Decades of lessons from HIV can help us deal with COVID-19

Since the 1980s, gay communities and their allies have proven that solidarity, behavioural changes, and information sharing are vital
Photo: Larry Kramer. By David Shankbone.
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As we start to become complacent during the current pandemic, no one really knows how to handle the next phase where COVID-19 becomes a part of normal life. The last comparable pandemic, caused by a deadly flu that broke out in 1918, devastated our societies more than a century ago. But looking to the more recent history of HIV can help us learn how to better prepare ourselves for further changes to our lives in the coming months and years.

The first cases of HIV in North America were identified in gay men in 1981. The disease later known as AIDS was at first given the wildly inaccurate name of gay-related immune deficiency, and the perception of it as a “gay disease” led to stigma that stifled the public health response.

Gay activists like Larry Kramer — who founded early advocacy groups Gay Men’s Health Crisis and AIDS Coalition to Unleash Power (known better as ACT UP, the latter was notorious for its use of direct action) — had to fight for recognition of both their worth as human beings and the exploding health crisis by governments and health organizations, the development of effective and accessible treatment and prevention, and the dissemination of information about HIV and AIDS. Gay men, and their allies, had to come together to advocate for themselves, take care of each other when they were sick, and help each other learn how to practise safer sex.

Important lessons can be drawn from HIV for dealing with public health emergencies and adjusting to life during a pandemic.

This solidarity among gay men and their allies during the 1980s and 1990s was instrumental in pushing society to respond to HIV and led to the kind of high-quality information, treatment, and prevention available today. Gay men have been navigating life with HIV for decades by helping each other take the necessary steps to reduce its spread, including going for regular testing, using condoms, having conversations about the relative risks of having sex with each other, and more recently using medication daily to prevent infection in a person without HIV (pre-exposure prophylaxis or PrEP) and suppressing infection in a person with HIV through antiretroviral treatment that reduces the virus to undetectable and untransmittable levels.

Despite differences between COVID-19 and HIV, important lessons can be drawn from HIV for dealing with public health emergencies and adjusting to life during a pandemic.

Since HIV mostly affected gay men, an already marginalized group in society, it was not initially taken as seriously as COVID-19, and gay activists had to work hard to be recognized by government officials. Dr. Anthony Fauci, one of the most influential voices on COVID-19, was already a leading public health official in the United States in the 1980s and was singled out by gay activists as being representative of the government’s apathy towards HIV and AIDS. Dr. Fauci eventually became a friend and hero to gay communities by reaching out to them and listening to their needs, even sitting down for discussions with ACT UP members. In this way, he learned to be a public health activist, whether advocating for access to experimental HIV treatment or calling for the use of face masks today.

We can also learn from HIV about the importance of solidarity. In the same way that gay men and their allies came together in their communities to face HIV and AIDS, we all need to come together to face COVID-19.

Both HIV and COVID-19 have disproportionately affected marginalized groups.

Gay men have had to change their sexual behaviour in order to reduce HIV transmission in their communities. Using HIV prevention strategies, like condoms and PrEP, and discussing them with sexual and romantic partners can be inconvenient, awkward, and even uncomfortable, but it’s still necessary in the interest of public health. Gay men have also had to engage in sometimes difficult conversations about these kinds of behavioural changes with members of their communities. By encouraging each other to change their behaviour, gay men and their allies have demonstrated solidarity around HIV prevention for decades, which has helped greatly reduce the spread of the virus.

COVID-19 also requires behavioural changes and preventative measures. Social distancing means that we have to modify how we physically interact with one another, and wearing masks means doing something that is sometimes inconvenient, awkward, and uncomfortable. However, these changes in behaviour are crucial for reducing the spread of the coronavirus. If we want to replicate the successes of HIV prevention in gay communities, then we need to encourage each other to do the right thing during COVID-19. This means using simple preventative measures, even when they become challenging, in order to protect everyone in society — especially since some people are not yet able, or willing, to make these changes consistently and correctly.

Both HIV and COVID-19 have disproportionately affected marginalized groups, including people who are Indigenous, Black, and Latino, people who are in poverty, people who are in prison, and people who do not have the support of family and friends.

Since HIV treatment and prevention are often less accessible to marginalized groups, gay men and their allies have often gone out of their way to care for them, especially during the early years when the families and friends of hospital patients would not visit them due to the stigma of AIDS.

Solidarity during COVID-19 should look a lot like the ongoing solidarity among gay men and their allies in relation to HIV.

Today, families and friends are usually not allowed to visit people with COVID-19 in hospitals because of worries about disease transmission. Since marginalized groups are often the most vulnerable during a pandemic, we have to remember to support them. Government initiatives, like the Canada Emergency Response Benefit, are one way to do that, but we also need to foster greater solidarity in society by acknowledging that COVID-19 disproportionately affects certain groups and then responding to those inequities through policy.

Solidarity during COVID-19 should look a lot like the ongoing solidarity among gay men and their allies in relation to HIV. Whether it’s using condoms and PrEP or social distancing and mask wearing, preventative measures require all of us to follow public health guidelines in order to effectively reduce the spread of these viruses. By staying informed, sharing credible information from public health organizations, and supporting each other in various other ways — including emotionally and financially — we can make sure that our families, friends, and neighbours stay safe.

The future of COVID-19 remains uncertain, but we can more safely and easily adjust to life if we try to emulate the solidarity of gay communities facing the ongoing HIV pandemic.

We need to foster even wider solidarity during this difficult time — by staying apart in order to come together.

Michael Montess is a PhD candidate in philosophy at York University in Toronto.

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