deal with some of the more difficult issues. The issues are becoming more prominent in the media (two examples: http://www.advocate.com/news_detail_ektid78359.asp, and http://www.washingtonpost.com/wp-dyn/content/article/2009/04/14/AR2009041403455.html), so we may as well get involved.

Progress on gay rights

Over the past few months, there has been an enormous amount of movement on the rights of same gender-couples to get married. We all know about California and the voter decision to support Prop 8. There was also, in November, legislation in Florida and Arizona that put various restrictions on same gender families. But then, this week alone, Iowa courts and Vermont legislature made same-gender marriage a reality in those states. The District of Columbia is taking similar action. On a national level, there has been increased discussion about letting civil unions be the rule of the land for all people, and marriages be the acts of churches - a compromise that for many seems to have merit.

At the same time, in Iraq, (see NYTimes article: http://www.nytimes.com/2009/04/08/world/middleeast/08gay.html?_r=1&emc=eta1) there is a backlash in some of the more conservative regions against gay men. As quoted from the article: "Clerics in Sadr City have urged followers to help root out homosexuality in Iraqi society, and the police have begun their own crackdown on gay men. 'Homosexuality is against the law,' said Lt. Muthana Shaad, at a police station in the Karada district, a neighborhood that has become popular with gay men. 'And it’s disgusting.' For the past four months, he said, officers have been engaged in a 'campaign to clean up the streets and get the beggars and homosexuals off them.'”

All progress has elements of violent reactivity. No doubt that there is a rapid change in the expansion of gay rights, but we can expect an increase in reactivity as well, unfortunately. It always seems to be a part of the struggle.

I think it is important that we as Friends and Friend-communities look to see what we can do to support the movement. Paradoxically, I do not think that what we should do is create a litmus test for gay marriage. I just don't think society as a whole is there yet. But I think we can create allies for gay marriage among those whom are not yet there, but who are repulsed by people such as Fred Phelps (see www.godhatesfags.com), and by the attitudes of Lt. Shaad as quoted in the Times. Patience and perseverance will get us there, with a dash of faith. We know that opponents to gay marriage are gearing up, and their tactic is going to be to divide, and let gay marriage be the dividing issue. If we react along these lines, rather than continue to reach across these lines to those who are not at the far extreme but just on other side of the line, we will do more harm than good. To react divisively plays right into the "us vs. them" game. I, for one, will continue to look to expand who the "us" is rather than focus on "them".

Are all homophobes equals?

So, I'm riding my bike to work the other day along the river in Georgetown and there's a bumper sticker on the back of a car that says "Marriage=1 man+1woman". My first thought was "homophobe". Thankfully, acivities like biking allow for deeper processing than the first reaction. So, as I made my way towards the Lincoln Memorial, I started to think about progess. Lincoln himself, by today's standards, would certainly be considered a racist, but in his day, he was very much a progressive. This had me thinking about the owner of this car, and a desire to not give him/her a piece of my mind, but to instead maybe ask a few questions.

Here are two perhaps most clarifying questions:
1. Is the origin of the bumper sticker related to same-gender marriage, polygamy, or both?
2 (and really, the more important, as far as dialog goes and assuming that the bumper sticker is really a statement about the sanctity of marriage, prop 8, etc) would be questions that seek to identify where this person stand on glbt rights in general. People as diverse as Barack Obama, Jim Wallis, Rick Warren, Pat Robertson and Fred Phelps (of www.godhatesfags.com fame) all stand against "Marriage=1 man+1man" (or woman+woman), but the clearly have very differnt takes in the bigger scheme of things.

What I am really starting to appreciate that we all draw lines in the sand on issues, but perhaps our most important allies are not those on our side of the line, but those just on the other side. I suspect that the leaders of movements recognize this, and often moderate messages to try and garner a 51% split. This is why there is so much yelling about gay marriage, and so little talk about couple's rights.

So, back to my bumper sticker friend; were I to first engage him/her, it would probably have been with an edge. But, given time to reflect, and to be still within, I am pretty confident that, given time, we could have a wonderful confersation. I'd hedge my bets that the person might be very much for most rights for the glbt community, if we had the chance to talk and get to know each other. Of course, in our drive-by bumper sticker culture, a beep of the horn and flip of the finger may also be part of the norm. I'm just not sure that this kind of venting helps advance the cause of peace.

"Gay bishop will kick off inauguration event"

"Gay bishop will kick of inauguration event" was the title of the e-mail that came in to my inbox from Human Rights Campaign.

Is that all that Bishop Robinson is?

There's not a whole lot to ponder about or to profoundly say about this. It is a sad commentary, I think, on the myopic vision of an organization as big as HRC that is supposedly out there representing all of us. It does speak to how I think the institutionalization of a cause ends up demeaning and dehumanizing the very people it is meant to serve (I've seen this in AIDS work as well).

More on Warren and Obama

Here's some more thoughts on Warren and Obama. As the national dialog continues, I really do see a lot of good coming from this: (this is originally posted on the William Penn House blog)

I often find myself, as the "gay guy who has worked with evangelicals", being asked my opinion about Rick Warren being such a visible part of the upcoming inauguration. Here are some of my responses:

1. I fully understand the disappointment and anger, especially on the heels of the passage of Proposition 8.

2. I'm not sure it's fair to say that Obama has "turned" on anything as much as partisans on the left (including glbt advocates) were blinded by their own zeal. Obama has been to Saddleback a few times (including HIV testing w/Sen Brownback a few years ago). Obama never said he supports same-sex marriage - in fact he has said the opposite. He certainly never claimed to make gay rights a priority.

3. I'm not sure that Obama is simply trying to woo people who did not support him. Obama won California fairly easily, but Prop 8 also passed. Clearly, many Obama supporters voted for Prop 8. I'm guessing if Obama were more assertive about gay rights, he would have had a narrower victory.

4. On a more "Quaker" level, anger is divisive. Is it our role, as Quakers, to necessarily have to choose sides on this issue, or can we find a more loving response? Rather than lament and fight, what if we were to instead say "this decision has been made. What is ours to do now?"

5. I think the gay community would do well to understand that there have been so many advancements over the past decade that society needs a rest. We are on a positive course without a doubt, and within ten years all will be well. In the meantime, let's step up responsibility rhetoric, rather than rights. An example? Let's step up HIV-prevention. There's too much complacency and even complicitness in the gay bars, pornography, and internet. We cannot simply sit back and blame the government for the continuing spread of HIV in the gay community.

6. Finally, I think the Warren announcement gives pause: let's look at the entirety of this person and of the movement. Much is being exposed. Warren has done a lot for poverty and AIDS. He (and moreso his wife, Kay) have talked of being open and loving to people with AIDS. How does this settle with judgment of those at-risk for HIV: do they need to get HIV for us to care? Warren has also been clear that his belief does come with questioning. In addition, I know many evangelical Christians who are also upset by this announcement, and also many non-evangelicals who have really liked Warren's work and now are re-thinking that because they did not know his stance on glbt marriage. Anything that exposes where we truly are in society, I think is a good thing.

Basically, I think this, along with the passage of Prop 8, are quickly going to be "2steps back, 4 steps forward". We are already seeing this as a new level of dialog has emerged about gay rights, the fullness of people like Rick Warren, how he differs from the Pat Robertson/James Dobson crowd, and the hypocricy of being a "leader" in the fight against AIDS while being against gay rights. An example is Frank Rich's column (12/28/08) where he says: "Equally lame is the argument mounted by an Obama spokeswoman, Linda Douglass, who talks of how Warren has fought for 'people who have H.I.V./AIDS.' Shouldn’t that be the default position of any religious leader? Fighting AIDS is not a get-out-of-homophobia-free card. That Bush finally joined Bono in doing the right thing about AIDS in Africa does not mitigate the gay-baiting of his 2004 campaign, let alone his silence and utter inaction when the epidemic was killing Texans by the thousands, many of them gay men, during his term as governor." Bringing the long needed discussion of the separation of AIDS work from the people who get HIV/AIDS and how they get it to the forefront can only be a good thing.

I think, ultimately, a lot of good can come from this. What will only delay the progress from here is letting anger get the best of us.

Rick Warren, Obama and gays

One of the big stories today is that Rick Warren is going to be doing the invocation at the Presidential inauguration next month. Many gay rights groups and supporters are up in arms, and have every right to be. Warren's church is in California, the state that just passed Prop 8. You can be pretty certain that most of Rick's congregation supported the measure, and if he just said the word, thousands would have voted the other way. So I fully understand why people are upset and disappointed with Obama for choosing Warren, and think the timing is a bit like throwing salt on the wounds.

But, I also see many good things that might come of this. See, I think what Obama may be most effective at doing early in his term as president is to further expose the world for what it is, and then bring healing to it with his compassion. Let's take this example:

First, thanks to the announcement today, Rick Warren has all of a sudden had to become much more accountable for his stand on gay rights. I'm sure that many people who have admired Rick's work - from his AIDS and poverty work to his book "A Purpose-Driven Life" did not know his stance on gay rights. In fact, I know many people who are staunch gay rights supporters and love Rick's work. Exposing this is not a bad thing. As Ricky Ricardo used to say to Lucy, "you got some 'splainin to do". Specifically, now Warren and perhaps many of his ilk will have more pressure to consider the dilemma: how do you maintain a stance that we need greater compassion for and inclusiveness of people with HIV/AIDS, while at the same time, condemn the very people who are most likely to get HIV in the US. Do gay people have to get HIV in order for them to become welcome? Does AIDS make someone more worthy of compassion? If that's so, how are we to stop the spread of HIV?

Second, what this announcement may also expose is the limits of Rick's reach within the emergent evangelical movement. Most of the people I know from that movement (granted, not a tone, but certainly some that are well-connected) are disappointed with this selection and would have preferred Jim Wallis. This will certainly bring greater scrutiny to just how progressive Warren is.

But, what is the right response from Quakers? Should we align with Human Rights Campaign, denounce the decision, and be angry and disappointed? Perhaps, as humans, these are understandable. But I think that the Quakerly presence calls us to look inside - especially those of us who are gay and lesbian - to acknowledge our hurt, to own it, and to speak to it. But then, let's reach out to accept this gesture of reaching out. Clearly, there are many issues that Obama and Warren do not agree on. Obama, back in 2006, took a lot of heat for going to Saddleback church to speak about HIV and to get tested there with Sen. Brownback of Kansas. The thing is, Obama has not changed his stance on issues - from stem cell/reproductive rights, to gay rights. It's important to keep in mind that he has never said he is for gay marriage - in fact he has said the opposite, although if the courts decide otherwise (as they did in California) he would be ok with that. The ability to join together despite differences is important these days.

As for gay rights and gay marriage, the day is coming. I actually think this announcement today is another step in that direction. I'm sure there will be many on the far right who will be denouncing Warren for being a part of the inauguration as well. As RF Kennedy said, one out of five people will always be against whatever you do. Let's try to be a part of the other 80%, but at the same time, be clear about who we are at all times and hold our heads high. I have found that if we hold that within ourselves, we can find ourselves seated at the table with people like Warren, sitting as equals.